The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 7 December 2019

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

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

PDF: The Sentinel_ period ending 7 Dec 2019

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

Attacks on multilateral system threaten global peace and security – The Elders

Governance – Multilateral System

Attacks on multilateral system threaten global peace and security
The Elders – 03 Dec 2019
The multilateral system is under unprecedented attack. Isolationist and arbitrary actions by leading powers, including the United States, are threatening to undermine critical efforts to tackle global challenges from nuclear disarmament and non-proliferation to climate change, and the regulation of international trade.

The Elders urge all world leaders to acknowledge that effective multilateralism is in their own national interest, regardless of size or strength. Getting others to cooperate by means of internationally-agreed mechanisms is less costly and more reliable than unilateral force.

Yet since 2017, the US has: withdrawn from the Paris Agreement on Climate Change; pulled out of the Iranian nuclear deal; left the UN Human Rights Council and UNESCO; abandoned the Intermediate-Range Nuclear Forces (INF) Treaty; unilaterally imposed trade barriers; and concurrently blocked the appointment of new judges at the World Trade Organization.

As an immediate step, WTO member states must respond to persistent US intransigence by appointing without further delay the necessary new judges to the Appellate Body by majority voting, to avoid the collapse of the WTO’s entire dispute settlement capability.

Following the formal US notification of its withdrawal from the Paris Agreement, all other signatories must now use the upcoming COP 25 summit in Madrid to urgently step up their climate action and ambition. Countries must cut carbon emissions more drastically and quickly than in previously-submitted pledges, and also adopt rigorous monitoring of compliance with such commitments.

The network of international covenants and institutions agreed and constructed since the end of the Second World War, with the United Nations at its core, is far from perfect. But it has nevertheless decisively supported the pursuit of peace, security and the protection of human rights, as well as economic and social progress across the globe, for over seven decades.

It is a sad irony that the multilateral system’s principal assailant, the US, is the very country that led the design and construction of its institutions in the 1940s and benefited enormously from it in the subsequent decades.

To make matters worse, the response by other influential powers has too often been erratic, uncoordinated and counter-productive. Most have opted to negotiate bilaterally with the US to try to resolve crises, further eroding existing multilateral frameworks.

This is myopic and self-harming. A regression from a rules-based system into power-based strategies will not result in a safer, more predictable or propitious environment for any country.

Without a concerted commitment to defend multilateralism, we will not bequeath a safe world to future generations. They will neither forget nor forgive such a collective failure.

UN asks the world to invest $29 billion in humanity in 2020

UN asks the world to invest $29 billion in humanity in 2020
:: A record 168 million people worldwide will need humanitarian assistance and protection in 2020.
:: Protracted conflicts, extreme weather events and crumbling economies have pushed millions to the brink of survival.
:: Humanitarian organizations today present their plans for how to respond and what it will cost.

(Geneva, 4 December 2019) – The United Nations in collaboration with hundreds of non-governmental humanitarian organizations today present the global overview of their plans to assist 109 million of the most vulnerable people caught up in humanitarian crises worldwide.

The Global Humanitarian Overview (GHO) 2020 is launched simultaneously in five locations – Geneva, Berlin, Brussels, London and Washington DC.

One in every 45 people on the planet are in need of food, shelter, health care, emergency education, protection or other basic assistance. The global humanitarian community stands ready to help and counts on the international community’s continued generosity to help them save more lives and alleviate human suffering in crises spanning 53 countries from Afghanistan to Zambia…

Comparable figures show that the number of people in need globally has increased by some 22 million over the past year. The main drivers of need are protracted and highly violent conflicts, extreme weather events associated with climate change and under-performing economies. The plans set out in the GHO 2020 aim to reach 109 million vulnerable people with aid and protection. The combined requirements are nearly US$29 billion.

“The brutal truth is 2020 will be difficult for millions of people. The good news is that the humanitarian response is getting better and faster in reaching the most vulnerable, including women, children and people with disabilities,” Emergency Relief Coordinator Mark Lowcock said, launching the GHO 2020 in Geneva…

In 2019, more people than forecasted needed humanitarian assistance, mostly because of conflicts and natural disasters. Donors generously provided a record $16 billion for inter-agency appeals between January and November 2019. Aid groups reached 64 per cent of the people targeted to receive aid through Humanitarian Response Plans in 22 of the countries for which data were available.

The GHO 2020 is available online

Note to Editors
[1] The Global Humanitarian Overview 2020 is based on Humanitarian Response Plans in Afghanistan, Burkina Faso, Burundi, Cameroon, Сentral African Republic, Chad, Democratic Republic of the Congo, Ethiopia, Haiti, Iraq, Libya, Mali, Myanmar, Niger, Nigeria, occupied Palestinian territories, Somalia, South Sudan, Sudan, Syria, Ukraine, Venezuela and Yemen.
[2] Other types of inter-agency plans are included for Bangladesh, DPR Korea and Venezuela/Regional.
[3] The GHO also includes Regional Refugee Response Plans for Burundi, Democratic Republic of the Congo, Nigeria, South Sudan and Syria.

IRC: Failure to end civil war in Yemen could cost $29 billion


Failure to end civil war in Yemen could cost $29 billion
IRC Press Release
Sana’a, Yemen, December 2, 2019 — Almost one year since the Stockholm agreement, the war in Yemen continues unabated. New International Rescue Committee research highlights the devastating impact of continued conflict on ordinary Yemenis. The international community must push the warring parties to build on a rare window of opportunity for peace to secure a nationwide ceasefire.

:: At the current rate of decline, it will take 20 years to return Yemen to pre-crisis levels of child hunger.
:: If the war continues for another five years it will cost the international community as much as $29 billion in humanitarian funding – more than the entire annual humanitarian budget globally.
:: The IRC is calling on members of the UN Security Council to use their significant diplomatic influence to build on recent political developments and kick-start UN-led negotiations.
:: The IRC reaches more than 21,000 people each week with healthcare and nutrition services, women’s protection and empowerment programs and education for children.

The IRC released a new report today detailing the devastating consequences a continuation of the war will have for the people of Yemen. “The War Destroyed Our Dreams” shows that at the current rate of decline, it will take 20 years for the country to return to pre-war levels of child malnutrition, which were already amongst the worst in the world. Another five years of fighting will cost the international community as much as $29 billion USD just to sustain the current level of humanitarian aid.

Recent developments in Yemen suggest a rare window of opportunity has opened to push for peace. The recent power sharing agreement between the Internationally Recognized Government (IRG) and the Southern Transitional Council (STC) offers hope for more inclusive peace talks. However, this is far from assured. World leaders must invest in diplomacy and put their full focus on bringing together warring parties for negotiations. A nationwide ceasefire is needed immediately to avoid further catastrophe…

Educational Attainment :: Young people struggling in digital world, finds latest OECD PISA survey

Educational Attainment

PISA [Program for International Student Assessment] 2018 Results
The OECD Programme for International Student Assessment (PISA) examines what students know in reading, mathematics and science, and what they can do with what they know. It provides the most comprehensive and rigorous international assessment of student learning outcomes to date. Results from PISA indicate the quality and equity of learning outcomes attained around the world, and allow educators and policy makers to learn from the policies and practices applied in other countries. This is one of six volumes that present the results of the PISA 2018 survey, the seventh round of the triennial assessment.


Young people struggling in digital world, finds latest OECD PISA survey
03/12/2019 –
One in four students in OECD countries are unable to complete even the most basic reading tasks, meaning they are likely to struggle to find their way through life in an increasingly volatile, digital world. This is one of the findings of the OECD’s latest PISA global education test, which evaluates the quality, equity and efficiency of school systems.

The OECD’s PISA 2018 tested around 600,000 15-year-old students in 79 countries and economies on reading, science and mathematics. The main focus was on reading, with most students doing the test on computers.

Most countries, particularly in the developed world, have seen little improvement in their performances over the past decade, even though spending on schooling increased by 15% over the same period. In reading, Beijing, Shanghai, Jiangsu and Zhejiang (China), together with Singapore, scored significantly higher than other countries. The top OECD countries were Estonia, Canada, Finland and Ireland…

The share of students with only very basic reading skills highlights the challenge countries, including those in the developed world, face in achieving the United Nations Sustainable Development Goals for 2030 (SDGs), particularly in relation to “ensuring inclusive and equitable quality education and promoting lifelong learning opportunities for all.” (SDG 4). The share of low-performers, both girls and boys, also increased on average between 2018 and 2009, the last time reading was the main focus of PISA…

Around 1 in 10 students across OECD countries, and 1 in 4 in Singapore, perform at the highest levels in reading. However, the gap between socio-economically advantaged and disadvantaged students is stark: the reading level of the richest 10% of students in OECD countries is around three years ahead of the poorest 10%. In France, Germany, Hungary and Israel, the gap is four years.

Yet some countries have shown an impressive improvement over the past few years. Portugal has advanced to the level of most OECD countries, despite being hit hard by the financial crisis. Sweden has improved across all three subjects since 2012, reversing earlier declines. Turkey has also progressed while at the same time doubling the share of 15-year-olds in school.

The latest PISA findings also reveal the extent to which digital technologies are transforming the world outside of school. More students today consider reading a waste of time (+ 5 percentage points) and fewer boys and girls read for pleasure (- 5 percentage points) than their counterparts did in 2009. They also spend about 3 hours outside of school online on weekdays, an increase of an hour since 2012, and 3.5 hours on weekends…

Around one in four students in OECD countries, on average, do not attain the basic level of science (22%) or maths (24%). This means that they cannot, for example, convert a price into a different currency…

Girls significantly outperformed boys in reading on average across OECD countries, by the equivalent of nearly a year of schooling. Across the world, the narrowest gaps were in Argentina, Beijing, Shanghai, Jiangsu and Zhejiang (China), Chile, Colombia, Costa Rica, Mexico, Panama and Peru. Boys overall did slightly better than girls in maths but less well in science…

One in four students in OECD countries are unable to complete even the most basic reading tasks, meaning they are likely to struggle to find their way through life in an increasingly volatile, digital world…

Ensuring access to affordable, timely vaccines in emergencies

Featured Journal Content

Bulletin of the World Health Organization
Volume 97, Number 12, December 2019, 789-856
Ensuring access to affordable, timely vaccines in emergencies
— Kate Elder, Barbara Saitta, Tanja Ducomble, Miriam Alia, Ryan Close, Suzanne Scheele, Elise Erickson, Rosalind Scourse, Patricia Kahn & Greg Elder
Vaccination is an effective intervention to reduce disease, disability, death and health inequities worldwide. Over the last two decades, vaccines have become more accessible in low-income countries; however, significant gaps remain, particularly in humanitarian emergencies, where populations face increased risks of many diseases. In 2013, the World Health Organization (WHO) published Vaccination in acute humanitarian emergencies: a framework for decision-making, to provide guidance on which vaccines to prioritize during emergencies.1 However, substantial obstacles, especially high prices for new vaccines, hinder implementation of this framework and of critical vaccination activities in emergency settings.

In response to these challenges, global health stakeholders held a series of consultations in 2016 and proposed a WHO-based mechanism, the Humanitarian Mechanism, for the rapid procurement of affordable vaccines during emergencies, to be used by nongovernmental organizations (NGOs), civil society organizations, United Nations (UN) agencies and governments.
Here we present the background of the creation of the mechanism from the perspective of Médecins Sans Frontières (MSF), including a description of our past challenges in accessing affordable pneumococcal conjugate vaccine (PCV; Box 1), a critical vaccine during many emergencies. We then describe how the mechanism has so far facilitated access to more affordable PCV and outline steps that could increase its potential for saving lives…

Next steps
Building on these initial successes, we see three critical elements of the mechanism, which if fully implemented, could greatly enhance its impact.

First, the mechanism needs to be better known among global health actors, including UN agencies and NGOs, who should be encouraged to use it under appropriate circumstances.

Second, while the mechanism’s terms of reference includes use by governments responding to emergencies,8 conditions attached to the PCV pledges discussed here (the only pledges to the mechanism so far) exclude governmental use. Manufacturers should allow governments to access the mechanism during emergencies to procure critical vaccines needed to protect their populations. Many middle-income countries already grapple with high vaccine prices for routine immunization programmes and may find the cost of extending vaccination to influxes of displaced people during emergencies prohibitive. While Gavi adopted a fragility, emergencies and refugees policy in June 2017 to allow more flexible use of Gavi-supported vaccine doses in specific contexts, strict criteria exist for how and where this flexibility can be applied, and it can only cover Gavi-eligible countries.12

Finally, the types of vaccines pledged to the mechanism by manufacturers should be expanded: the only commitments to date are for pneumococcal conjugate vaccines. Current and future manufacturers should commit other vaccines with affordability and accessibility challenges to the mechanism, so they can be procured rapidly at the lowest global price

The mechanism is a significant step forward in delivering life-saving vaccines to populations caught in emergencies and conflict. The mechanism’s mandate is strengthened by multiple organizations recognizing the gap between existing technical guidelines and constraints on their implementation, that is, the lack of rapidly available, affordable vaccines. While the mechanism does not address the broader systemic failures of the vaccine market, it was created to specifically address the failure of the global vaccine market to meet relatively small, urgent vaccine procurement needs efficiently and affordably. Further steps are needed for the mechanism to reach its full potential; however, it already provides a critical platform during humanitarian crises for expanding the number of people who can receive life-saving vaccines.



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

Ebola Outbreak in DRC 70: 03 December 2019
Situation Update
In the week of 25 November to 1 December 2019, 10 new confirmed EVD cases were reported from two health zones in two affected provinces in the Democratic Republic of the Congo. The confirmed cases in this week came from Mabalako (50%, n=5) and Mandima (50%, n=5) Health Zones.
In the past week, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations.
On the night of 27 November 2019, an attack on the Ebola response camp in Biakato Mines resulted in the death of three responders and the injury of seven others. Response personnel in Biakato were relocated to Goma, and the majority of response activities in the area have been suspended. On the same night, a separate attack on the Ebola coordination office in Mangina resulted in one death. Most response personnel in Mangina have also been relocated. As of 2 December 2019, North Kivu Province has declared ‘ville morte’ and many response activities have been suspended across the province.
As seen previously during this outbreak, such disruptions limit contact tracing, surveillance, and vaccination efforts, and they may result in increased transmission…


WHO Director-General praises bravery of health workers during visit to eastern Democratic Republic of Congo following fatal attacks on Ebola responders
1 December 2019 News release


Democratic Republic of Congo
As security situation deteriorates, MSF withdraws staff from Biakato
Statement 6 Dec 2019
On 4 December 2019, Medecins Sans Frontières (MSF) took the painful decision to temporarily withdraw our staff from the Biakato region of Ituri province, Democratic Republic of Congo. After months of working extremely closely with the community to address the health needs in the region, MSF is saddened to have made this decision….


Gavi Board approves new Ebola vaccine programme
New Delhi, 5 December 2019 – A global emergency stockpile of Ebola vaccines will be available to countries for outbreak response and prevention following the approval of a new Ebola vaccine programme by the Board of Gavi, the Vaccine Alliance, which met this week in New Delhi, India.

Gavi will open a new funding window, with estimated investment of US$ 178 million between now and 2025 for the new Ebola vaccine programme. Gavi-supported low- and middle-income countries will be able to access the stockpile free of charge and will receive support for the operational costs of vaccination campaigns. Wealthier countries will be able to access vaccines but will be expected to self-finance.

As well as creating the emergency stockpile, Gavi will also support targeted preventative vaccination outside of an outbreak in high-risk populations, such as health workers, in countries at risk. The target populations and scope of countries will be based on future recommendations by the WHO’s Strategic Advisory Group of Experts on Immunisation (SAGE).

“Today, I think about Ebola victim Dr Ameyo Adadevoh, a true vaccine hero who died stopping the Ebola virus from spreading in Nigeria and we should all be excited by the Alliance decision,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board. “This is a historic milestone in humanity’s fight against this horrific disease. Just five years ago we faced an Ebola outbreak in West Africa with no vaccine and no way to treat the disease. Today, thanks to the heroic efforts of countless patients, health workers, scientists, manufacturers, donors, partners as well as the leadership of African countries, we now have one vaccine approved for use and more on their way, as well as rapid diagnostics and several promising treatments. With these tools at our disposal, the battle against Ebola can be won, and I’m proud of the role Gavi has played in this.”
The W
HO’s SAGE Working Group on Ebola Vaccines and Vaccination has provided guidance that the global emergency stockpile should be maintained at 500,000 licensed doses of vaccines. The price of Ebola vaccines funded by Gavi will be defined as part of a tender process managed by UNICEF, as Gavi’s partner and procurement agency.

There are currently eight candidate Zaire Ebolavirus vaccines at different phases of development. This includes Merck’s vaccine currently being used under compassionate use as part of the response to the ongoing DRC outbreak, which has recently received conditional marketing approval from the European Commission and prequalification from the WHO. More than 250,000 people have received it since the outbreak started in August last year. Moreover, close to a thousand people have received a second candidate vaccine manufactured by Johnson & Johnson as part of a study in North Kivu, DRC.

“The Ebola vaccine has shown extraordinary efficacy in tackling the outbreak in the DRC,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This achievement demonstrates the Alliance at its best. Now that funding has been approved, we will get to work with manufacturers and our Alliance partners to build the stockpile. It will be critical for Gavi to secure enough funding for the 2021-2025 period to maintain this Ebola vaccine programme in order to protect people, health systems and economies that may be threatened by this devastating disease in the future.”

A coordinating mechanism to decide how and when the vaccine stockpile will be deployed will be established with partner organisations.


Public Health Emergency of International Concern (PHEIC)

Polio this week as of 04 December 2019
:: To provide an insight on the status of polio eradication efforts as at September 2019, the WHO Director-General’s report on polio eradication to the upcoming Executive Board (EB) meeting has been published here. Available in six languages, the report summarizes the programmatic, epidemiological and financial challenges to securing a lasting polio-free world.

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan — one WPV1 case and one WPV1 positive environmental sample;
:: Pakistan — 25 WPV1 positive environmental samples;
:: Angola — 16 cVDPV2 cases and four cVDPV2 positive environmental samples.


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

WHO Grade 3 Emergencies [to 7 Dec 2019]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 70: 03 December 2019

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 7 Dec 2019]

:: WHO supports Angola’s Government efforts to end polio outbreak 02 December 2019

Afghanistan – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – 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
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified


WHO Grade 1 Emergencies [to 7 Dec 2019]

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
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 – No new digest announcements identified
Yemen – No new digest announcements identified


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth
:: 06 December 2019 Southern Africa: Humanitarian Key Messages, December 2019

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified