Emergencies

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

Last WHO Situation Report published 23 June 2020

Ebola outbreak in western Democratic Republic of the Congo reaches 100 cases
21 August 2020
Brazzaville – The number of cases in the ongoing Ebola outbreak in western Democratic Republic of the Congo (DRC) has reached 100, a near two-fold increase in a little over five weeks.
This latest outbreak, DRC’s 11th, was declared on 1 June 2020 in Equateur Province. A cluster of cases was initially detected in Mbandaka, the provincial capital. The outbreak has since spread to 11 of the province’s 17 health zones. Of the 100 cases reported so far, 96 are confirmed and four are probable. Forty-three people have lost their lives.
The outbreak presents significant logistical challenges, with affected communities spanning large distances in remote and densely-forested areas of the province, which straddles the Equator. At its widest points, the outbreak is spread across approximately 300 km both from east to west and from north to south. It can take days to reach affected populations, with responders and supplies often having to traverse areas without roads, necessitating long periods of river boat travel.
An Ebola outbreak occurred in the same province in May 2018 and was contained in less than three months with 54 cases and 33 deaths recorded.
“With 100 Ebola cases in less than 100 days, the outbreak in Equateur Province is evolving in a concerning way,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “The virus is spreading across a wide and rugged terrain which requires costly interventions and with COVID-19 draining resources and attention, it is hard to scale-up operations.”…

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

WHO Grade 3 Emergencies [to 29 Aug 2020]

Democratic Republic of the Congo
:: Ebola outbreak in western Democratic Republic of the Congo reaches 100 cases 21 August 2020

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

::::::

WHO Grade 2 Emergencies [to 29 Aug 2020]
Iraq
:: WHO delivers ambulances and health technologies to Ministry of Health in the Kurdistan region to support emergency referrals and COVID-19 containment efforts Erbil, 25 August 2020

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Libya – No new digest announcements identified
Malawi – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
HIV in Pakistan – 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

::::::

WHO Grade 1 Emergencies [to 29 Aug 2020]

Chad – No new digest announcements identified
Djibouti – Page not responding at inquiry
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syria ǀ Situation Report #2, Alouk Water Station, 28 August 2020
:: Syria ǀ Situation Report #1, Alouk Water Station, 25 August 2020

Yemen
:: 23 August 2020 Yemen Situation Report, 23 Aug 2020 [EN/AR]
Highlights
:: Funding shortage closes life-saving programmes as humanitarian needs rise
:: COVID-19 strategy refreshed as COVID-19 continues to spread across Yemen
:: Fuel crisis is another shock to the humanitarian situation in northern governorates
:: Hopes of a UN assessment mission to avert a catastrophic oil spill from the Safer tanker falter
:: Air strikes causing civilian casualties double in the second quarter of 2020

::::::

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.
COVID-19
:: Coronavirus disease 2019 (COVID-19) Situation Report 41: occupied Palestinian territory, issued 27 August 2020, information for period: 5 March – 27 August 2020

East Africa Locust Infestation
:: Desert Locust situation update – 24 August 2020

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

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 22 August 2020 :: Number 330

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 22 Aug 2020

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

Aligning Legislative, Spending Decisions with Climate Action Key to Recovering from COVID-19 Pandemic, Secretary-General Tells Speakers of Parliament
19 August 2020
SG/SM/20213
Following are UN Secretary-General António Guterres’ remarks at the opening of the Inter-Parliamentary Union (IPU) World Conference of Speakers of Parliament on the theme: “Parliamentary leadership for more effective multilateralism that delivers peace and sustainable development for the people and planet”, in New York:
[Editor’s text bolding]

…First, of course, is the COVID-19 pandemic. We face an unprecedented disaster, from economic wreckage to an education deficit imperiling an entire generation, from the aggravation of humanitarian crises to the deepening of already troubling infringements of human rights. We have surpassed 21 million cases and 770,000 deaths — and the toll continues to grow and even accelerate in some places.

The United Nations family is working across many fronts to save lives, control transmission of the virus, ease the fallout and recover better. We have shipped personal protective equipment and other medical supplies to more than 130 countries. We continue to press for a global ceasefire and to fight the plague of misinformation.

Across the weeks, we have issued analysis and policy recommendations spanning the full range of affected countries, sectors, issues and populations. From the beginning, the United Nations has been calling for massive global support for the most vulnerable people and countries — a rescue package amounting to at least 10 per cent of the global economy. We are also supporting work to accelerate research and development for a people’s vaccine, affordable and accessible to all.

As we address the emergency today, we must learn its many lessons for tomorrow. Even before the virus, our societies were on shaky footing, with rising inequalities, worsening degradation of the environment, shrinking civic space, inadequate public health and untenable social frictions rooted in governance failures and a lack of opportunities.

The pandemic has spotlighted these injustices in especially stark terms. It has also exposed the world’s fragilities in general. And so, we cannot go back to what was, but rather must turn the recovery into a real opportunity to do things right for the future…

Nowhere will that be more important than in responding to the climate crisis. As bad as COVID-19 is, climate disruption has the potential to cause even greater damage and upheaval. Despite some progress in raising awareness and forging coalitions, we continue to face two overarching realities: first, climate-related destruction continues to intensify. Second, climate ambition is still falling short of what science tells is necessary and what the Paris Agreement is meant to achieve.

Political leaders are rightly focused on responding to the pandemic. But, while COVID-19 has forced the postponement of the COP26 [twenty-sixth Session of the Conference of the Parties to the United Nations Framework Convention on Climate Change] until 2021, a climate emergency is already upon us. We must achieve net-zero emissions before 2050, and 45 per cent cuts by 2030.

As we strive to overcome one crisis, we have an opening to address another — and steer our world onto a more sustainable path. We have the policies, the technology and know-how. In that spirit, I am asking all countries to consider six climate positive actions as they rescue, rebuild and reset their economies.

First, we need to make our societies more resilient and ensure a just transition.

Second, we need green jobs and sustainable growth.

Third, bailouts of industry, aviation and shipping should be conditional on aligning with the goals of the Paris Agreement.

Fourth, we need to stop wasting money on fossil fuel subsidies and the funding of coal. Coal should have no place in any rational recovery plan.

Fifth, we need to consider climate risk in all decision-making. This is more important than ever in the coming months as companies, investors and countries make far-reaching financial decisions about the future. Sixth, we need to work together. Quite simply, how the world recovers from COVID-19 is a “make or break moment” for the health of our planet.

The recovery must also get at the other sources of instability and drivers of discontent — including severe and systemic inequalities both within and between countries and communities. From racism and gender discrimination to income disparities, these deeply entrenched violations of human rights threaten our well being and our future.

Moreover, inequality damages not just its immediate targets, but everyone, including its very perpetrators. It is a brake on human development. It is associated with economic instability, corruption, financial crises, increased crime and poor physical and mental health. And today, new dimensions of inequality are taking shape. For example, the digital divide threatens to exacerbate long-standing inequalities.

That is why I have been calling for a new social contract at the national level. This should feature a new generation of social protection policies and safety nets, including universal health coverage and the possibility of a universal basic income. Education and digital technology can be two great enablers and equalizers, by providing new skills and lifelong opportunities.

And at the international level, we need a new global deal to ensure that power, wealth and opportunities are shared more broadly and equitably. We need a fair globalization and a stronger voice for developing countries.

Parliamentarians have a central role to play in helping the world respond to the pandemic wake-up call. We need you to align your legislation and spending decisions with climate action and the Sustainable Development Goals.

As I said earlier this year in my Call to Action for Human Rights, we need you to protect civic space, which is under assault in many places. We need legislatures to push back against efforts to use the pandemic to repress people and restrict human rights. Human rights — including freedom of expression and assembly — are essential at any time, but especially important to ensure the free flow of information on the pandemic.

We look to parliaments to advance gender equality — in general and within your own ranks. Most parliaments remain overwhelmingly male. This must change — including through the use of special temporary measures. And we need you to show that multilateralism delivers real, added value. COVID 19 has highlighted both the life-saving importance of multilateralism and its many deficits in its current form.

How fast we emerge from this crisis will depend not only on the solidarity we show within our communities and our countries, but also on the degree to which Governments, scientists, businesses and of course parliaments can cooperate together across borders and continents.

This is the meaning of multilateralism. It is not an ideology; it is simply a methodology, the best one we have, to deal with truly global challenges. Today’s challenges demand a networked multilateralism, in which the United Nations and its agencies, the World Bank and the International Monetary Fund, regional organizations, trade organizations and others work together more closely.

We also need an inclusive multilateralism. Governments and executive branches today are far from the only players. Civil society, the business community, local authorities, cities and regional governments are assuming more and more leadership roles in today’s world. This, in turn, can help lead to an effective multilateralism with power and mechanisms to make global governance work where it is needed.
I am hopeful. In the space of just months, billions of people have had to change how they work, consume, move around and interact.

Trillions of dollars have been mobilized to save lives and livelihoods. Ideas that were deemed impossible or impractical are suddenly on the table or in the pipeline. This shows what can be done in the face of an emergency and with a spirit of common cause. I attach the highest importance to our partnership.

This year, as we mark the seventy-fifth anniversary of the United Nations, we have been working closely with the Inter-Parliamentary Union and national parliaments to talk about our future — and I am very grateful for your efforts to bring the debate into your parliamentary halls and your constituencies.

I look forward to continuing this global conversation with you in the crucial period ahead, and to realizing our aspirations for the future we want and the United Nations we need.

Featured Journal Content

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 22 Aug 2020]

Systematic human rights violations, traumatic events, daily stressors and mental health of Rohingya refugees in Bangladesh
Almost 900,000 Rohingya refugees currently reside in refugee camps in Southeastern Bangladesh. Prior to fleeing Myanmar, Rohingya experienced years of systematic human rights violations, in addition to other historical and more recent traumatic events such as the burning of their villages and murder of family members, friends and neighbors. Currently, many Rohingya struggle to meet basic needs in refugee camps in Bangladesh and face mental health-related concerns that appear linked to such challenges. The purpose of this study is to describe systematic human rights violations, traumatic events, daily stressors, and mental health symptoms and to examine relationships between these factors.
Authors: Andrew Riley, Yasmin Akther, Mohammed Noor, Rahmat Ali and Courtney Welton-Mitchell
Content type: Research
20 August 2020

Assessing the capacity for conflict and health research in Lebanon: a qualitative study
Conflicts pose new challenges for health systems, requiring rapid and practical approaches to meet emerging needs on the ground. Lebanon has been highly influenced by surrounding conflicts in the Middle East and North Africa (MENA) region, especially the Syrian crisis. Strengthening research capacity to collect evidence on conflict in the MENA region and beyond is crucial to inform healthcare policy and practice. For targeted capacity strengthening interventions, the main objective of this paper is to present key findings of a needs assessment of conflict and health research in Lebanon. This will support recent efforts to scale up context-specific policies, interventions to strengthen the country’s health system, and research capacity.
Authors: Nassim El Achi, Gladys Honein-Abouhaidar, Anthony Rizk, Elsa Kobeissi, Andreas Papamichail, Kristen Meagher, Abdulkarim Ekzayez, Ghassan S. Abu-Sittah and Preeti Patel
Content type: Research
18 August 2020

Beirut

Lebanon Humanitarian Fund Gives $8.5 Million to Support Communities Affected by Beirut Blast – OCHA
20 August 2020

Children affected by Beirut explosions in need of psychological support as 50 per cent show signs of trauma- UNICEF
08/21/2020

UN High Commissioner for Refugees affirms immediate support to 100,000 individuals affected by devastating Beirut blast and additional funding for COVID-19 response
21 Aug 2020

IOM Appeals to International Community to Fund Relief Efforts for Migrant Workers in Lebanon
2020-08-14 12:59
Geneva – The International Organization for Migration (IOM) is launching an appeal today (14/08) to raise urgent funds for its response to the emergency in Lebanon – triggered by the explosion last week at the Port of Beirut and further exacerbated by the ongoing economic and…

COVID-19 – Children/Protection

COVID-19 causes disruptions to child protection services in more than 100 countries, UNICEF survey finds
[Editor’s text bolding]
NEW YORK, 18 August 2020 – Violence prevention and response services have been severely disrupted during the COVID-19 pandemic, leaving children at increased risk of violence, exploitation and abuse, according to a global survey by UNICEF.

Of 136 countries that responded to UNICEF’s Socio-economic Impact Survey of COVID-19 Response, 104 countries reported a disruption in services related to violence against children. Around two thirds of countries reported that at least one service had been severely affected, including South Africa, Malaysia, Nigeria and Pakistan. South Asia, and Eastern Europe and Central Asia have the highest proportion of countries reporting disruptions in the availability of services.

“We are just beginning to fully understand the damage done to children because of their increased exposure to violence during pandemic lockdowns,” said UNICEF Executive Director Henrietta Fore. “Ongoing school closures and movement restrictions have left some children stuck at home with increasingly stressed abusers. The subsequent impact on protection services and social workers means children have nowhere to turn for help.”

As countries adopted prevention and control measures to contain COVID-19, many vital violence prevention and response services were suspended or interrupted as a result. More than half of the countries reported disruptions in case management, referral services and home visits by child welfare and social workers to children and women at risk of abuse. Violence prevention programmes, children’s access to child welfare authorities, and national helpline services have also been affected in many countries, according to the responses.

Even before the pandemic, children’s exposure to violence was widespread, with about half of the world’s children experiencing corporal punishment at home; roughly 3 in 4 children aged 2 to 4 years regularly subjected to forms of violent discipline; and 1 in 3 adolescent girls aged 15 to 19 having been victimised by their intimate partner at some point in their lives…

In response, UNICEF is supporting governments and partner organisations to maintain and adapt critical prevention and response services for children affected by violence during COVID-19. For example, in Bangladesh, UNICEF has provided personal hygiene items including masks, hand sanitizers and eye protectors for social service workers to safely support children living on the streets, in slums, and in climate-affected and hard-to-reach areas, as well as recruiting and training additional social workers for the national Child Helpline 1098.

“Child protection systems were already struggling to prevent and respond to violence against children, and now a global pandemic has both made the problem worse and tied the hands of those meant to protect those at risk,” added Fore. “Too many children rely on child protection systems to keep them safe. In times of crisis, governments must have immediate and long-term measures that protect children from violence, including designating and investing in social service workers as essential, strengthening child helplines and making positive parenting resources available.”

Milestones :: Perspectives :: Research

WHO Emergencies Press Conference on coronavirus disease outbreak – 18 August 2020
Streamed live on Aug 18, 2020 https://www.youtube.com/watch?v=OWTnMdwUkDw
[Excerpts]
…00:09:24 [DG – Tedros Adhanom Ghebreyesus]
Sharing finite supplies strategically and globally is actually in each country’s national interest. No-one is safe until everyone is safe. No one country has access to research and development, manufacturing and all the supply chain for all essential medicines and materials and if we can work together we can ensure that all essential workers are protected and proven treatments like dexamethasone are available to those who need them.

With PPE and tests a collaboration between the public andprivate sectors meant supply was increased in order to support fair and equitable use of scarce products.

As new diagnostics, medicines and vaccines come through the pipeline it’s critical that countries don’t repeat the same mistakes. We need to prevent vaccine nationalism and for this reason WHO is working with governments and the private sector to both accelerate the science through the ACT accelerator and ensure that new innovations are available to everyone everywhere, starting with those at highest risk.

00:10:57
Since May WHO has been in extensive consultations to develop a new framework to guide fair and equitable access to diagnostics, therapeutics and vaccines for COVID-19 across all countries. These cross-cutting principles are key to the promotion of equitable access and fair allocation of these essential health products for the greatest impact globally.

For example once a successful vaccine has been identified WHO’s strategic advisory group will provide recommendations for their [sic] appropriate and fair use. The allocation of vaccines is proposed to be rolled out in two phases. In phase one dose will be allocated proportionally to all participating countries simultaneously to reduce overall risk. In phase two consideration will be given to countries in relation to threat and vulnerability. Front-line workers in health and social care settings are prioritised as they are essential to treat and protect the population and come in close contact with high mortality-risk groups.

Initial data has shown that adults over 65 years old and those with certain comorbidities are at the highest risk of dying from COVID-19. For most countries a phase-one allocation that builds
up to 20% of the population would cover most of the at-risk groups.

00:12:50
If we don’t protect these highest-risk people from the virus everywhere and at the same time we can’t stabilise health systems and rebuild the global economy… This is what the first crucial phase of the vaccine allocation mechanism aims to do.

We are all so interconnected. As a small example vaccine developed in one country may need to be filled in vials with stoppers that are produced in another using materials for the high-grade glass that are only available from yet another country.

We will need to quickly manufacture billions of doses to reach all those who need the vaccine, which means hundreds of millions of glass vials and ways to transport them effectively. All this means elite planning at the highest level is needed right now to prepare to vaccinate and treat the world as new technologies come down the pipeline.

00:14:09
As we accelerate the science solidarity is needed to provide a joint solution to the pandemic. The COVAX global vaccines facility is the critical mechanism for joint procurement and pooling risk across multiple vaccines, which is why today I sent a letter to every member state encouraging them to join the COVAX facility.

Like an orchestra we need all instruments to be played in harmony to create music that everyone enjoys. One or two instruments playing by themselves just wouldn’t suffice when the
world is waiting and listening intently.

We will work to bring the band together, to promote science, solutions and solidarity because we believe to our core that we do it best when we do it together. I thank you…

EMERGENCIES

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)

Editor’s Note:
The most recent COVID-19 Situation Report posted is dated 16 August 2020. These daily reports seem to have been replaced with Weekly Epidemiological Updates, the first issue of which is dated 17 August 2020 as just below.

Weekly Epidemiological Update – 1
Coronavirus disease 2019 (COVID-19)
17 August 2020

Confirmed cases :: 22 812 491 [week ago: 21 026 758]
Confirmed deaths :: 795 132 [week ago: 755 786]

Key weekly updates
:: “There are two essential elements to addressing the pandemic effectively: leaders must step up to take action and citizens need to embrace new measures…My message is crystal clear: suppress, suppress, suppress the virus.”
WHO Director-General Dr Tedros, at his regular media briefing on Monday, 10 August

:: The Access to COVID-19 Tools (ACT) Accelerator, is a global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. Nine vaccine candidates are currently in the portfolio of the vaccines pillar (called COVAX) and going through phase two or phase three trials. This portfolio, already the broadest in the world, is constantly expanding. The ACT-Accelerator is the only up-and-running global initiative that brings together all the global research and development, manufacturing, regulatory, purchasing and procurement needed for all the tools required to end the pandemic.

:: Access to basic handwashing facilities is a key condition for schools to be able to operate safely in the midst of the COVID-19 pandemic. Yet the latest data from the WHO/UNICEF Joint Monitoring Programme (JMP) found that 43% of schools worldwide lacked access to basic handwashing with soap and water in 2019. UNICEF and partners have published a Framework for Reopening schools and guidance on hand hygiene, which compliments Key Messages and Actions for COVID-19 Prevention and Control in Schools and Considerations for school-related public health measures in the context of COVID-19.

:: WHO has published updated guidance on home care for patients with suspected or confirmed COVID-19 and the management of their contacts. The document provides guidance on the issues to be considered when deciding whether or not to provide care for COVID-19 patients at home and offers advice for health workers and caregivers providing that care.

:: WHO has published the Emergency Global Supply Chain System (COVID-19) catalogue, which lists all medical devices, including personal protective equipment, medical equipment, medical consumables, single use devices, laboratory and test-related devices that may be requested through the COVID-19 Supply Portal.

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

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 19 August 2020
:: A cVDPV1 outbreak has been detected in Yemen. WHO and UNICEF are supporting local health authorities to plan and launch an effective outbreak response to limit virus spread.
:: Next week the African Regional Certification Committee is anticipated to announce that the African Region has met the required standard to be certified as wild polio free. To mark the occasion, a live stream to the virtual ceremony will be publicly accessible via WHO channels and a dedicated website.
:: The 18th report of the Independent Monitoring Board has been published on the GPEI website. The report presents an analysis of the current status of eradication efforts and makes recommendations to help accelerate progress toward interruption of wild poliovirus and the absence of all circulating vaccine-derived polioviruses (cVDPVs). The GPEI welcomes the IMB’s recommendations, scrutiny and shared commitment to polio eradication, and will continue to work closely with the IMB, polio-affected countries and partners to optimize the polio. [See excerpts below]
:: Dr Ana Elena Chevez has dedicated over twenty years of her life to protecting children from vaccine preventable diseases. In the latest story in our ‘Women Leaders’ series, she shares advice for the next generation of women leaders.

Summary of new WPV and cVDPV viruses this week (AFP cases and environmental samples):
:: Afghanistan: three WPV1 cases, one WPV1 positive environmental sample and five cVDPV2 positive environmental samples
:: Pakistan: two WPV1 cases, two WPV1 positive environmental samples and two cVDPV2 positive environmental samples
:: Cote d’Ivoire: four cVDPV2 cases
:: Nigeria: one cVDPV2 case
:: Somalia: two cVDPV2 cases and four cVDPV2 positive environmental samples
:: Sudan: two cVDPV2 cases
:: Yemen: 15 cVDPV1 cases

::::::

18th report of the Independent Monitoring Board
THE NEW NORMAL. FINDING THE PATH BACK TO ERADICATION IN THE TIME OF CORONAVIRUS
July 2020 :: 60 pages
INTRODUCTION. [excerpts]
…It is essential that the Polio Programme remembers that, by the end of 2019, it stood on very shaky ground. There were massive challenges both in interrupting wild poliovirus transmission in the endemic areas and in managing many vaccine-derived poliovirus outbreaks.

Cases of poliovirus had increased fivefold between 2018 and 2019. There was uncertainty and doubt surrounding the effectiveness of strategies and tools.

At the Polio Oversight Board meeting, that immediately followed the Abu Dhabi Pledging Conference, on 20 November 2019, donor countries made an unprecedented demand that the GPEI should review and reform its governance and accountability structures. This did not reflect a reduced determination by these donors to get the job done, but rather the depth of their concern that there was no clear end in sight for polio eradication, and a lack of clear accountability in a $1 billion a year spending programme.

Even before COVID-19, many donor countries’ overseas aid budgets were being heavily scrutinised. With the coronavirus’s savage impact on national economies, the case that polio dollars are safe in GPEI hands will, in future, need to be more convincingly made to the governments and taxpayers of these countries. At the same time, there is greater need for resources than originally planned.

Each year of failure to eradicate polio results in enormous health, opportunity, and economic costs. The budgetary needs of the programme are increasing steeply. They will increase further if vaccine-derived poliovirus outbreaks continue to occur on a wide scale. Also, conducting polio campaigns in a COVID-19 environment will be much slower, will need many more precautions (such as personal protective equipment), and, as a result, will be more expensive.

…Overall, since late February and early March 2020, more than 60 polio vaccination campaigns, of different geographical scales, have been paused in 38 countries. Six million doses of vaccine had been delivered to those countries. They could not be used. Another 100 million doses have been procured, but still await shipment because of air freight disruption. Some of these vaccines have been delivered, in the weeks running up to vaccination campaigns that were resumed in July 2020. However, other batches of vaccines will be nearing the end of their shelf life and the Polio Programme will have to bear the costs of the waste and resupply. Also, some of the suppliers are reaching storage capacity and may well be forced to stop production, and there may be longer-term implications for manufacturers…

The Polio Programme is now poised for resumption when vaccine rounds can be planned and start again. The GPEI has set up a new committee to oversee this process, to be called the GPEI Continuity Planning and Facilitation Group (PFG). Its objectives include:
:: To facilitate development and tracking of a comprehensive global level GPEI workplan, in support of regional and country polio eradication activities, to adjust to the COVID-19 pandemic;
:: To identify any long-term strategic adjustments to the Polio Endgame Strategy 2019–2023 that may be required in the post-emergency phase of the COVID-19 pandemic in order to ensure sustainable, effective programme operations…

CONCLUSIONS. [excerpts]
It remains deeply inspiring to have a global vision of a world free of polio. It is a noble cause. It is important to many dedicated individuals currently working in the Polio Programme, and to others who have given a major part of their professional careers to the endeavour. It is a solemn reminder of front-line workers who lost their lives, and those who still do, to blind hatred for their personification of a humanitarian ideal. Ultimately, it will be a public good for all people of the world.

That vision currently seems a distant pinpoint of light. The Polio Programme is in dire straits. With a worsening epidemiological position, during 2019, for both wild and vaccine-derived poliovirus cases, the world was hit by a devastating pandemic of coronavirus. A yawning funding gap is opening up.

The Polio Programme stands in the middle of 2020 confronted by twin challenges that stand in the way of eradication. The first is the challenge of facing up to the real reasons that it went off track in 2019 into a jaw-dropping slump of performance at a time that the “almost there” narrative was believed by too many people. The phrase now being used to encourage everyone is: “The last mile is always the most difficult”. The Polio Programme is too forgiving of itself.

The second is the challenge of making the right choice of paths, emerging from the coronavirus crisis. An oft-repeated phrase at the IMB meeting was that the COVID-19 pandemic has a “silver lining” for the polio eradication programme. What that meant to those at the meeting who referred to it, or what it should mean for everyone involved in the future delivery is less clear.

What is overwhelmingly clear, though, for the Polio Programme at country level, at regional level, and at global level is that to “keep calm and carry on” through this complex situation would be inexcusable.

The criticality of developments over the next several months for polio eradication cannot be overstated. The opportunity of COVID-19 to finally determine innovative and integrated delivery strategies provides a lifeline for polio eradication. The risk of a Polio Programme going back into the field tired and half-hearted about needing new ideas could be the death knell of the programme. The GPEI Strategy Committee, in particular, needs to understand the gravity of the times and treat them as such..

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

Emergencies

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

Last WHO Situation Report published 23 June 2020

::::::

WHO Director-General’s opening remarks at the media briefing on COVID-19
21 August 2020
…I would like to begin today’s briefing with an update on the Ebola outbreak in the Equateur province of the Democratic Republic of the Congo.
The outbreak continues to increase and to spread geographically. Yesterday, the 100th case was reported, with 43 deaths in 11 health zones across the province.
There is currently a delay of about 5 days from the onset of symptoms to when an alert about a suspected case is raised.
This is concerning, because the longer a patient goes without treatment, the lower their chances of survival, and the longer the virus can spread unseen in communities.
The situation has been further complicated by a strike by health workers, which is affecting activities including vaccination and safe burials.
DRC has the best-trained workforce in the world for Ebola. This situation needs to be resolved as quickly as possible.
WHO and our partners are working intensively in communities to find cases and shorten the delay.
We’re also supporting the government of DRC to take a stronger role in the response, and to prepare areas that have not been affected so far.
There continues to be an urgent need for increased human resources and logistics capacity to support an effective response across an ever-expanding geographical area, and to help health officials identify cases earlier.
The government of DRC has developed a plan that needs about US$40 million. We urge partners to support this plan…

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

WHO Grade 3 Emergencies [to 22 Aug 2020]

Democratic Republic of the Congo – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 22 Aug 2020]
Iraq
:: WHO concludes COVID-19 awareness-raising campaign in the south 19 August 2020

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Libya – No new digest announcements identified
Malawi – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
HIV in Pakistan – 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

::::::

WHO Grade 1 Emergencies [to 22 Aug 2020]

Chad – No new digest announcements identified
Djibouti – Page not responding at inquiry
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Recent Developments in Northwest Syria – Situation Report No. 19 – As of 21 August 2020
:: Syrian Arab Republic: COVID-19 Response Update No. 09 – 21 August 2020

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.
COVID-19 – No new digest announcements identified
East Africa Locust Infestation – No new digest announcements identified

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

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 15 August 2020 :: Number 329

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 15 Aug 2020

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

Financial Times
14 August 2020
Opinion
Keeping the torch of global democracy alight
Authoritarians are not necessarily gaining the upper hand
The editorial board

In Belarus this week, protests over rigged elections have been met by mass arrests and a hail of rubber bullets from the thuggish security services of “Europe’s last dictator”. In Hong Kong, China has stepped up its crackdown on democracy and press freedom. Surveying the urban tumult in many parts of the world it is easy to form an impression that the democratic cause is under siege. Yet it is not necessarily authoritarians who should be taking heart.

The clampdowns appear to confirm an intensifying assault on democracy and pluralism. Freedom House, the US-based watchdog, found 2019 was the 14th straight year of decline in global freedom. Some 64 countries experienced a deterioration in political rights and civil liberties. Only 37 witnessed improvements.

Yet positive conclusions can be drawn, too. In Hong Kong and Minsk, protesters have taken to the streets specifically to defend or demand democratic freedoms. Hong Kong’s unrest last year grew out of opposition to an extradition bill that threatened to corrode rule of law. Imposing a draconian national security law was Beijing’s response. Belarus has seen political consciousness flower after 26 years of one-man rule. The autocrats may force the democratic impulse underground, but it will not die.

Not just outright autocrats are facing resistance. Bulgaria has seen weeks of rallies against government corruption. In Beirut, protests amid the wreckage of this month’s port explosion have toppled a second government in under a year. Many of those protesting are part of a new movement. The people power they represent is something politicians everywhere must take account of.

Indeed, though dampened by the pandemic, 2020 has marked at least a partial continuation of 2019, when demonstrations were the most numerous since the Arab Spring in 2011, or even since 1989. They had few parallels in terms of geographical spread.

Nor has coronavirus delivered a boost for authoritarian systems. China has sought to contrast its success in containing the outbreak in Wuhan with the Trump administration’s inept response in the US. But China’s initial cover-up, which allowed the virus to spread more widely than it should, highlighted the shortcomings of its system.

The political scientist Francis Fukuyama argues a competent state apparatus, trust in government and effective leadership count for more in tackling the pandemic than the type of political system. But some democracies have performed notably well, and especially some female leaders such as Germany’s Angela Merkel and New Zealand’s Jacinda Ardern. Strongmen who tried to deny the virus — Brazil’s Jair Bolsonaro, Mr Trump, and Belarus’s Alexander Lukashenko — have come off badly.

Not all protests in the past 18 months were democracy-related; some of the biggest were calls to act on climate change. Taken together, however, they suggest an innate impulse among peoples across geographical boundaries to rise up against inept, corrupt or repressive leadership. Black Lives Matter rallies in the US and elsewhere demonstrate the urge even in richer countries to oppose injustice.

Western countries face a dilemma over how far to intervene in support of democratic movements — especially when, as in Hong Kong or Belarus, that might bring them into conflict with China or Russia. Aside from rhetorical support, acting as exemplars is vitally important. This year’s US election will be a test. If, as some Americans fear, Mr Trump adopts tactics verging on the authoritarian, the damage to the global democratic cause will be hard to repair.

Beirut

UN human rights experts call for justice and accountability in response to Beirut explosion
GENEVA (13 August 2020) – The colossal deadly explosion in Beirut on 4 August requires a prompt and independent investigation that underscores international human rights obligations, clarifies responsibilities related to the explosion, and leads to justice and accountability, UN human rights experts* said today. They issued the following statement:

“The scale and impact of the lethal explosion are unprecedented. We are deeply concerned about the level of irresponsibility and impunity surrounding human and environmental devastation on this scale. The catastrophic blast occurred while Lebanon is already confronted by a devastating political, economic and financial crisis, as well as the COVID-19 pandemic, leading to a sharp deterioration of human rights protection and much suffering…

This explosion and its aftermath have brought into focus systemic problems, a deficit of good governance, and allegations of widespread corruption. This has resulted in a failure to ensure protection of the rights of all without discrimination, including the rights to life, personal liberty, health, housing, food, water, education, and to a healthy environment. We are concerned that this tragedy will expose cracks in the executive, legislative, and justice institutions, leading to delays and challenges in ensuring effective remedies for all those affected.

We support calls for a prompt, impartial, credible and independent investigation based on human rights principles, to examine all claims, concerns and needs in relation to the explosion as well as the underlying human rights failures. The investigation should be protected from any undue influence and be given a strong and broad mandate to effectively probe any systemic failures of the Lebanese authorities and institutions to protect human rights. Any such investigation should integrate a gender-lens and must also grant victims and their relatives effective access to the investigative process, respecting their right to be informed and to participate. The investigation, as well as other actions linked to the disaster, must also protect the privacy as well as the confidentiality of the identities and testimony of victims, witnesses, associates, colleagues and their families. The findings and recommendations of the investigation should be made public.

The investigation should also consider Lebanon’s international obligations governing the handling of dangerous substances and the right of everyone to information on risks to life and health. In addition to human rights and criminal law, the investigation should also examine Lebanon’s obligations under international commercial and shipping law.

We stand ready to cooperate with the Lebanese authorities, civil society, and the international community including by supporting the investigation(s) and other measures in order to minimize the harm of this disaster, ensure accountability, build back better in full respect of the multi-religious and multi-cultural fabric of the society and prevent similar tragedies in the future. The international community should also provide timely and effective support to all the people in Lebanon, including their demands for justice, based on international solidarity and cooperation.

In view of the seriousness of our concerns, we urge consideration of a special debate at the UN Human Rights Council this September so as to explore all possible avenues by which (i) Justice for the multiple victims of the explosion, and for the people in Lebanon at large, is rendered effectively, transparently and impartially; (ii) Non-repetition is secured through long-term systemic reforms based on open consultations with the people in Lebanon; and (iii) Urgent assistance is provided by the international community to Lebanon and its people to address the immediate needs of shelter, food, medical, health and other related needs emerging from the disaster.

We also stand in solidarity with the people of Lebanon, and especially extend our concern and condolences to the victims.
ENDS

The Experts:
Mr. Marcos A. Orellana, Special Rapporteur on the implications for human rights of the environmentally sound management and disposal of hazardous substances and wastes;
Ms. Agnès Callamard, Special Rapporteur on extrajudicial, summary or arbitrary executions;
Mr. Michael Fakhri, Special Rapporteur on the right to food;
Ms. Fionnuala D. Ní Aoláin, Special Rapporteur on the promotion and protection of human rights and fundamental freedoms while countering terrorism;
Michael Lynk, Special Rapporteur on the situation of human rights in the Palestinian Territory occupied since 1967;
Mr. Clément Nyaletsossi Voule,Special Rapporteur on the rights of peaceful assembly and association;
Mr. Léo Heller, Special Rapporteur on the human rights to water and sanitation;
Mr. Diego García-Sayán, Special Rapporteur on the Independence of Judges and Lawyers;
Ms. Claudia Mahler, Independent Expert on the enjoyment of all human rights by older persons;Working Group on the issue of human rights and transnational corporations and other business enterprises,
Surya Deva, Elżbieta Karska, Githu Muigai, Dante Pesce (Vice-Chair), Anita Ramasastry (Chair); Ms. Yuefen Li, Independent Expert on the effects of foreign debt and other related international financial obligations of States on the full enjoyment of all human rights, particularly economic, social and cultural rights;
Ms. E. Tendayi Achiume, Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance;
Mr. Obiora C. Okafor, Independent Expert on human rights and international solidarity;
Mr. Ahmed Shaheed, Special Rapporteur on freedom of religion or belief;
Mr. Nils Melzer, Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment;
Ms. Elizabeth Broderick (Chair), Ms. Melissa Upreti (Vice Chair), Ms. Alda Facio, Ms. Meskerem Geset Techane, Ms. Ivana Radačić, Working Group on discrimination against women and girls;
Mr. David R. Boyd, Special Rapporteur on human rights and the environment;
Mr. Olivier De Schutter, Special Rapporteur on extreme poverty and human rights;
Mr. Balakrishnan Rajagopal, Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context;
Ms. Isha Dyfan, Independent Expert on the situation of human rights in Somalia;
Mr. Joe Cannataci,Special Rapporteur on the right to privacy;
Ms. Siobhán Mullally, Special Rapporteur on trafficking in persons, especially women and children;
Ms. Tlaleng Mofokeng, Special Rapporteur on the right to physical and mental health;
Ms. Cecilia Jimenez-Damary, Special Rapporteur on the human rights of internally displaced persons; Members of the Working Group on Arbitrary Detention: Ms. Leigh Toomey (Chair-Rapporteur), Ms. Elina Steinerte (Vice-Chair), Mr. José Guevara Bermúdez, Mr. Seong-Phil Hong, Mr. Sètondji Adjovi;
Ms. Irene Khan, Special Rapporteur on the promotion and protection of the right to freedom of opinion and expression.

Indigenous Peoples

USAID Launches its First Policy on Promoting the Rights of Indigenous Peoples
August 10, 2020
Statement by USAID Acting Administrator Barsa
The launch of the Policy on Promoting the Rights of Indigenous Peoples (PRO-IP) is a historic step for the U.S. Agency for International Development (USAID). This groundbreaking policy represents the first time the Agency has laid out specific guidance for how we globally engage, work with, and empower Indigenous Peoples in a systematic way. Efforts are already under way to build institutional capacities in the Amazon Basin and in Nicaragua, support the Batwa from the Congo Basin to reduce the threat of deforestation and commercial bushmeat trade, improve livelihoods and food security across 237 Indigenous Peoples communities in Paraguay, and promote rights awareness at the government level in Uganda.

PRO-IP recognizes the value of Indigenous Peoples’ own decision-making processes, expertise as environmental and cultural stewards, and aspirations as rightful leaders for their development priorities. Further, it recognizes that they should be critical partners with USAID in the conservation of cultural and natural resources. PRO-IP builds on USAID’s experience in supporting Indigenous Peoples’ rights, consistent with our strategic approach to empower individuals and communities through helping governments, civil society including faith-based organizations, and the private sector on the Journey to Self-Reliance.

USAID is also pleased to announce the creation of the first global public-private partnership for Indigenous Peoples. Under USAID’s Global Development Alliance (GDA), the Indigenous Peoples Alliance for Rights and Development Program will provide technical support to our Missions globally to implement PRO-IP effectively.

Featured Journal Content

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

Collective property rights reduce deforestation in the Brazilian Amazon
Kathryn Baragwanath and Ella Bayi
PNAS first published August 11, 2020. https://doi.org/10.1073/pnas.1917874117
Significance
Deforestation in the Amazon has reached record highs in 2019 and poses a serious threat to climate change. In Brazil, about 2 million hectares of indigenous land are still awaiting homologation, and thus do not have their full property rights. We find that granting property rights significantly reduces the levels of deforestation inside indigenous territories, and the results are of significant orders of magnitude. Our local effects indicate that areas of land right inside a territory with full property rights experience significantly less deforestation than those right outside of the border. Collective property rights might thus provide an effective way to reduce deforestation in the Brazilian Amazon.
Abstract
In this paper, we draw on common-pool resource theory to argue that indigenous territories, when granted full property rights, will be effective at curbing deforestation. Using satellite data, we test the effect of property rights on deforestation between 1982 and 2016. In order to identify causal effects, we combine a regression discontinuity design with the orthogonal timing of homologation. We find that observations inside territories with full property rights show a significant decrease in deforestation, while the effect does not exist in territories without full property rights. While these are local average treatment effects, our results suggest that not only do indigenous territories serve a human-rights role, but they are a cost-effective way for governments to preserve their forested areas. First, obtaining full property rights is crucial to recognize indigenous peoples’ original right to land and protect their territories from illegal deforestation. Second, when implemented, indigenous property rights reduce deforestation inside indigenous territories in the Amazon rainforest, and could provide an important positive externality for Brazil and the rest of the world in terms of climate change mitigation.

Gates Open Research
https://gatesopenresearch.org/browse/articles
[Accessed 15 Aug 2020]
Software Tool Article metrics AWAITING PEER REVIEW
Utilizing passive sensing data to provide personalized psychological care in low-resource settings [version 1; peer review: awaiting peer review]
Prabin Byanjankar, Anubhuti Poudyal, Brandon A Kohrt, Sujen Man Maharjan, Ashley Hagaman, Alastair van Heerden
Peer Reviewers Invited
Funder: Bill and Melinda Gates Foundation
PUBLISHED 05 Aug 2020
Abstract
Background: With the growing ubiquity of smartphones and wearable devices, there is an increased potential of collecting passive sensing data in mobile health. Passive data such as physical activity, Global Positioning System (GPS), interpersonal proximity, and audio recordings can provide valuable insight into the lives of individuals. In mental health, these insights can illuminate behavioral patterns, creating exciting opportunities for mental health service providers and their clients to support pattern recognition and problem identification outside of formal sessions. In the Sensing Technologies for Maternal Depression Treatment in Low Resource Settings (StandStrong) project, our aim was to build an mHealth application to facilitate the delivery of psychological treatments by lay counselors caring for adolescent mothers with depression in Nepal.
Methods: This paper describes the development of the StandStrong platform comprising the StandStrong Counselor application, and a cloud-based processing system, which can incorporate any tool that generates passive sensing data. We developed the StandStrong Counselor application that visualized passively collected GPS, proximity, and activity data. In the app, GPS data displays as heat maps, proximity data as charts showing the mother and child together or apart, and mothers’ activities as activity charts. Lay counselors can use the StandStrong application during counseling sessions to discuss mothers’ behavioral patterns and clinical progress over the course of a five-week counseling intervention. Awards based on collected data also can be automatically generated and sent to mothers. Additionally, messages can be sent from counselors to mother’s personal phones through the StandStrong platform.
Discussion: The StandStrong platform has the potential to improve the quality and effectiveness of psychological services delivered by non-specialists in diverse global settings.

Featured Journal Content

The Lancet
Aug 15, 2020 Volume 396 Number 10249 p447-512
https://www.thelancet.com/journals/lancet/issue/current
Editorial
Humanitarian crises in a global pandemic
The Lancet
On Aug 19, the world will mark a UN World Humanitarian Day very different from any other. But while COVID-19 captures the world’s focus, other humanitarian crises also need attention, as evidenced most recently by the tragic aftermath of the explosion in Beirut.

Even before COVID-19, 2020 was going to be a year marked by humanitarian need. Mark Lowcock, head of the UN Office for the Coordination of Humanitarian Affairs (UNOCHA), predicted that in 2020 “168 million people worldwide will need humanitarian assistance and protection. That represents about one person in 45 on the planet. It is the highest figure in decades.” Conflict in Yemen, Syria, DR Congo, the Sahel, and elsewhere is driving food shortages and displacement of people—the UN estimated that 80% of Yemenis require urgent humanitarian aid. Deepening economic crises, such as in Venezuela, are causing hunger and mass migration, and climate change is increasing the risk of natural disasters, famine, and drought. There were 79·5 million forcibly displaced people by the end of 2019, and access to health care is often poor in these settings; 80% of all refugees live in low-income and middle-income countries with weak health systems.

COVID-19 is exacerbating the inequalities faced by individuals and families in humanitarian crises. With national governments looking inwards and putting their own citizens first, people in need of humanitarian assistance are being neglected.

As the COVID-19 pandemic has spread, governments worldwide have introduced travel restrictions, inadver tently stopping aid workers from travelling, and thereby hampering humanitarian responses. In some cases, aid workers already in-country cannot deliver vital services because of government restrictions aimed at protecting their own citizens. In Greece, asylum seekers and migrants are still under strict lockdown regulations as the rest of the country returns to normality, limiting their access to basic services. Globally, the risk of starvation in some camps because of a lack of access to aid constitutes a bigger threat than the virus itself, according to Amnesty International.

An interruption of aid means even less access to soap and water, which is important for controlling the spread of COVID-19. Other non-pharmaceutical interventions—physical distancing and avoiding crowds and indoor spaces—are unsuitable in many humanitarian settings. Cox’s Bazar in Bangladesh, for example, has a population density of 40 000 people per km2, 40 times more than the country as a whole. Isolating confirmed cases is extremely difficult under these circumstances, and personal protective equipment is often difficult to obtain because countries have introduced export restrictions.

Governments are also using the pandemic as an excuse to advance anti-migrant agendas under the flimsy pretext of protecting their citizens from COVID-19. The USA suspended asylum and large swaths of the immigration programme, despite having the highest number of COVID-19 cases in the world. Since March 20, the Trump administration has turned back more than 20 000 migrants at the US border, which is a violation of domestic and international legal obligations. In Bosnia, local authorities cut off the water supply to migrant populations to force them to move on.

Humanitarian organisations are responding, and the pandemic is giving them a chance to develop new ways of working. Whether moving to offering more services remotely, giving patients more medicines at a time to minimise contact, or using their experiences to develop tailored local responses, these organisations will keep trying to better serve people in humanitarian crises. But they cannot succeed unsupported.

UNOCHA suggests that the global COVID-19 humanitarian response plan will cost US$10·3 billion, but only 20% has so far been pledged. By contrast, in just 2 months, governments spent $10 trillion on economic stimuli for their own economies. COVID-19 will worsen health burdens in humanitarian settings, and international disputes over resources have left people in these settings without support. This is nonsensical. If nothing else, COVID-19 is likely to persist in humanitarian settings where health care is poor even if the rest of the world moves on, constantly risking another outbreak.

As states find themselves consumed with their own more immediate problems, they must remember that other humanitarian crises around the world have not diminished, and that the inequality exacerbated by COVID-19 is not resolved by myopically focusing on local problems. True concern for inequality demands attention to all the world’s humanitarian needs.

Milestones :: Perspectives :: Research

INCB, WHO and UNODC statement on access to internationally controlled medicines during COVID-19 pandemic
Scope (COVID-19 and non-COVID-19 patients affected by the pandemic)
14 August 2020 Statement
The International Narcotics Control Board (INCB), the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) call on governments to ensure that the procurement and supply of controlled medicines in countries meet the needs of patients, both those who have COVID-19 and those who require internationally controlled medicines for other medical conditions.

There is a need to ensure access to controlled medicines such as sedatives and analgesics for intubation protocols for the treatment of patients with COVID-19. Non-COVID patients continue to require controlled medicines for the management of pain and palliative care, surgical care and anaesthesia, mental health and neurological conditions, and for the treatment of drug use disorders.

It is important to remember the needs of existing patients who require controlled medicines for the management of these health conditions. These patients faced barriers to accessing controlled medicines before the COVID-19 pandemic. The COVID-19 pandemic has further resulted in interruptions of the medicines supply chain, and it is critical that access to essential health services and medications not be forgotten or de-prioritised during this pandemic.

Need for equitable access
As the pandemic increasingly affects countries with under-resourced health infrastructure and services, it is an ethical imperative to ensure that all people in all countries of the world are able to access essential medicines. This includes those medicines that are under international control.

Governments should ensure that sufficient quantities of internationally controlled medicines, of assured quality, are available and affordable to people under medical care.  Throughout the duration of the pandemic and beyond the acute phase of burden on the healthcare infrastructure, it is critical that governments work cooperatively to ensure that no country, no region, no district, no city and no patient is left behind. Competent national authorities, manufacturers, suppliers and distributors play a crucial role in ensuring that internationally controlled medicines urgently needed for medical treatment are available within and across national borders.  The supply chain is the foundation of quality medical care because without the necessary supplies, including essential controlled medicines, patients will suffer.

Solutions to address barriers
Governments are reminded that in acute emergencies, it is possible under the International Drug Control Conventions to utilize simplified control procedures for the export, transportation and supply of medicinal products containing controlled substances, especially in those cases where the competent authorities in the importing countries may not be operating at full capacity. Competent national authorities may permit the export of medicines containing narcotic drugs and/or psychotropic substances to affected areas even in the absence of the corresponding import authorizations and/or estimates. Urgent deliveries do not need to be included in the estimates of the receiving countries affected by emergencies. When possible, competent national authorities are also encouraged to issue electronic import and export authorizations through the INCB International Import and Export Authorization System (I2ES), PEN Online and share related contingency measures in the forum therein.

Countries should ease COVID-19 related transport restrictions for controlled medicines and consider local production solutions when feasible, to meet the COVID-19 driven demand spikes.

To assist countries as they work to find solutions to the lack of access and availability of controlled medicines, the three organizations suggest the following technical assistance and support documents:
:: Countries are encouraged to refer to the Guide on Estimating Requirements for Substances under International Control developed by the International Narcotics Control Board and the World Health Organization for use by Competent National Authorities.
:: Countries are encouraged to refer to WHO’s toolkit on the clinical care of severe acute respiratory infections, which includes guidance on the use of controlled medicines for the treatment of COVID-19 patients.
:: Countries are further advised to utilize WHO’s operational guidance for maintaining essential services during an outbreak to balance the demands of responding to the COVID-19 pandemic whilst simultaneously ensuring that essential health services and provision of medication for other ongoing medical conditions are maintained.
:: Countries are encouraged to refer to normative guidance such as the WHO List of Essential Medicines and guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents.
:: Countries are further advised to refer to and utilize the strategies presented in UNODC’s Technical Guidance: Increasing Access and Availability of Controlled Medicines developed in collaboration with experts, civil society partners and other international partners.
:: Under the UNODC-WHO-UICC Joint Global Program, countries are encouraged to reach out to UNODC and WHO for technical assistance and support at the national level that also involves civil society partners.

Conclusions
The work of doctors, nurses, and health care professionals in general, who provide treatment and care to people including the most vulnerable, needs to be supported and safe and effective medicines should be available, accessible and affordable at all times for people who need them.

INCB, WHO and UNODC are committed to continue to work together to address this critical issue and will expand joint efforts to engage with other partners and increase advocacy and technical assistance to countries for improving access to controlled medicines during the COVID-19 pandemic and mitigate barriers to ensure that both patients affected by COVID-19 or by other non-COVID-related conditions requiring medicines under international control have access to these medicines when they need them.

EMERGENCIES

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)

Situation report – 208
Coronavirus disease 2019 (COVID-19)
15 August 2020

Confirmed cases :: 21 026 758 [week ago: 19 187 943 ]
Confirmed deaths :: 755 786 [week ago: 716 075]

Highlights [selected]
:: The International Narcotics Control Board, World Health Organization, and the United Nations Office on Drugs and Crime have released a statement calling on governments to ensure that the procurement and supply of controlled medicines in countries meet the needs of patients, both those who have COVID-19 and those who require internationally controlled medicines for other medical conditions.

:: While several countries i n the Americas have implemented innovative strategies to boost immunization programmes during the COVID-19 pandemic, concerns about risk of exposure, as well as challenges accessing services during lockdown, have led to a reduction in vaccination coverage. This was shown in a series of surveys carried out by the WHO Regional Office for the Americas.

:: Africa is marking six months since the first cases of COVID-19 were detected on the continent. Cases have been gradually increasing, with South Africa bearing the brunt of the crisis, with over hal f a mi l lion cases and 11 000 deaths

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

COVID-19 Vaccines – Access/Procurement/Supply

CEPI reserves manufacturing capacity for COVID-19 vaccines at SK bioscience
13 Aug 2020
:: Vaccine manufacturing capacity in 2020 and 2021 has been reserved for vaccines designated by CEPI.
:: Reserved manufacturing capacity at SK bioscience will support COVAX goal to produce 2 billion doses of safe and effective vaccine by the end of 2021.
August 13 2020, Oslo, Norway– An agreement between CEPI and SK bioscience Co. Ltd. (SK bioscience) has secured capacity to manufacture COVID-19 vaccines at SK bioscience’s facilities in South Korea, supporting the goal of CEPI and its COVAX partners to produce 2 billion doses of safe and effective vaccine by the end of 2021.
Under the terms of the agreement, SK bioscience will reserve manufacturing capacity in 2020 and 2021 exclusively for the development and production of COVID-19 vaccines designated by CEPI. CEPI has an option to extend the reservation of manufacturing capacity beyond 2021, should it be needed…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 12 August 2020
:: A cVDPV2 outbreak has been detected in Sudan. WHO and UNICEF are working closely with the Ministry of Health to plan and launch an effective outbreak response to limit virus spread.
:: Polio vaccination campaigns continue to resume in countries worldwide in the context of strict COVID-19 infection prevention and control measures. This week a campaign will go ahead in some areas of Pakistan, the second held in the nation since campaigns resumed in July.
:: Dr. Joanna Nikulin has been appointed as the Coordinator of the GPEI Hub in Amman, Jordan, effective immediately. Dr. Nikulin has over 15 years of experience in polio eradication, immunization and child health, and has served in some of the most challenging settings worldwide. She has been acting as the interim Hub Coordinator since September 2019.
:: Tributes have been paid by the polio programme to David Newberry, fondly remembered as the ‘father of the Core Group Polio Project’. After years spent eradicating smallpox and fighting guinea worm, David turned his determination and expertise to the battle against polio. Under his leadership, immense progress was made against polio in countries including Angola, India, Ethiopia, Uganda, Bangladesh and Nepal. Colleagues of David extend their deepest sympathies to his family and friends, and remember him fondly here.

Summary of new WPV and cVDPV viruses this week (AFP cases and environmental samples):
:: Afghanistan: 14 cVDPV2 cases and eight cVDPV2 positive environmental samples
:: Pakistan: five WPV1 positive environmental samples and one cVDPV2 positive environmental sample
:: Chad: five cVDPV2 cases
:: Cote d’Ivoire: six cVDPV2 cases
:: Democratic Republic of the Congo (DR Congo): one cVDPV2 case
:: Ethiopia: two cVDPV2 cases
:: Mali: two cVDPV2 positive environmental samples
:: Sudan: three cVDPV2 positive environmental samples

::::::

Polio vaccination campaigns resume in Afghanistan and Pakistan after COVID-19 disruptions leave 50 million children unimmunized
KATHMANDU, 11 August 2020 – Polio immunization campaigns have resumed in Afghanistan and Pakistan – the last two polio-endemic countries in the world – months after COVID-19 left 50 million children without their polio vaccine.

In Afghanistan, polio immunization programmes restarted in three provinces in July. A second campaign covering almost half of the country will start this month. In Pakistan, an initial round of vaccinations took place at the end of July, covering about 780,000 children. A nationwide vaccination campaign is slated to start later this month.

“These life-saving vaccinations are critical if children are to avoid yet another health emergency,” said Jean Gough, UNICEF Regional Director for South Asia. “As the world has come to see only too well, viruses know no borders and no child is safe from polio until every child is safe.”…

Child vaccination drives, including polio campaigns, were halted in both Afghanistan and Pakistan in March 2020 to avoid the risk of COVID-19 transmission to children, caregivers and vaccinators themselves. As a result, reported polio cases have reached 34 in Afghanistan and 63 in Pakistan, including in some previously polio-free parts of the country…

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