PLoS One
http://www.plosone.org/
[Accessed 23 April 2016]

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Research Article
Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework
Patience A. Afulani, Cheryl Moyer
Research Article | published 22 Apr 2016 | PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0154110

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Effect of Village Health Team Home Visits and Mobile Phone Consultations on Maternal and Newborn Care Practices in Masindi and Kiryandongo, Uganda: A Community-Intervention Trial
Richard Mangwi Ayiasi, Patrick Kolsteren, Vincent Batwala, Bart Criel, Christopher Garimoi Orach
Research Article | published 21 Apr 2016 | PLOS ONE

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 23 April 2016)

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Commentary: Averting a global fisheries disaster
Boris Worm
PNAS 2016 ; published ahead of print April 19, 2016, doi:10.1073/pnas.1604008113
Oceans cover 71% of Earth’s surface and support an estimated 3 billion people with food and vital micronutrients (1). Consequently, the fate of the ocean and its living resources is a first-order question in ecology and environmental science (2). In this context, a 2006 panel of ecologists and fisheries scientists empirically charted the consequences of an ongoing depletion of marine biodiversity, such as declining fisheries, reduced water quality, loss of habitat, and less resilient ecosystems (3). The paper became widely known, however, for a scenario of global fisheries collapse derived from extrapolating catch trends to the year 2048. This projection served as a flash point in the ongoing discussion about the sustainability of global fisheries, or lack thereof (4). A polarized debate ensued, which was productively addressed by a subsequent panel that highlighted solutions for rebuilding depleted fisheries, where appropriate governance structures exist (5). That work, however, along with several follow-up papers (6⇓–8), did not revisit the original projections. A new paper in PNAS (9) now uses updated methodology and an innovative combination of available data on catch trends, life history, and stock assessments to revisit the prospect of a global fisheries disaster, and what may be required to avert it.

The analysis of Costello et al. (9) confirms that the average state of global fish stocks is poor and declining. Of 4,714 fisheries assessed in the year 2012, only 32% remained at or above the biomass target that supports maximum sustainable yield (BMSY), whereas 68% have slipped below that critical threshold. This compares to 63% of assessed stocks tracking below BMSY in 2006 (5). Even more concerning is the finding that only 35% of stocks are currently fished at …

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Biological Sciences – Ecology:
Predicting the spread of marine species introduced by global shipping
Hanno Seebens, Nicole Schwartz, Peter J. Schupp, and Bernd Blasius
PNAS 2016 ; published ahead of print April 18, 2016, doi:10.1073/pnas.152442711
Significance
Predicting the arrival of alien species remains a big challenge, which is assumed to be a consequence of the complexity of the invasion process. Here, we demonstrate that spreading of alien marine species can be predicted by a simple model using only global shipping intensities, environmental variables, and species occurrence data. We provide species lists of the next potentially invading species in a local habitat or species causing harmful algal blooms with their associated probability of invasion. This will help to improve mitigation strategies to reduce the further introduction of alien species. Although this study focuses on marine algae, the model approach can be easily adopted to other taxonomic groups and their respective drivers of invasion.
Abstract
The human-mediated translocation of species poses a distinct threat to nature, human health, and economy. Although existing models calculate the invasion probability of any species, frameworks for species-specific forecasts are still missing. Here, we developed a model approach using global ship movements and environmental conditions to simulate the successive global spread of marine alien species that allows predicting the identity of those species likely to arrive next in a given habitat. In a first step, we simulated the historical stepping-stone spreading dynamics of 40 marine alien species and compared predicted and observed alien species ranges. With an accuracy of 77%, the model correctly predicted the presence/absence of an alien species in an ecoregion. Spreading dynamics followed a common pattern with an initial invasion of most suitable habitats worldwide and a subsequent spread into neighboring habitats. In a second step, we used the reported distribution of 97 marine algal species with a known invasion history, and six species causing harmful algal blooms, to determine the ecoregions most likely to be invaded next under climate warming. Cluster analysis revealed that species can be classified according to three characteristic spreading profiles: emerging species, high-risk species, and widespread species. For the North Sea, the model predictions could be confirmed because two of the predicted high-risk species have

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Knowledge Systems for Sustainable Development Special Feature Sackler Colloquium –
Perspective: Crafting usable knowledge for sustainable development
William C. Clark, Lorrae van Kerkhoff, Louis Lebel, and Gilberto C. Gallopin
PNAS 2016 ; published ahead of print April 18, 2016, doi:10.1073/pnas.1601266113
Abstract
This paper distills core lessons about how researchers (scientists, engineers, planners, etc.) interested in promoting sustainable development can increase the likelihood of producing usable knowledge. We draw the lessons from both practical experience in diverse contexts around the world and from scholarly advances in understanding the relationships between science and society. Many of these lessons will be familiar to those with experience in crafting knowledge to support action for sustainable development. However, few are included in the formal training of researchers. As a result, when scientists and engineers first venture out of the laboratory or library with the goal of linking their knowledge with action, the outcome has often been ineffectiveness and disillusionment. We therefore articulate here a core set of lessons that we believe should become part of the basic training for researchers interested in crafting usable knowledge for sustainable development. These lessons entail at least four things researchers should know, and four things they should do. The knowing lessons involve understanding the coproduction relationships through which knowledge making and decision making shape one another in social–environmental systems. We highlight the lessons that emerge from examining those coproduction relationships through the ICAP lens, viewing them from the perspectives of Innovation systems, Complex systems, Adaptive systems, and Political systems. The doing lessons involve improving the capacity of the research community to put its understanding of coproduction into practice. We highlight steps through which researchers can help build capacities for stakeholder collaboration, social learning, knowledge governance, and researcher training.

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 23 April 2016]

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Research
Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care
Maternal death reviews and obstetric audits identify causes and circumstances related to occurrence of a maternal death or serious complication and inform improvements in quality of care.
Julia Hussein, Atsumi Hirose, Oluwatoyin Owolabi, Mari Imamura, Lovney Kanguru and Friday Okonofua
Reproductive Health 2016 13:47
Published on: 22 April 2016

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Study protocol
Taking stock: protocol for evaluating a family planning supply chain intervention in Senegal
In Senegal, only 12 % of women of reproductive age in union (WRAU) were using contraceptives and another 29 % had an unmet need for contraceptives in 2010–11. One potential barrier to accessing contraceptives …
Francesca L. Cavallaro, Diane Duclos, Rebecca F. Baggaley, Loveday Penn-Kekana, Catherine Goodman, Alice Vahanian, Andreia C. Santos, John Bradley, Lucy Paintain, Jérémie Gallien, Antonio Gasparrini, Leah Hasselback and Caroline A. Lynch
Reproductive Health 2016 13:45
Published on: 21 April 2016

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Editorial
We need to stop female genital mutilation!
José M. Belizán, Suellen Miller and Natasha Salaria
Reproductive Health 2016 13:43
Published on: 18 April 2016

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Commentary
The ongoing violence against women: Female Genital Mutilation/Cutting
Female Genital Mutilation/Cutting (FGM/C) comprises different practices involving cutting, pricking, removing and sometimes sewing up external female genitalia for non-medical reasons.
Jacinta K. Muteshi, Suellen Miller and José M. Belizán
Reproductive Health 2016 13:44
Published on: 18 April 2016

Science
22 April 2016 Vol 352, Issue 6284
http://www.sciencemag.org/current.dtl

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In Depth
Refugee crisis brings new health challenges
By Kai Kupferschmidt
Science22 Apr 2016 : 391-392
Imported pathogens are a much bigger threat to migrants than they are to Europeans.
Summary
More than a million refugees and migrants entered Europe last year, mostly from Syria, Afghanistan, and Iraq. This exodus is creating new challenges for European public health officials. Many of the migrants come from countries where public health systems are in disarray, and some are infected with pathogens that are rare, or even unheard of, in Europe. Germany saw a 30% increase in the number of tuberculosis cases in 2015; doctors also need to be prepared for diseases they have never seen before. Still, scientists say that the influx of unusual infections is far less a threat to native-born Europeans than to the health of the refugees themselves.

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Policy Forum
Filling in biodiversity threat gaps
By L. N. Joppa, B. O’Connor, P. Visconti, C. Smith, J. Geldmann, M. Hoffmann, J. E. M. Watson, S. H. M. Butchart, M. Virah-Sawmy, B. S. Halpern, S. E. Ahmed, A. Balmford, W. J. Sutherland, M. Harfoot, C. Hilton-Taylor, W. Foden, E. Di Minin, S. Pagad, P. Genovesi, J. Hutton, N. D. Burgess
Science22 Apr 2016 : 416-418
Only 5% of global threat data sets meet a “gold standard”
Summary
The diversity of life on Earth—which provides vital services to humanity (1)—stems from the difference between rates of evolutionary diversification and extinction. Human activities have shifted the balance (2): Species extinction rates are an estimated 1000 times the “background” rate (3) and could increase to 10,000 times the background rate should species threatened with extinction succumb to pressures they face (4). Reversing these trends is a focus of the Convention on Biological Diversity’s 2020 Strategic Plan for Biodiversity and its 20 Aichi Targets and is explicitly incorporated into the United Nations’ 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs). We identify major gaps in data available for assessing global biodiversity threats and suggest mechanisms for closing them.

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Perspectives
Waste not, want not, emit less
By Jessica Aschemann-Witzel
Science22 Apr 2016 : 408-409
Reducing food waste in the supply chain and at home can help to reduce carbon emissions
Summary
Ensuring a sufficient supply of quality food for a growing human population is a major challenge, aggravated by climate change and already-strained natural resources. Food security requires production of some food surpluses to safeguard against unpredictable fluctuations (1). However, when food is wasted, not only has carbon been emitted to no avail, but disposal and decomposition in landfills create additional environmental impacts. Decreasing the current high scale of food waste is thus crucial for achieving resource-efficient, sustainable food systems (2). But, although avoiding food waste seems an obvious step toward sustainability, especially given that most people perceive wasting food as grossly unethical (3), food waste is a challenge that is not easily solved.

Sustainability
Volume 8, Issue 3 (March 2016)
http://www.mdpi.com/2071-1050/8/2

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Editorial:
Introduction to the Special Issue on the Sustainable Asia Conference 2015
by Yongrok Choi, Malin Song and Seunghwan Myeong
Sustainability 2016, 8(3), 266; doi:10.3390/su8030266
Abstract:
Of late, Asian countries have been experiencing serious environmental disasters, such as the particulate matter (PM) smog in China, a yellow sand storm in Korea, and the Fukuyama nuclear power station shutdown in Japan. Since its inauguration in 2009, the Sustainable Asia Conference (SAC) has evolved into one of the leading international conferences for coping with these environmental challenges and presenting novel and fundamental advances in sustainable development for Asia. This editorial for SAC 2015 will highlight the contents and new methodologies put forth by selected papers, presenting diverse implications in sustainable policies and business strategies.

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Article:
New Key Performance Indicators for a Smart Sustainable City
Sustainability 2016, 8(3), 206; doi:10.3390/su8030206
by Minako Hara, Tomomi Nagao, Shinsuke Hannoe and Jiro Nakamura
Received: 30 September 2015 / Revised: 5 February 2016 / Accepted: 18 February 2016 / Published: 3 March 2016
Abstract:
We propose key performance indicators (KPIs) based on the Gross Social Feel-Good Index to evaluate a smart sustainable city and report the results of a field trial in a city located almost at the center of the Tokyo Metropolitan Area. We developed KPIs based on the following concepts: (1). The triple bottom line is the basic evaluation criteria; (2). The same unit is used for every evaluation criterion; (3). The KPIs can be used to assess a diverse range of smart sustainable cities with different goals. With the proposed KPIs of smart sustainable cities, indicators are divided into four layers for simplicity: the triple bottom line and “satisfaction” lie in the first layer. Since the notion of “society” is broad, it is further split into “safety”, “health”, and “comfort”, which are positioned in the second layer. The third layer includes indicators such as “information security” and “ubiquitous society” from the perspective of information communication technology (ICT). We conducted a trial evaluation by applying the proposed KPIs to individual ICT solutions of “Internet Protocol announcements”, “Wi-Fi around the station” and “information transmission and control” which have already been installed in a smart sustainable city.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 16 April 2016

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 &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 16 April 2016

blog edition: comprised of the 35+ entries  posted below.

Editor’s Note:
As we approach the World Humanitarian Summit in Istanbul on 23-24 May 2016, we are encountering analyses on the state of humanitarian response and humanitarianism overall. Below are summaries of new reports by ODI and ActionAid International on behalf of the Transforming Surge Capacity Project.

World Humanitarian Summit: https://consultations.worldhumanitariansummit.org/whs_about

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Time to let go: remaking humanitarian action for the modern era
ODI – Humanitarian Policy Group
Research reports and studies – April 2016 :: 84 pages
Team leader and main author: Christina Bennett; Editor and co-author: Matthew Foley
Pdf: http://www.odi.org/sites/odi.org.uk/files/resource-documents/time_to_let_go_report.pdf

Foreword
This report reflects a growing sense, both from our own research on the ‘changing humanitarian landscape’ and in conversations with colleagues, that the ‘traditional’ humanitarian sector is on the cusp of a decisive moment in its history.

For three-quarters of a century, the stalwarts of humanitarian assistance and emergency relief – Western donors and non-governmental organisations, the Red Cross Movement and UN agencies – have seen themselves as the essential heart of humanitarian action: indispensable players, both as implementing agencies and as the arbiters of the norms and standards governing the conduct of relief.

What became increasingly plain as our research progressed was that this centrality and indispensability was, if not an illusion, then at least a very partial picture of the reality of global humanitarian assistance. Northern NGOs, the UN system and the Red Cross are by no means redundant – the billions of dollars still being channelled through them is testament to that – but they are just one part of a much broader universe of assistance made up of a myriad of other actors, with their own distinctive traditions and cultures of care.

Drawing on recent HPG research, this report – a collective effort by the HPG team, as well as the fruit of insights from thinkers and doers in humanitarianism from around the world – reflects on this complexity, and sketches out some of its implications, both for the practical business of emergency assistance and for the principles, ethos and culture that underpin it.

If humanitarianism really is the broad church we believe it to be, what does the concept of ‘humanitarian’ even mean? How should we respond to these challenges, and is change desirable or even possible? These are very large questions, and this report cannot provide complete answers. Hopefully, though, it will contribute to a fuller and more constructive debate on the future direction of humanitarian policy and practice.
Sara Pantuliano
Director, Humanitarian Policy Group
April 2016

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Press Release
Time to let go: remaking humanitarian action for the modern era
As the international humanitarian system faces a crisis of legitimacy, the Humanitarian Policy Group’s landmark report proposes a new model of humanitarian action.

…The humanitarian sector is suffering a crisis of legitimacy.

Despite a decade of system-wide reforms, the sector is failing to adapt to meet the needs of people in crises. As humanitarian emergencies become more frequent, more complex and last longer, the need for radical change is ever growing.

Drawing on four years of research, this report argues that the humanitarian system needs to let go of some fundamental – but outdated – assumptions, structures and behaviours to respond effectively to modern day crises. It argues for a new model of humanitarian action, one that requires letting go of the current paradigm.

First, the UN and large international NGOs need to let go of power and control, to enable national and local aid organisations to lead crisis response.

Second, the humanitarian system needs to let go of the incentives that place organisational drives for greater resources and visibility above the needs of crisis-affected people.

Third, the humanitarian system needs to let go of its own exceptionalism and accept that different forms of relief – from development organisations, religious organisations and private sector companies – can co-exist and can be equally legitimate…

State of Surge Capacity in the Humanitarian Sector
ActionAid International on behalf of the Transforming Surge Capacity Project
April 2016 :: 56 pages
REPORT AUTHORS: LOIS AUSTIN AND GLENN O’NEIL
Pdf: http://www.chsalliance.org/files/files/Resources/Articles-and-Research/Surge-Humanitarian-Report-Final.pdf

Executive Summary [excerpts]
RESEARCH BACKGROUND
This research report is one part of the Transforming Surge Capacity Project of the Start Network. The project aims to improve the capacity of humanitarian organisations to scale up resources for emergency response, and to pilot and build evidence of ways of working that are collaborative and locally focused and which engage with a range of different stakeholders involved in humanitarian response. Led by ActionAid, the project brings together eleven agencies – Action Against Hunger, CAFOD, CARE, Christian Aid, International Medical Corps, Islamic Relief, Muslim Aid, Plan, Save the Children and Tearfund. CHS Alliance is a technical partner for the project and is responsible for this research. The Communicating with Disaster Affected Communities (CDAC) Network is also a technical partner.

The report presents an analysis of the current state of surge across the humanitarian sector, drawing from aid agency views on working collectively on surge and providing an assessment of changes in surge practice since 2007. The research aims to provide an update of a 2007 review of surge capacity and surge capacity mechanisms within international NGOs, which was commissioned by the Emergency Capacity Building Project and was carried out by People In Aid. The 2007 research highlighted the need for global aid organisations to be able to scale up human, financial and material resources in order to effectively fulfil their humanitarian mandates and recommended increased collaboration across the sector in order to improve surge capacity. Another core recommendation was the need to develop surge capacity at country and regional levels as well as at global headquarters…

…CONCLUSIONS
The key conclusions meaning from this research on the current state of surge within the humanitarian sector are as follows:
Conclusion 1
Demand and response: The last decade has seen a rising demand for surge responses, due to the rise in the number of natural disasters, the number of people affected by conflict and their cross-border and regional implications. As a result, humanitarian agencies have to increasingly deploy for surge across multiple crises, simultaneously stretching resources and capacity.

Conclusion 2
Local capacity: There is a need for increased funding and capacity building of local actors. Capacity needs to focus on the ability of aid agencies to maintain sufficient skilled staff, to have flexible internal systems and to support the capacity of partners. Maintaining a pool of qualified staff for surge is a critical issue, particularly at the national level. At the same time, many agencies relying on local partners for surge delivery are concerned with their capacity and are looking for more sustainable ways to support them. This is additionally challenging due to the sporadic and often unpredictable nature of surge.

Conclusion 3
New and emerging surge response models: A number of new models for implementing effective surge responses have been developed in the last decade. These include the creation of specialist support and service providers such as the Assessment Capacities Project (ACAPS), MapAction and the Joint IDP Profiling Service (JIPS) – organisations that are able to provide rapid, specialised and detailed services to support the surge responses of operational humanitarian organisations.

In addition, the growth of specialised technical and sector rosters focusing on humanitarian communication – also known as communicating with communities such as CDAC-N,1 gender, protection and cash transfer programming for example have facilitated the humanitarian sector (and in particular the UN system) in ensuring that specific HR surge needs are met.

Conclusion 4
Improved coordination: There has been an improvement with regard to internal coordination within a number of humanitarian networks and organisations such as the UN and the International Red Cross and Red Crescent Movement. However, there remain ongoing challenges relating to coordination with national governments and new actors. There is a need for the humanitarian sector to address this challenge which goes beyond surge and impacts on humanitarian work in general.

Conclusion 5
Internal organisational coordination: Having organisation-wide and cross-organisation clarity relating to management structures during a response is considered to be beneficial for response operations. A number of humanitarian organisations have developed organisation-wide approaches to surge in the last decade including the implementation of surge policies and plans; accelerated decision-making procedures; and rapid access to financing. There remains room to further advance internal coordination, particularly in relation to coordination with HR, logistics and administration in order to support effective surge responses.

Conclusion 6
Surge staffing and management: The majority of aid agencies have appointed teams or individuals responsible for surge at their global HQs. Many larger agencies have reinforced their international emergency response teams and internal rosters with an increased reliance on expensive yet effective permanent stand-by surge personnel. Ensuring and maintaining consistent surge set-up at national level remains a challenge where agencies are still testing different approaches.

Conclusion 7
Collaboration: There are examples of positive surge collaboration, particularly with federated networks, partnering on rosters and those organisations that operate through local partners, and to a lesser extent with the private sector. However, there are few examples of inter-organisational collaboration (particularly at the global level), resulting in continued uncoordinated and duplicative surge responses. The advantages of increased collaboration – such as cost effectiveness, increased coverage of humanitarian needs, and capacity building in new areas – highlight a clear link to more effective addressing of humanitarian needs. However, humanitarian organisations stress that there are complications and disadvantages to collaboration. These disadvantages are primarily organisational as opposed to needs-related, and include differences in policy and mandate, diverse operational working modalities and competition for resources and staff. There is increased collaboration at the national as opposed to global level, with HQ focusing on finding, organising and mobilising staff and resources and national surge focusing on getting those resources to people in need. This is an area where humanitarian organisations could further learn from national public sector bodies that have developed coordinated collaboration practices.

Conclusion 8
Surge learning: There is a large appetite within the humanitarian aid sector to share learning, knowledge and ideas on surge responses. There is currently no forum or community of practice for this sharing. A major step towards collaboration and reducing duplication would be to develop such a forum or a community for surge practitioners and interested organisations.

Development aid rises again in 2015, spending on refugees doubles – OECD
13/04/2016 – Development aid totalled USD 131.6 billion in 2015, representing a rise of 6.9% from 2014 in real terms as aid spent on refugees in host countries more than doubled in real terms to USD 12 billion. Stripping out funds spent on refugees, aid was still up 1.7% in real terms, according to official data collected by the OECD Development Assistance Committee (DAC).

Official development assistance (ODA) from the 28 countries in the DAC averaged 0.30% of gross national income, the same level as in 2014. Measured in real terms – correcting for inflation and for a sharp depreciation in many DAC country currencies against the dollar last year – ODA is up 83% since 2000, when the Millennium Development Goals were agreed.

The 2015 data show that bilateral aid to the poorest countries rose by 4% in real terms, in line with commitments by DAC donors to reverse recent declines. Bilateral aid, making up around two-thirds of ODA, is aid provided by one country to another country. A survey of donor spending plans through 2019 suggests flows to the poorest countries will keep rising.

Funds spent on hosting or processing refugees in donor countries accounted for 9.1% of ODA in 2015, up from 4.8% in 2014, when in-donor refugee costs totalled USD 6.6 billion. The rise in refugee costs did not significantly eat into development programmes, with around half of donor countries using money from outside their aid budgets to cover refugee costs.

“Countries have had to find large sums to cover the costs of an historic refugee crisis in Europe, and most have so far avoided diverting money from development programmes. These efforts must continue. We also welcome that more aid is being provided to the poorest countries,” said OECD Secretary-General Angel Gurría. “Governments must ensure that development aid keeps rising. They also need to develop long-term options for meeting future refugee costs and the integration of refugees in our societies, while ensuring at the same time that ODA reaches those countries and people that need it the most.”

An unprecedented 1.5 million refugees claimed asylum in OECD countries in 2015, more than a million in Europe. DAC rules allow member countries to count certain refugee-related expenses as ODA for the first year after their arrival. Three countries – Australia, Korea and Luxembourg – do not count refugee costs as ODA. Others – Austria, Greece, Italy, the Netherlands and Sweden – saw refugee costs account for more than 20% of their ODA in 2015.

Humanitarian aid also rose by 11% in real terms in 2015 to USD 13.6 billion.

The 2015 data shows ODA rose in 22 countries, with the biggest increases in Greece, Sweden and Germany. Six countries reported lower ODA, with the steepest declines in Portugal and Australia. Of the several non-DAC members who report their aid flows to the OECD body, the United Arab Emirates posted the highest ODA/GNI ratio in 2015 at 1.09%

Only six of the 28 DAC countries – Denmark, Luxembourg, The Netherlands, Norway, Sweden and the United Kingdom – met a United Nations target to keep ODA at or above 0.7% of GNI.

ODA makes up more than two thirds of external finance for least-developed countries and the DAC is pushing for it to be used more as a lever to generate private investment and domestic tax revenues in poor countries. The DAC is also looking at clarifying the rules for which refugee costs can be counted as ODA.

“We need to remember that the best way to achieve the Sustainable Development Goals and avoid future refugee crises is to continue the current momentum of aid flows, particularly to the neediest and most fragile countries,” said DAC Chair Erik Solheim. “I am glad that we have reversed the recent declines in aid to the poorest countries and that most countries aren’t spending large amounts of their ODA on hosting refugees.”

UNHCR statement on violence on the Greece-FYROM border on 10 April
11 April 2016
(This statement is attributable to UNHCR Spokesperson Adrian Edwards)
Yesterday’s violence at the Greece-Former Yugoslav Republic of Macedonia border near Eidomeni and the extensive scenes we have all seen of teargas in use are a matter of great worry to UNHCR. It should be too for all who are concerned with Europe’s response to the situation of refugees and migrants.

Time and again in recent months we have seen tension unfolding at various European borders, between security forces on the one hand and people fleeing war and in need of help on the other. People get hurt and property is damaged. Harm is done to perceptions of refugees and to Europe’s image alike. Everyone loses.

In recent days media and public attention has focused on how the EU-Turkey agreement is being implemented in the Aegean islands and in Turkey. We should not forget the many other refugees and migrants who continue to be affected by the situation, especially the nearly 46,000 on the Greek mainland who arrived before the agreement took effect. At Eidomeni, about 11,000 have been sleeping for many weeks now in the open in dismal conditions, fuelling hopelessness and despair.

UNHCR is ready to support the voluntary transfer of people to sites to be put in place by the Greek Government, including with the necessary services while registration and processing is taking place. This is urgent. In the meantime, in Eidomeni, UNHCR together with the Greek Government, Greek NGOs and other partners are providing food, medical support, help for persons with specific needs, and prevention and response to sexual and gender based violence.

A wider solution – namely to relocate those who may qualify for international protection to other European States – has been agreed for many months. It needs action.

Violence is wrong whatever the circumstances. UNCHR hopes Europe will take the necessary steps now, and we stand ready to help governments further in fulfilling their obligations to refugees.

Relocation and Resettlement: EU Member States urgently need to deliver
European Commission – Press release
Strasbourg, 12 April 2016
Relocation and Resettlement: EU Member States urgently need to deliver
Today, the Commission gives an update on the progress made up until 11 April 2016 and assesses the actions undertaken by Member States to implement the emergency relocation and European resettlement schemes. Overall, progress since the Commission’s first report has been unsatisfactory: on relocation, little progress has been made since mid-March, while we see good progress on resettlement. Good progress on resettlement is also the result of the EU-Turkey agreement which has shifted greater focus onto resettlement efforts. Greater efforts on relocation, however, are increasingly urgent in view of the humanitarian situation in Greece.

Commissioner for Migration, Home Affairs and Citizenship, Dimitris Avramopoulos said: “EU Member States need to urgently deliver on their political and legal commitment to relocate persons in need of international protection from Greece and Italy. We cannot be satisfied with the results achieved so far. Relocation efforts have to be increased dramatically to reply to the urgent humanitarian situation in Greece and to prevent any deterioration of the situation in Italy. Member States also need to speed up and increase their resettlement efforts. To effectively close the backdoor to irregular and dangerous migration routes, we have to open safe and legal routes to Europe for people in need of international protection. With the EU-Turkey agreement and the 1:1 mechanism in force, it has become even more urgent for Member States to deliver swiftly on their resettlement commitments.”…

International Community Endorses New Initiative to Support Refugees, Host Communities, Recovery and Reconstruction in the Middle East and North Africa
WASHINGTON, April 15, 2016 – Eight nations and the European Commission today pledged a package of more than US$1 billion — US$141 million in grants, US$1 billion in soft loans, US$500 million in guarantees – to a World Bank-led financing initiative in support of Syrian refugees and host communities in Jordan and Lebanon, as well as recovery and reconstruction across the region. The package means that the new facility will be able to generate up to US$800 million in concessional loans in the next year.

Japan, France, the United Kingdom, the United States, Germany, Canada, the Netherlands, Norway and the European Commission each pledged their initial financial contributions to the New Financing Initiative to Support the Middle East and North Africa Region. The pledging occurred at a ministerial conference co-chaired by the President of the World Bank Group, the Secretary General of the United Nations and the President of the Islamic Development Bank Group. The conference brought together ministers from G7, Gulf Cooperation Council, European and MENA countries, as well as the heads of various multilateral development banks and international organizations.

“Today’s strong show of support for the people of the Middle East and North Africa is an example of how the international community can come together to address major challenges,” said World Bank Group President Jim Yong Kim. “These grants mean we can now begin expanding programs to help Jordan and Lebanon cope with the impact of the Syrian refugee crisis, while guarantees will allow multi-lateral development banks to increase their financing in support of countries across the region confronting the multiple consequences of instability. I am confident of mobilizing additional support for recovery and reconstruction, and reaching our goal of raising US$1 billion in grants over the next five years, which we will leverage to create US$3 to 4 billion in much needed concessional financing.”

The new financing initiative was launched jointly by the World Bank Group, the United Nations and the Islamic Development Bank Group in October of last year. The goal of the initiative is to rally the international community and improve coordination among international organizations, to meet the scale of both the MENA region’s humanitarian and development needs. The three organizations formed a working group which over the last six months, together with representatives of 26 supporting and benefitting countries, as well as nine regional and international organizations, has focused on developing the structure of the initiative and a roadmap for its implementation.

Meeting the Real Needs of Syrian Civilians: A Message to the Humanitarian Task Force
April 14, 2016
It has been 60 days since the U.S. and Russia signed the Munich agreement, calling for increased attention to address the dire humanitarian conditions inside Syria. In this time the Humanitarian Task Force (HTF)—established by the 23-member International Syria Support Group (ISSG)—has helped push for UN convoys to enter 31 communities designated by the UN as besieged and hard-to-reach areas delivering short-term supplies for 400,000 people since the beginning of the year, less than 10 percent of people in need in those areas.

This is positive, but it is nowhere near enough. Parties to the conflict continue to prevent access to many areas and even when convoys are approved, vital items such as medical supplies continue to be removed. The Syrian conflict is among the worst catastrophe in modern times and reflects the absolute failure of the international community to halt the brutal and unnecessary cycle of violence. At this critical time, we must not let Syria also be a humanitarian failure. The international community must redouble efforts to hold parties to the conflict accountable and press for humanitarian breakthroughs that can have a real impact for Syria’s civilians struggling to meet their basic needs. The ISSG and HTF are central to achieving this aim.

NGOs working in Syria have four key messages for the ISSG and the HTF:
.1. Focus beyond delivery of commodities to enable humanitarian activities that support the resilience of Syrians in the longer term.
The recent convoys are welcomed, but they do not represent sustained, humanitarian access. Humanitarian access is not a one-off or periodic delivery of commodities. And we are concerned that an over-emphasis on the convoys has detracted from other types of assistance that are needed just as urgently, including medical, health, water, sanitation, education, psychosocial support, and child protection services. Humanitarian access should mean that doctors and health care workers have regular access and supplies to tend to the sick and evacuate those in urgent need of care, that farmers have access to seeds and fertilizer, that clean water is available and sanitation services provided, and that children no longer have to resort to eating grass out of hunger.

Syrian organizations on the front lines consistently say communities require these ongoing services and the ability to produce and grow their own food. The delivery of food parcels, shelter and household items, while important, is the most basic option. While necessary in some places, humanitarians, if allowed, can also engage in more sustainable and efficient approaches. In addition to emergency assistance, the focus should also be on the planting season, the provision of livestock, the winter harvest and the development of supply chains for services. Humanitarian organizations have the capacity to develop seed banks and markets during war, even in besieged or conflict-affected communities. In Aleppo governorate, for example, NGOs have supported farmers in planting 3,900 hectares of wheat in the past several months and have provided seeds and fertilizer purchased from the local markets. These efforts can help assist with emergency needs and help Syrians to be active participants in providing for their families and communities.

.2. Ensure future convoys are more effective in meeting the priority needs of Syrians and place increased emphasis on full humanitarian access.
Any success in bringing life-saving assistance to those in besieged and hard-to-reach areas should be welcomed, but their effectiveness could be significantly improved. Most importantly, future convoys must be informed and driven by impartial needs assessment, which will only be possible if local Syrian organizations and local stakeholders are permitted access. They should include personnel to deliver services and repair infrastructure, such as water and health infrastructure. They should insist on the ability to evacuate those needing urgent medical attention, as well as delivering medicine, surgical equipment and other medical supplies. They should deliver inputs for food production and other items contributing to greater resilience. They should include the ability to independently assess and monitor aid delivery to ensure it responds to what is most needed. Finally, the convoys should carry with them dedicated protection monitors who can report back with much-needed information about vulnerable groups, particularly women and children, to enable better protection services.

.3. Push for access negotiations that extend to all humanitarian actors, not just UN agencies.
The ISSG should focus on freedom of movement for aid to reach communities by those best placed to reach them. This should extend in particular to Syrian humanitarian actors that are serving their communities with emergency and longer-term support—both those that are registered with Damascus and those that are not able to obtain registration. Many Syrian humanitarian workers are placing themselves at great risk to serve their communities. Unregistered humanitarians are currently cast as criminals. Humanitarian staff and partners should not have to work under the threat of prosecution, aerial bombardments, arrests, abduction, or detention simply for serving civilians. The ISSG should prioritize the protection of aid workers and recognition by all parties of the impartiality of aid agencies, in line with customary international law.

.4. Reject the use of humanitarian aid as a political bargaining chip or a weapon of war.
To date, it is clear that the approval for UN cross line convoys is thoroughly linked to political negotiations. We are concerned that convoy permission is being used as a means of enticing populations into entering or maintaining localized truce agreements, while simultaneously penalizing those that will not.The continued exclusion of places like Darayya, Duma, and Moadamiya from the approved list of convoys suggests that approvals are tied to the political process and control of these high priority areas – not based on humanitarian need. Besiegement cannot continue to be used as a weapon against civilians and humanitarian aid cannot be a tool for political wrangling by a state. Fundamental humanitarian values are being challenged and this is a test of the international community’s commitment to humanitarian principles. The ISSG should resist and prevent any future attempts to link humanitarian access to other political negotiations. Humanitarian values should not be compromised by political agendas.

This framework is achievable if parties to the conflict are finally held accountable for their obligations—we owe it to the Syrian women, men and children suffering from this seemingly intractable conflict to uphold these standards. When humanitarian standards are not met and when humanitarian assistance is not responsive to the real needs on the ground, not sufficiently coordinated, and not effectively monitored it brings a terrible human cost. Failing to live up to these standards means well-intentioned aid is less effective, or at worst, even harmful. There must be a stronger focus on scaling up assistance that is based on locally-driven assessments, rooted in local partnerships, and strengthening local markets where they are functioning. Parties to the conflict must be pressed to allow these interventions to take place.

Syrians have endured five years of brutal conflict, but they have not lost their resilience or their hope. We have seen Syrians adapt and cope with the most intolerable conditions—and we will do our best to support them in every way possible. As humanitarians, it is not within our power to end the war—but we can speak loudly about our commitment to serve those in need and not give up on the values we hold closely. We call on parties to the conflict to urgently come to the negotiating table and commit to end the violence once and for all, as the only way to finally end the massive human suffering. In the meantime, there must be a firm commitment to regaining the momentum on humanitarian access that was seen in the days after the Munich Agreement. The ISSG and HTF must make this a top priority, and do much better to meet the needs of Syrian civilians.

The following organizations, many of whom are operational in besieged and hard-to-reach areas, support this statement:
Bihar Relief
Bonyan Organization
CARE International
Caritas Switzerland
Choubbak Amal
Cham for Development
Elaff Union for Relief and Development
Emissa
International Humanitarian Relief
Live 4 Syria (L4S)
Maram Foundation
Maddad
Mercy Corps
Nabea Al Hayat
Olive Branch
Space of Hope
Syrian American Medical Society (SAMS)
Syrian NGO Alliance
Syria Relief and Development
Syria Relief Network
Qatar Red Crescent
World Vision International
ZOA

Deportations of refugees and migrants from Greece must be halted
15 April 2016
Deportations of refugees and migrants from Greece to Turkey must be halted immediately and people wanting to seek asylum should not be kept in detention, said Oxfam, Norwegian Refugee Council and Solidarity Now.

Refugees could be returned to Turkey without having had a proper asylum hearing or without receiving the necessary information about their legal rights, the aid agencies warn. Forced returns to Turkey were restarted after a pause last week.

Over 6,300 refugees and migrants have arrived on the Greek islands since the EU-Turkey deal came into effect on 20 March, and are being arbitrarily held in detention camps. The majority of these new arrivals have applied for asylum. While the European Commission said on 4 April that Greece had sent 1,500 asylum case officers and police officers to the islands, there is no evidence of this additional capacity on the ground.

The Greek Asylum Service remains severely understaffed with only a handful of officials and caseworkers on the island to process cases, who are struggling to cope with the demand of asylum requests. Unless the promised additional capacity arrives, the quality of the asylum process will be severely compromised.

Compounding the pressure are new ‘emergency measures’ adopted into law by the Greek Government on 3 April, which includes an expedited ‘fast track’ asylum hearing to determine admissibility. Under these new procedures, Greek asylum officials must undertake complex asylum examinations, including decisions on whether or not Turkey is considered a safe country for return. These complex reviews that determine a person’s future take place in just one day.

Farah Karimi, Oxfam Executive Director said: “Thousands are being held in squalid detention centres on the Greek Islands – this is the state of Europe in 2016 – while the returns deal was pushed through to the detriment of these stranded suffering people by the EU which claims to be a bastion for human rights. Shame on the EU for prioritizing detention and deportation over people’s rights to safety and dignity.”

Even with the support of this promised extra staff, it will take weeks to process the asylum claims of the more than 6,300 people currently being held in overcrowded detention centres on the Greek islands.

Jan Egeland, Secretary General of the Norwegian Refugee Council said, “It is shocking to see how Europe is mistreating men, women and children fleeing to our continent for protection from war and persecution. Asylum seekers are kept with migrants in overcrowded detention camps deprived of dignity and basic human rights. Disgraceful conditions are placing people at risk. European politicians hold the keys to this crisis, and should immediately open the camps.”

The aid agencies claim that living conditions in the detention centres are deteriorating rapidly with many people sleeping outdoors or in cramped shelters.

Epaminondas Farmakis, Managing Director of SolidarityNow said: “Europe can no longer look away from this inhumane situation in which people continue to risk their lives. It must ensure that the people on the move will live in open and secure structures as long as they remain in the country. It is more important, however, to immediately stop deportations to Turkey and to guarantee that these people can exercise their basic right- that of asylum.”

There remains no routine identification of vulnerable people and aid agencies report ongoing detention of children, pregnant women, people with disabilities and those with medical needs. In Lesbos and Chios, Pakistanis who perceive their treatment to be discriminatory have threatened to commit suicide.

There is, additionally, growing insecurity as a result of rising frustration and tensions. There have already been incidents of violence at night and women in particular are extremely vulnerable under such circumstances.

Aid agencies are calling on Europe to:
– Immediately halt all returns from Greece to Turkey.
– Immediately open all camps where people have expressed intention to seek asylum.
– Immediately improve security to ensure a protective environment for all people inside the closed facility.
– Maintain the integrity of the asylum claims process and ensure people have access to legal aid as a matter of urgency.
– Increase the number of staff working with the Greek Asylum Service on the islands to process these claims and ensure people are able to access their right to claim asylum before any deportation order is issued.
– Put an end to arbitrary arrests and detentions. The increasing use of detention as a restriction of the freedom of movement of asylum-seekers on the grounds of their irregular entry is a major concern.

Europe is imprisoning refugee children
Greece
Norwegian Refugee Council
(04.04.2016
“It is outrageous that young and innocent children fleeing war are kept imprisoned behind barbed wire in overcrowded detention facilities on European soil”, said Secretary General of the Norwegian Refugee Council Jan Egeland.

Refugees and migrants arriving on the Greek islands after the EU-Turkey deal came into effect on 20 March are being sent to closed camps – while awaiting a chance to seek asylum or face being returned to Turkey. Some of the men, women and children on the Greek islands have now been kept in detention for up to two weeks.

“The camps in Greece need to be opened immediately. There are no justifications for keeping asylum seekers in Greece in closed facilities and the situation inside the camps is deteriorating rapidly, putting people in danger”, said Egeland.

“The way the EU-Turkey deal is being implemented at the moment is a disgrace to Europe”, he added. “We would never have accepted this for our own children – and we cannot accept it for others.”

NRC and other humanitarian organizations have suspended some activities at the registration center at Chios after it was turned into a detention facility.

“We cannot support the running of enforced detention facilities, but we are ready to assist if the authorities agree to open the camps”, said Egeland.

According to the plan, Greece may start returning people to Turkey as early as Monday 4 April, despite concerns that many of those arriving have not had their legal rights explained to them, nor had a chance to receive a fair asylum hearing.

“Europe gave birth to the Refugee Convention when our own forefathers were displaced by war. Now Europe risks becoming the same convention’s burial agent. No people should be returned to Turkey before necessary safeguards are in place – and all people who seek asylum in Greece must be secured a fair, individual process, said Egeland.

The agreement with Turkey, aimed at discouraging people from crossing the Mediterranean from Turkey to Greece, may end up putting refugees and migrants at increased risk, argues NRC.

“As long as we are not solving the real problems, the wars in Syria, Iraq and Afghanistan and the desperate situation for refugees in neighbouring countries, people will continue to flee to Europe for protection. We fear people will seek other and more dangerous routes, like going from Libya to Italy or across the Black Sea”, said Egeland.

UNICEF urges full hearings for refugee and migrant children stranded in Greece
GENEVA, 6 April 2016 – With the process of returning refugees and migrants from the Greek islands to Turkey underway as part of the EU-Turkey agreement, UNICEF reminds States of their duty to care and protect all children and give them a full and fair hearing when deciding on their future.

UNICEF welcomes a new Greek law, which came into force on 4 April, exempting certain vulnerable groups, including unaccompanied and separated children, children with disabilities, victims of distress and trauma, pregnant women and women who recently gave birth, from “exceptional border procedures” or returns. However more needs to be done.

Currently more than 22,000 refugee and migrant children are stranded in Greece, facing an uncertain future and even forms of detention since the agreement went into effect last month.
UNICEF calls for a well-managed process to be put in place to determine each child’s best interests and fulfill the basic needs of all children – including adequate accommodation, health care and protection against trafficking and exploitation in line with international and European laws.

Children have specific grounds to claim international protection; such as if faced with the threat of recruitment to armed forces or forced marriage. The European Commission has stipulated that returns will be in accordance with international and European law.

“Any decision about any child, whether a toddler or a teenager, whether with family or not, should be guided by the best interests of that child,” said Marie-Pierre Poirier, Special Coordinator for the Refugee and Migrant Crisis in Europe.
“Children need to be heard. A rushed decision to return can lead to a rash result and going back to a place of fear and violence. Children, no matter where they come from, must have access to basic services at all times,” she added.

Capacity to care and support for unaccompanied and separated children has been overstretched in Greece. With nowhere to house them, many are taken into temporary “protective custody”, or de facto detention within closed first reception or police facilities, for increasingly extended periods.

“UNICEF is concerned about reports that some children are being detained due to their migration status. Escaping war and seeking survival is never a crime,” said Poirier.

Unaccompanied and separated children, are among the most vulnerable and make up about 10 percent of all refugee and migrant children in Greece, or some 2,000, but not all are registered. Between January and mid-March 2016, 1,156 unaccompanied and separated children had been registered in Greece (an increase of over 300 per cent in the rate of registration compared to the same period in 2015).

The first returns to Turkey from the Greek islands were monitored this week by UNICEF’s partners, in Dikili port, Izmir province. UNICEF will continue to work closely with Turkish Government authorities to provide humanitarian assistance. Turkey currently hosts over 2.7 million Syrian refugees.

UNICEF has been helping Syrian refugee children and families since 2012. Last year UNICEF, working with government and civil society partners, provided support to over 400,000 Syrian children with education, protection and basic services.

Increasing Economic Growth in Fragile States Can Help Prevent Future Refugee Crises—World Bank President
BERLIN, April 5, 2016—World Bank Group President Jim Yong Kim today said that the world’s powers need to pay far greater attention to boosting developing economies and creating jobs in the most fragile countries in order to give more opportunity to people in those nations and to prevent future refugee crises.

Speaking at the German Institute for Economic Research, Kim noted that boosting inclusive economic growth and reducing extreme poverty was critical to helping avoid an even greater refugee crisis in the coming years. Citing World Bank projections that extreme poverty globally would only fall to 6 percent by 2030 if economic growth mirrors the average growth rate of the last decade, Kim said that would mean that in the most fragile states, the poverty rate would remain extraordinarily high, at 47 percent of the population.

“All of Europe and all of Germany are rightly focused on the refugee crisis on the continent today, but if fragile states still have 47 percent of their people living on less than 2 euros a day by 2030, while the developed world prospers, the flow of migrants and refugees will not stop,” said Kim.

Kim stated that how the World Bank Group engages in the fight against poverty will need to change, and that global issues such as forced displacement carry important implications for how the World Bank will operate going forward.

“For instance, our Board – in a groundbreaking decision just last month – offered Jordan, a middle-income country, rates that we had reserved for the poorest countries, because of their enormous generosity in hosting more than 1 million Syrian refugees,” Kim stated. “We have provided an initial $100 million loan at concessional rates normally reserved for only the poorest countries and will provide an additional $200-400 million dollars in concessional financing to build a special economic enterprise zone, which will help create many thousands of jobs for both Syrian refugees and Jordanians over the next five years. This is a truly novel effort that must now be taken to scale and implemented in other countries as well.”…

World Bank Group, UNICEF urge greater investment in early childhood development
WASHINGTON, April 14, 2016 – World Bank Group President Jim Yong Kim and UNICEF Executive Director Anthony Lake today jointly urged global and national leaders to step up and accelerate action and investments in nutrition and early childhood development (ECD) programmes as a critical foundation for equitable development and economic growth.

The two organizations announced the establishment of a new alliance that aims to make ECD a global policy, programming and public spending priority, to give all young children access to quality services that improve their health, nutrition, learning ability and emotional well-being.

Advances in neuroscience and recent economic studies show that early childhood experiences have a profound impact on brain development and on subsequent learning, health, and adult earnings. Children who are poorly nourished and nurtured, or those who do not receive early stimulation, are likely to learn less in school and earn less as adults.

Globally, millions of children under the age of five are at risk of never reaching their full developmental potential. One out of four children under five (159 million) are stunted due to poor nutrition, with numbers significantly higher in parts of Africa and South Asia. Nearly half of all 3 to 6 year olds don’t have access to pre-primary education. In Sub-Saharan Africa, 80 percent are not enrolled in pre-primary programmes.

“The time has come to treat childhood stunting as a development and an economic emergency,” said World Bank Group President Jim Yong Kim. “How will countries compete in what will certainly be a more digitalized global economy in the future if a third or more of their children are stunted? Our failure to make the right investments in early childhood development is condemning millions of children to lives of exclusion. We can’t promise to equalize development outcomes, but we can insist on equalizing opportunity.”…

African Partners, World Bank Commit to Provide Identification to Millions
WASHINGTON, April 14, 2016 —African leaders and development partners agreed on a common approach for accelerating the provision of unique identification to millions of people in Africa as a means to foster more inclusive economies and greater regional integration.

At a high-level meeting on Wednesday during the World Bank-IMF Spring Meetings, representatives from the African Union, the Economic Community of West African States, the East African Community, African Ministers of Finance, development partners and the World Bank Group committed to join efforts in providing identification to millions of people across Africa through a more integrated and regional approach.

“Identification provides a foundation for other rights and gives a voice to the voiceless,” said World Bank Vice President for Africa Makhtar Diop. “It is indispensable for ensuring access to education, financial services, and health and social benefits.”

The World Bank will work with countries in collaboration with regional bodies like the African Union to develop a set of harmonized standards to support interoperability between national identification systems and mutual recognition of identification documents.

“People have a right to legal identity and recognition which are essential prerequisites for decent work, livelihoods and well-being,” said African Union Commission Deputy Chairperson, Erastus Mwencha. “Those issues are at the core of Agenda 2063 and the Sustainable Development Goals, and require access to technology, resources, as well as advocacy and capacity.”…

Investing in treatment for depression and anxiety leads to fourfold return
World Health Organization/World Bank Group press release – Depression and anxiety disorders cost the global economy US$1 trillion each year
12 April 2016, Washington DC, USA — Every US$ 1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work, according to a new WHO-led study which estimates, for the first time, both the health and economic benefits of investing in treatment of the most common forms of mental illness globally. The study, published today in The Lancet Psychiatry, provides a strong argument for greater investment in mental health services in countries of all income levels.

“We know that treatment of depression and anxiety makes good sense for health and wellbeing; this new study confirms that it makes sound economic sense too,” said Dr Margaret Chan, Director-General of the World Health Organization (WHO). “We must now find ways to make sure that access to mental health services becomes a reality for all men, women and children, wherever they live.”

Depression and anxiety are increasing
Common mental disorders are increasing worldwide. Between 1990 and 2013, the number of people suffering from depression and/or anxiety increased by nearly 50%, from 416 million to 615 million. Close to 10% of the world’s population is affected, and mental disorders account for 30% of the global non-fatal disease burden. Humanitarian emergencies and ongoing conflict add further to the need for scale-up of treatment options. WHO estimates that, during emergencies, as many as 1 in 5 people are affected by depression and anxiety.
Returns on investment in treatment far outweigh the costs

The new study calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the fifteen years from 2016-2030. The estimated costs of scaling up treatment, primarily psychosocial counselling and anti-depressant medication, amounted to US$ 147 billion. Yet the returns far outweigh the costs. A five percent improvement in labour force participation and productivity is valued at US$ 399 billion, and improved health adds another US$ 310 billion in returns.

However, current investment in mental health services is far lower than what is needed. According to WHO’s Mental Health Atlas 2014 survey, governments spend on average 3% of their health budgets on mental health, ranging from less than 1% in low-income countries to 5% in high-income countries.

“Despite hundreds of millions of people around the world living with mental disorders, mental health has remained in the shadows,” said Jim Yong Kim, President of the World Bank Group. “This is not just a public health issue—it’s a development issue. We need to act now because the lost productivity is something the global economy simply cannot afford. ”…