The Lancet Infectious Diseases – Apr 2016

The Lancet Infectious Diseases
Apr 2016 Volume 16 Number 4 p385-506 e34-e63
http://www.thelancet.com/journals/laninf/issue/current

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Editorial
Costs, compassion, and the case for vaccination
The Lancet Infectious Diseases
DOI: http://dx.doi.org/10.1016/S1473-3099(16)00139-0
Summary
If you want an overview of the major political issues in the UK, the government’s petitioning website is a good place to start. Calls for action on Islamic State, immigration, and the National Health Service (NHS) have all garnered hundreds of thousands of signatures. But the most popular current petition—indeed, the issue that has received the most signatures ever on the site—concerns meningitis B vaccination.

Public funding for research on antibacterial resistance in the JPIAMR countries, the European Commission, and related European Union agencies: a systematic observational analysis
Ruth Kelly, Ghada Zoubiane, Desmond Walsh, Rebecca Ward, Herman Goossens
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Open Access

Preventive malaria treatment for contacts of patients with Ebola virus disease in the context of the west Africa 2014–15 Ebola virus disease response: an economic analysis
Cristina Carias, Bradford Greening Jr, Caresse G Campbell, Martin I Meltzer, Mary J Hamel
449

Potential for reduction of burden and local elimination of malaria by reducing Plasmodium falciparum malaria transmission: a mathematical modelling study
Jamie T Griffin, Samir Bhatt, Marianne E Sinka, Peter W Gething, Michael Lynch, Edith Patouillard, Erin Shutes, Robert D Newman, Pedro Alonso, Richard E Cibulskis, Azra C Ghani
Open Access

Association between spending on social protection and tuberculosis burden: a global analysis
Andrew Siroka, Ninez A Ponce, Knut Lönnroth

Lancet Global Health – Apr 2016

Lancet Global Health
Apr 2016 Volume 4 Number 4 e215-e286
http://www.thelancet.com/journals/langlo/issue/current

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Comment
A second affordable oral cholera vaccine: implications for the global vaccine stockpile
Sachin N Desai, Lorenzo Pezzoli, Stephen Martin, Alejandro Costa, Carmen Rodriguez, Dominique Legros, William Perea
Summary
On Dec 23, 2015, WHO prequalified a second affordable oral cholera vaccine (OCV), Euvichol (Eubiologics, South Korea), which is expected to double current global OCV production and has the potential to further increase production capacity.1 The increased production will have implications for vaccine availability and reduced costs per dose, and will ultimately represent an added value for global cholera prevention and control.

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Articles
Accuracy of the WHO Haemoglobin Colour Scale for the diagnosis of anaemia in primary health care settings in low-income countries: a systematic review and meta-analysis
Heiko Marn, Julia Alison Critchley

Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials
NEOVITA Study Group

The UN Commission on Life Saving Commodities 3 years on: global progress update and results of a multicountry assessment
Paul M Pronyk, Bennett Nemser, Blerta Maliqi, Nora Springstubb, Diana Sera, Rouslan Karimov, Elizabeth Katwan, Benedicte Walter, Pascal Bijleveld, UNCoLSC Technical Resource Teams, UN Agency Leads, UNCoLSC Monitoring and Evaluation Advisory Group

The Neglected Dimension of Global Security — A Framework for Countering Infectious-Disease Crises

New England Journal of Medicine
March 31, 2016 Vol. 374 No. 13
http://www.nejm.org/toc/nejm/medical-journal
Special Report
The Neglected Dimension of Global Security — A Framework for Countering Infectious-Disease Crises
Peter Sands, M.P.A., Carmen Mundaca-Shah, M.D., Dr.P.H., and Victor J. Dzau, M.D.
N Engl J Med 2016; 374:1281-1287 March 31, 2016 DOI: 10.1056/NEJMsr1600236
[Initial text]
Pandemics and epidemics have ravaged human societies throughout history. The plague, cholera, and smallpox killed tens of millions of people and destroyed civilizations. In the past 100 years, the “Spanish Flu” of 1918–1919 and HIV–AIDS caused the deaths of nearly 100 million people.

Advances in medicine have transformed our defenses against the threat of infectious disease. Better hygiene, antibiotics, diagnostics, and vaccines have given us far more effective tools for preventing and responding to outbreaks. Yet the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS), and the recent West African Ebola outbreak show that we cannot be complacent (Figure 1). Infectious-disease outbreaks that turn into epidemics and potential pandemics can cause massive loss of life and huge economic disruption.

Indeed, Ebola demonstrated how ill-prepared we are for such infectious-disease crises. There were failures at almost every level. Identifying the outbreak in the community and raising alerts took too long. Local health systems were quickly overwhelmed. Response teams did not adequately engage communities and deepened distrust in health authorities. The international response was slow, cumbersome, and poorly coordinated. Rapid diagnostics, protective equipment, effective therapeutics, and a vaccine were lacking. Ultimately, the crisis was contained, thanks to the courage and commitment of medical staff and communities on the ground and a massive deployment of international resources. Yet the cost in human lives and economic and social disruption was far greater than it should have been.

In this context, the Commission on a Global Health Risk Framework for the Future was initiated in the spring of 2015. Eight sponsors came together to support the initiative. The U.S. National Academy of Medicine provided leadership and guidance. An International Oversight Group comprising 12 leaders in science, business, and government was established to set up and guide the Commission…

Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 2 April 2016)

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Research Article
Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa
Muhammad Hamza, Maryam A. Idris, Musa B. Maiyaki, Mohammed Lamorde, Jean-Philippe Chippaux, David A. Warrell, Andreas Kuznik, Abdulrazaq G. Habib
Research Article | published 30 Mar 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004568
Author Summary
Antivenom is the main intervention against snakebite poisoning but is relatively scarce, unaffordable and the situation has been compounded further by the recent cessation of production of effective antivenoms and marketing of inappropriate products. Given this crisis, we assessed the cost effectiveness of providing antivenoms in West Africa by comparing costs associated with antivenom treatment against their health benefits in decreasing mortality. In the most comprehensive analyses ever conducted, it was observed the incremental cost effectiveness ratio of providing antivenom ranged from $1,997 in Guinea Bissau to $6,205 for Liberia and Sierra-Leone per death averted while cost per Disability Adjusted Life Year (DALY) averted ranged from $83 for Benin Republic to $281 for Sierra-Leone. There is probability of 97.3–100% that antivenoms are very cost-effective in the analyses. These demonstrate antivenom is highly cost-effective and compares favorably to other commonly funded healthcare interventions. Providing and broadening antivenom access throughout areas at risk in rural West Africa should be prioritized given the considerable reduction in deaths and DALYs that could be derived at a relatively small cost.

Knowledge and Perceptions about Clinical Trials and the Use of Biomedical Samples: Findings from a Qualitative Study in Rural Northern Ghana

PLoS One
http://www.plosone.org/
[Accessed 2 April 2016]

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Research Article
Knowledge and Perceptions about Clinical Trials and the Use of Biomedical Samples: Findings from a Qualitative Study in Rural Northern Ghana
Samuel Chatio, Frank Baiden, Fabian Sebastian Achana, Abraham Oduro, James Akazili
Research Article | published 01 Apr 2016 | PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0152854
Abstract
Introduction
Clinical trials conducted in sub-Saharan Africa have helped to address the prevalent health challenges. The knowledge about how communities perceive clinical trials is however only now evolving. This study was conducted among parents whose children participated in past clinical trials in northern Ghana to assess their knowledge and perceptions of clinical trials and the use of biomedical samples.
Method
This was a qualitative study based on eighty in-depth interviews with parents. The participants were randomly selected from among parents whose children were enrolled in a clinical trial conducted in the Kassena-Nankana districts between 2000 and 2003. The interviews were transcribed and coded into emergent themes using Nvivo 9 software. The thematic analysis framework was used to analyze the data.
Results
Study participants reported that clinical trials were carried out to determine the efficacy of drugs and to make sure that these drugs were suitable for human beings to use. The conduct of clinical trials was perceived to have helped to reduce the occurrence of diseases such as malaria, cerebrospinal meningitis and diarrhea. Quality of care was reported to be better in clinical trials than in the routine care. Parents indicated that participation in clinical trials positively influenced their health-seeking behavior. Apprehensions about blood draw and the use to which samples were put were expressed, with suspicion by a few participants that researchers sold blood samples. The issue of blood draw was most contentious.
Conclusion
Parents perception about the conduct of clinical trials in the study districts is generally positive. However, misconceptions made about the use of blood samples in this study must be taken seriously and strategies found to improve transparency and greater community acceptability.

Global fishery prospects under contrasting management regimes

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 2 April 2016)

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Biological Sciences – Sustainability Science – Social Sciences – Environmental Sciences:
Global fishery prospects under contrasting management regimes
Christopher Costello, Daniel Ovando, Tyler Clavelle, C. Kent Strauss, Ray Hilborn, Michael C. Melnychuk, Trevor A. Branch, Steven D. Gaines, Cody S. Szuwalski, Reniel B. Cabral, Douglas N. Rader, and Amanda Leland
PNAS 2016 ; published ahead of print March 28, 2016, doi:10.1073/pnas.15204201
Significance
What would extensive fishery reform look like? In addition, what would be the benefits and trade-offs of implementing alternative approaches to fisheries management on a worldwide scale? To find out, we assembled the largest-of-its-kind database and coupled it to state-of-the-art bioeconomic models for more than 4,500 fisheries around the world. We find that, in nearly every country of the world, fishery recovery would simultaneously drive increases in food provision, fishery profits, and fish biomass in the sea. Our results suggest that a suite of approaches providing individual or communal access rights to fishery resources can align incentives across profit, food, and conservation so that few trade-offs will have to be made across these objectives in selecting effective policy interventions.
Abstract
Data from 4,713 fisheries worldwide, representing 78% of global reported fish catch, are analyzed to estimate the status, trends, and benefits of alternative approaches to recovering depleted fisheries. For each fishery, we estimate current biological status and forecast the impacts of contrasting management regimes on catch, profit, and biomass of fish in the sea. We estimate unique recovery targets and trajectories for each fishery, calculate the year-by-year effects of alternative recovery approaches, and model how alternative institutional reforms affect recovery outcomes. Current status is highly heterogeneous—the median fishery is in poor health (overfished, with further overfishing occurring), although 32% of fisheries are in good biological, although not necessarily economic, condition. Our business-as-usual scenario projects further divergence and continued collapse for many of the world’s fisheries. Applying sound management reforms to global fisheries in our dataset could generate annual increases exceeding 16 million metric tons (MMT) in catch, $53 billion in profit, and 619 MMT in biomass relative to business as usual. We also find that, with appropriate reforms, recovery can happen quickly, with the median fishery taking under 10 y to reach recovery targets. Our results show that commonsense reforms to fishery management would dramatically improve overall fish abundance while increasing food security and profits.

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH) February 2016

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
February 2016 Vol. 39, No. 2
http://www.paho.org/journal/

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ARTÍCULOS DE INVESTIGACIÓN ORIGINAL/ORIGINAL RESEARCH ARTICLES
Establishing national noncommunicable disease surveillance in a developing country: a model for small island nations[Introducción de la vigilancia nacional de las enfermedades no transmisibles en un país en desarrollo: un modelo para las pequeñas naciones insulares]
Angela M. Rose, Ian R. Hambleton, Selvi M. Jeyaseelan, Christina Howitt, Rhea Harewood, Jacqueline Campbell, Tanya N. Martelly, Tracy Blackman, Kenneth S. George, Trevor A. Hassell, David O. Corbin, Rudolph Delice, Patsy Prussia, Branka Legetic, and Anselm J. Hennis

Traslación a la práctica de estrategias de empoderamiento en la prevención del dengue: facilitadores y barreras [Translation into practice of empowerment strategies for dengue prevention: facilitators and barriers]
Dennis Pérez, Marta Castro, Ángel Manuel Álvarez, Lizet Sánchez, María Eugenia Toledo, Damayanti Matos, Patrick Van der Stuyft y Pierre Lefèvre

Determinants of tuberculosis in countries of Latin America and the Caribbean [Determinantes de la tuberculosis en los países de América Latina y el Caribe]
Gustavo Bergonzoli, Luis G. Castellanos, Rodolfo Rodríguez, and Lina María Garcia

Diagnóstico de salud y percepción de riesgos, elementos clave para una propuesta de intervención en comunidades indígenas en México [Health diagnosis and risk perception: key elements of a proposed intervention for indigenous communities in Mexico]
Mónica Terán-Hernández, Fernando Díaz-Barriga y Ana Cristina Cubillas-Tejeda

Analysis of registered cancer clinical trials in Latin America and the Caribbean, 2007–2013 [Análisis de los ensayos clínicos sobre el cáncer registrados en América Latina y el Caribe del 2007 al 2013]
Bridget Lee, Luis G. Cuervo, Pablo Rodríguez-Feria, and Silvana Luciani

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OPINIÓN Y ANÁLSIS/OPINION AND ANALYSIS
Salud global: una visión latinoamericana [Global health: a Latin American vision]
Álvaro Franco-Giraldo

Engage key social concepts for sustainability

Science
01 April 2016 Vol 352, Issue 6281
http://www.sciencemag.org/current.dtl

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Policy Forum
Engage key social concepts for sustainability
By Christina C. Hicks, Arielle Levine, Arun Agrawal, Xavier Basurto, Sara J. Breslow, Courtney Carothers, Susan Charnley, Sarah Coulthard, Nives Dolsak, Jamie Donatuto, Carlos Garcia-Quijano, Michael B. Mascia, Karma Norman, Melissa R. Poe, Terre Satterfield, Kevin St. Martin, Phillip S. Levin
Science01 Apr 2016 : 38-40
Summary
With humans altering climate processes, biogeochemical cycles, and ecosystem functions (1), governments and societies confront the challenge of shaping a sustainable future for people and nature. Policies and practices to address these challenges must draw on social sciences, along with natural sciences and engineering (2). Although various social science approaches can enable and assess progress toward sustainability, debate about such concrete engagement is outpacing actual use. To catalyze uptake, we identify seven key social concepts that are largely absent from many efforts to pursue sustainability goals. We present existing and emerging well-tested indicators and propose priority areas for conceptual and methodological development.

Social Science & Medicine – Volume 153, Pages 1-266 (March 2016)

Social Science & Medicine
Volume 153, Pages 1-266 (March 2016)
http://www.sciencedirect.com/science/journal/02779536/153

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Review Article
Polio vaccine hesitancy in the networks and neighborhoods of Malegaon, India
Original Research Article
Pages 99-106
Jukka-Pekka Onnela, Bruce E. Landon, Anna-Lea Kahn, Danish Ahmed, Harish Verma, A. James O’Malley, Sunil Bahl, Roland W. Sutter, Nicholas A. Christakis
Abstract
Objectives
Eradication and control of childhood diseases through immunization can only work if parents allow their children to be vaccinated. To learn about social network factors associated with polio vaccine hesitancy, we investigated social and spatial clustering of households by their vaccine acceptance status in Malegaon, India, an area known for vaccine refusal and repeated detection of polio cases.
Methods
We interviewed family heads from 2462 households in 25 neighborhoods in July 2012 and constructed social networks based on advice seeking from other households. We restricted our main analyses to surveyed households for which we also had data on whether they accepted the polio vaccine for their eligible children or not.
Results
Data from 2452 households was retained and these households made 2012 nominations to 830 households. Vaccine-refusing households had fewer outgoing ties than vaccine-accepting households. After excluding 24 isolated households, vaccine-refusing households had 189% more nominations to other vaccine-refusing households (93% more in the largest component of the network) compared to vaccine-accepting households, revealing that vaccine-refusing households cluster in the social network. Since roughly half of all ties connect households within neighborhoods, vaccine-refusing clusters lie in spatially localized “pockets”.
Conclusions
The social (and spatial) clustering of vaccine-refusing households could be leveraged to tailor communication strategies to improve vaccine acceptance and community perceptions of immunization programs for polio and other vaccine-preventable diseases.

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Does parental migration really benefit left-behind children? Comparative evidence from Ethiopia, India, Peru and Vietnam
Original Research Article
Pages 230-239
Cuong Viet Nguyen
Abstract
Millions of children are left behind when their parents migrate from home to another place. This study examines whether parental migration can affect health and cognitive ability of left-behind children aged at 5–8 years old in Ethiopia, India, Peru, and Vietnam. It uses data on 7725 children in the four countries collected from Young Lives surveys in 2007 and 2009. It finds that although parental migration helps families increase per capita consumption, it does not improve health and cognitive ability of children. The effect of parental migration varies across different countries and different types of migration. In Ethiopia, parental migration does not have a significant effect on children. However, parental migration reduces health outcomes of children in other three countries and decreases cognitive ability test scores in India and Vietnam. The negative effect on children tends to be higher for long-term parental migration than short-term parental migration.
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Citizenship or Repression? Coca, Eradication and Development in the Andes

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 2 April 2016]

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Research Article
Citizenship or Repression? Coca, Eradication and Development in the Andes
Thomas Grisaffi, Kathryn Ledebur
Abstract
For over two decades the US has funded repressive forced coca eradication in Peru, Colombia and Bolivia to reduce the illegal cocaine trade. These policies have never met their stated goals and have generated violence and poverty. In 2006 Bolivia definitively broke with the US anti-narcotics model, replacing the militarized eradication of coca crops with a community-based coca control strategy. The program substantially reduced the coca crop while simultaneously respecting human rights and allowing farmers to diversify their livelihoods. This article outlines the elements of the Bolivian initiative that ensure its continued successful functioning. It explores to what extent this model can be translated to other Andean contexts.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 26 March 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 26 March 2016

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

EU Turkey Agreement [to 26 March 2016]

EU Turkey Agreement

Editor’s Note:
We lead again this week with the “EU-Turkey Agreement” as it continues to generate serious concern and action from agencies, NGOs and other actors in the European migrant-refugee crisis. Equally, we see it as establishing new and uncomfortable precedents.
Below, we include statements of concern from the UN High Commissioner for Human Rights, UNICEF and IOM, and statements defining withdrawal of and limits to humanitarian support in Greece from UNHCR, MSF, IRC and Oxfam. This summary is not attempting to be exhaustive, but we believe it is indicative of the situation.

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UN rights chief expresses serious concerns over EU-Turkey agreement
GENEVA (24 March 2016) – The UN High Commissioner for Human Rights Zeid Ra’ad Al Hussein on Thursday expressed serious concerns about the recent agreement between the European Union and Turkey, pointing to what he termed “a contradiction at the heart of the agreement,” as well as raising concerns regarding arbitrary detention of refugees and migrants.

“The declared aim to return all refugees and migrants contrasts with the assurances about individual assessments,” the High Commissioner said. “If the safeguards are to be considered real, then the individual assessments must allow for the possibility that the persons in question will not in fact be returned. Otherwise it could still qualify as a collective expulsion.”

The EU-Turkey agreement calls for cases to be processed under the EU’s Asylum Procedures Directive, and goes on to state that “Migrants not applying for asylum or whose application has been found unfounded or inadmissible in accordance with the said directive will be returned to Turkey.”

Zeid expressed concern that this language presents a real risk of overlooking human rights law obligations, which require States to examine arguments against return beyond those found in refugee law. Such needs could arise, for example, in the case of children; victims of violence, rape, trauma and torture; individuals with specific sexual orientation; persons with disabilities; and a range of others with legitimate individual protection needs.

The UN Human Rights Chief urged Greece to handle all individual cases with genuine attention to all protection grounds required under international human rights law, including at the appeals stage.

Zeid said he has particular concerns about returns being carried out on the basis of asylum claims in Greece being found ‘inadmissible’ because Turkey is a ‘safe third country’ or a ‘first country of asylum.’

“Even if Turkey does expand its refugee definition to include non-Europeans, or passes laws qualifying certain nationalities for ‘temporary protection,’ it may not be considered fully safe for all returns in the near future. Refugee and migrant protection systems are not simply words on paper, but require trained personnel, tailored policies, infrastructure and other concrete practical measures that take time to establish,” the High Commissioner said. “Disturbingly, there have also been recent reports of forcible returns amounting to refoulement from Turkey.”

The UN human rights chief backed the strong concerns expressed on Tuesday by other UN agencies, UNHCR and UNICEF, at the use of detention for all new arrivals in the Greek islands, including children and other vulnerable persons, adding that this appears to contravene a range of international and EU human rights laws and standards, including that immigration detention should be a measure of last resort, and the principle of “best interests of the child.” The UN Committee on the Rights of the Child has emphasized that children should never be detained on the basis of their migration status or that of their parents.

The High Commissioner expressed his concern that all returns must be carried out in full respect of the human rights and dignity of each individual being returned, including through ensuring that any consent for voluntary return is given free of any coercion and that those who are forcibly returned are protected against disproportionate use of force and other abuse of their rights and dignity.

Finally, the High Commissioner regretted that the envisaged so-called ‘one-for-one’ scheme for resettlement is to take place “within the framework of the existing commitments” to resettlement or relocation – without creating new commitments to legal pathways. He urged the EU to implement practical recommendations made by UN and other international organizations and experts concerning the creation of other regular channels for entry, including family reunification, other humanitarian pathways, and regulated labour migration in response to real labour market needs.

“This crisis is manageable if the EU acts on the basis of its own well-established and greatly respected laws and principles, and invests seriously in addressing root causes and supporting comprehensive solutions on the basis of international human rights treaties they have ratified,” Zeid said. “However, if the EU starts to circumvent international law, there could be a deeply problematic knock-on effect in other parts of the world.”

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UNHCR redefines role in Greece as EU-Turkey deal comes into effect
Briefing Notes, 22 March 2016
This is a summary of what was said by UNHCR spokesperson Melissa Fleming – to whom quoted text may be attributed – at the press briefing, on 22 March 2016, at the Palais des Nations in Geneva.

This past Sunday, the provisions agreed between the EU and Turkey to stem the large-scale arrival of refugees and migrants to Greece and beyond into Europe came into effect. Starting already on Saturday, the Greek authorities accelerated the transfer to the mainland of an estimated 8,000 refugees and migrants who had arrived on the islands before the 20th of March. This was to separate them from people arriving after that date and who will be subject to the new return policy.

Arrivals on Lesvos have so far continued. As of this morning 934 people had arrived since Sunday. They are being held at a closed registration and temporary accommodation site in Moria on the east of the island. The remaining 880 people who arrived before Sunday are being hosted about a kilometre away at the Kara Tepe centre, which is run by the local municipality and remains an open facility.

UNHCR has till now been supporting the authorities in the so-called “hotspots” on the Greek islands, where refugees and migrants were received, assisted, and registered. Under the new provisions, these sites have now become detention facilities. Accordingly, and in line with our policy on opposing mandatory detention, we have suspended some of our activities at all closed centres on the islands. This includes provision of transport to and from these sites. However, UNHCR will maintain a presence to carry out protection monitoring to ensure that refugee and human rights standards are upheld, and to provide information on the rights and procedures to seek asylum.

UNHCR staff will also continue to be present at the shoreline and sea port to provide life-saving assistance (including transport to hospitals where needed). We are counselling new arrivals on asylum in Greece, including on family reunification and on access to services. And we are identifying people with specific needs.

UNHCR is concerned that the EU-Turkey deal is being implemented before the required safeguards are in place in Greece. At present, Greece does not have sufficient capacity on the islands for assessing asylum claims, nor the proper conditions to accommodate people decently and safely pending an examination of their cases.

UNHCR is not a party to the EU-Turkey deal, nor will we be involved in returns or detention. We will continue to assist the Greek authorities to develop an adequate reception capacity.
Uncertainty is making the new arrivals nervous. Many still hope that the border will open. Many have run out of money. There is also an urgent need for information. The Greek police have been distributing leaflets in Arabic and Persian informing people that the border is closed and advising them to go to camps where better conditions are provided. But the capacity of nearby camps has been reached, and more camps need to be opened including for candidates for relocation.

Under the EU’s Emergency Relocation Mechanism, European countries agreed to relocate 160,000 asylum seekers, including 66,400 out of Greece and 39,600 out of Italy. As of 21 March 2016, 22 countries had made 7015 places available for asylum seekers to be relocated under the programme and a total of 953 asylum seekers had been relocated (384 out of Italy and 569 out of Greece).

Meanwhile, on the Greek mainland in Idomeni, an estimated 10,000-12,000 people, including some 4,000 children, are camping in dire conditions at an informal site near the border, close to a railway track. The majority are families, many of them with young children. Hygiene is a major concern, negatively impacting people’s health. People are burning plastic and rubbish to keep warm. The general environment is very challenging. UNHCR and partners have been working to improve capacity by providing family-sized and large tents for up to 2,400 people and collecting rubbish. Mobile latrines have been put in place, but they are not enough. Tents have been provided for vulnerable families and individuals, including 30 unaccompanied minors. UNHCR has been visiting detention centres where unaccompanied children are in protective custody. Food distribution has been arranged by several organisations (sandwich and a drink), three times a day, as well as the distribution of milk, baby food, and diapers.

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New EU-Turkey agreement on refugee and migrants could leave children at risk: UNICEF
GENEVA, 22 March 2016 – UNICEF today expressed concern that the new agreement between the EU and Turkey, which comes into effect this week, does not address the pressing humanitarian needs of 19,000 refugee and migrant children stranded in Greece. Children make up 40 percent of the refugee and migrant population in Greece. It is estimated that unaccompanied children make up 10 percent of the child population.

UNICEF warned the new agreement could push children and families to take other more dangerous routes including the central Mediterranean Sea. UNICEF welcomes EU leaders’ commitment to determining the individual status of refugees and migrants rather than collective expulsions, push-back practices or other measures that may be harmful to children.

The children’s agency, however, urges that a number of priorities are addressed:
:: Unaccompanied and separated children are properly identified and taken into protective care rather than detention. They are entitled to a full hearing and assessment of their best interests prior to any decision related to them, including on return. The capacity of state institutions in Greece needs to be scaled up significantly to deal with this new caseload.

:: Child and family support services such as child friendly spaces, and safe mother and baby areas are rapidly expanded in ‘Blue Dots’ services.

:: Children stranded for longer periods in Greece will require an expanded set of basic services such as emergency education. Many children have been out of school for several months and would benefit even from short term learning.

:: To prevent disease outbreaks among children, urgent consideration has to be given to vaccinating refugee and migrant children, especially as many have been living in unsanitary conditions for weeks. An initial response would include vaccinating against measles, polio and pneumococcal infections.

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IOM: Migrants Must Fully Benefit from Protection under International Law
03/22/16
Switzerland – IOM has called upon the international community to address the current migrant rights deficit, highlighting the fact that migrants do not adequately benefit from the protection granted to them under international law.

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Greece: MSF Ends Activities at Primary Lesvos Transit Camp
March 22, 2016
New York/Athens, March 22, 2016 — The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) has decided to suspend its activities linked to the Moria “hotspot” until further notice. Moria is the main camp on the island of Lesvos where all arrivals are identified, registered, and fingerprinted before being relocated or returned to their home countries. The decision follows the EU-Turkey deal announced Friday, which will lead to the forced return of migrants and asylum-seekers from the Greek Island.

“We made the extremely difficult decision to end our activities in Moria because continuing to work inside would make us complicit in a system we consider to be both unfair and inhumane,” said Marie Elisabeth Ingres, MSF head of mission in Greece. “We will not allow our assistance to be instrumentalized for a mass expulsion operation, and we refuse to be part of a system that has no regard for the humanitarian or protection needs of asylum seekers and migrants.”

MSF will close all activities linked to the “hotspot” of Moria, including the transportation of refugees to the center, and the water and sanitation activities and medical clinic inside. MSF will continue to run its transit center in Mantamados, where new arrivals are offered first aid assistance, and its sea rescue activities on the northern beaches of Lesvos. It will also continue to run mobile clinics on the island of Lesvos for those outside of the hotspot location.
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Since July 2015, MSF has provided medical consultations, mental health support, distributed relief items, and conducted water and sanitation activities in Moria camp in Lesvos. MSF has carried out 24,314 consultations in the island of Lesvos, including 12,526 in Moria. MSF psychologists have assisted 401 people through individual sessions and have conducted 584 group sessions with 3,532 participants. Teams were also providing temporary shelter and transportation between the North and the registration centers of Moria and Kara Tepe in the South of the island. As of March 13, MSF transported 12,952 new arrivals.

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The International Rescue Committee Will Not Transport Refugees to Closed Facility at Moria, Lesvos
Lesbos, Greece 23 Mar 2016 –
On Monday evening the IRC informed the Greek coastguard that we would not transport refugees to the closed facility at Moria. We cannot knowingly participate in the transportation of some of the world’s most vulnerable to a place where their freedom of movement is in question.

We will continue to provide for refugees’ basic and protection needs at Kara Tepe camp and, should refugees land on Lesvos’ north shore we are ready to assist them with the essential services they need.

The IRC has been working on the Greek island of Lesbos since July 2015 delivering clean water and sanitation in several refugee transit sites and providing newly arrived refugees with much needed information about the registration process and essential services. We continue to provide specialized services to the most vulnerable refugees, including people with limited mobility and children separated from their families. In early March the IRC’s emergency response team was deployed to Northern Greece to assist with the response there. In the short term the IRC’s protection and environmental health team are responding at Idomeni, the informal refugee site on Greece’s northern border.

More information about the IRC’s response to the Europe Refugee Crisis at this link.

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Says no to police-run detention facilities
(23.03.2016) Refugee Crisis
The Norwegian Refugee Council (NRC) has decided to suspend a number of activities at the refugee and asylum seeker so-called ‘Hotspot’ facillity, Vial, on the island of Chios. “We cannot work independently and safely in a police-run detention facility. Now that it is a detention centre we no longer have adequate access to provide assistance to vulnerable refugees,” said Alain Homsy, Head of NRC operations in Greece.

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Oxfam suspends aid operations in Moria camp in protest to the suspension of migrants’ rights by the EU and Turkey
24 March 2016
Oxfam has today suspended all of its operations in the Moria camp, on the Greek island of Lesvos, in response to the deteriorating treatment of migrants due to the recent deal struck between the EU and Turkey. The Greek authorities are transforming reception facilities into detention centers, where people will be held pending their mass return to Turkey.

World Bank Group, United Nations, and Islamic Development Bank Pledge Support for Stability in Middle East and North Africa

World Bank Group, United Nations, and Islamic Development Bank Pledge Support for Stability in Middle East and North Africa
Beirut, March 24, 2016 — World Bank Group President Jim Yong Kim, United Nations Secretary-General Ban Ki-moon and President of the Islamic Development Bank Group Dr. Mohamed Ali Al-Madani arrived in Lebanon today at the start of a joint visit to rally global support for the shared responsibility of promoting peace and development in the Middle East and North Africa (MENA) region.

The three organizations are jointly supporting an initiative to raise additional financing needed to help countries in the region cope with the immediate consequences of conflict, while laying the foundations for recovery and reconstruction.

With the Syrian conflict entering its sixth year, and the region coping with one of the largest refugee crises since World War II, all three leaders pledged to work closely together in the region. The three organizations recently launched the New Financing Initiative to Support the MENA Region aimed at uniting the international community for the level of support required to meet the region’s immense challenges. Through innovative financing, the initiative plans to provide concessional financing to Lebanon and Jordan –both middle-income countries hosting large numbers of refugees — and to expand the funding available to countries struggling with slow growth and high youth unemployment because of instability.

At the Supporting Syria and the Region conference that took place in February in London, the World Bank Group announced that it will triple its investment in the region as compared to the previous five years. Funding from the New Financing Initiative to Support the MENA Region combined with current programs is expected to total about US$20 billion over the coming five years.

In addition, in response to the current crisis, the Bank will announce $200 million in new financing during the trip to support education and create jobs. This will come in addition to the current more than $1.5 billion of Bank commitments in the two countries, as well as the scaling up of financial support to Iraq, which has now reached $2 billion and which is projected to equal $5 billion in the coming few years.

International Criminal Court (ICC) [to 26 March 2016]

Editor’s Note:
We have been monitoring the increasingly robust statements from UNESCO around protecting cultural heritage in conflict and similar contexts, including discussion around how military assets might be required, even if this is a last and unhappy option.

This week, the ICC brought to trial – with unprecedented speed and effect – a defendant accused of destroying a range of cultural heritage in Timbuktu, and received an unanticipated admission of guilt.

In parallel, the IPU (Inter Parliamentary Union) adopted an extensive resolution around these themes at its 134th Assembly which, among other calls-to-action, “proposes to include the protection of cultural and historical sites in multilateral peacekeeping operations…”

We include content from these two important developments below with links to the full text.

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International Criminal Court (ICC) [to 26 March 2016]
http://www.icc-cpi.int/en_menus/icc/Pages/default.aspx
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24/03/2016
ICC Pre-Trial Chamber I confirms the charge against Ahmad Al Faqi Al Mahdi and commits him to trial
Situation: Republic of Mali
Case: The Prosecutor v. Ahmad Al Faqi Al Mahdi
Today, 24 March 2016, Pre-Trial Chamber I of the International Criminal Court (“ICC” or “Court”) confirmed against Ahmad Al Faqi Al Mahdi the war crime charge regarding the destruction of historical and religious monuments in Timbuktu (Mali), and committed Mr Al Mahdi to trial before a Trial Chamber.

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24/03/2016
Statement of the Prosecutor of the International Criminal Court, Fatou Bensouda, following admission of guilt by the accused in Mali war crime case: “An important step for the victims, and another first for the ICC”
Today the Pre-Trial Chamber I of the International Criminal Court (“ICC”) confirmed the charge of war crime brought by my Office against Mr Ahmad Al Faqi Al Mahdi, and committed him to trial for attacking historic monuments and buildings dedicated to religion in Timbuktu, Mali between approximately 30 June and 11 July 2012. Following this decision, I can now publicly note a further significant development.

On 1 March 2016, Mr Al Mahdi explicitly expressed before ICC Judges and in the presence of his lawyers, his wish to plead guilty. He did so during the course of the confirmation of charges proceedings, at a point where the exchanges were in closed session. This part of the court record has now been made public.

This case is in many ways historically important in that it focuses exclusively on the war crime of intentionally directing attacks against ‘cultural property’. The deliberate and wanton destruction of historic mausoleums and buildings dedicated to religion, as witnessed in this case, caused severe harm to the religious practices, historical heritage, and cultural identity of the people of Timbuktu, Malians and the region more generally. The loss was not locally confined. The magnitude of the loss of such irreplaceable physical embodiment of history and culture was felt by the whole of humanity, and at the expense of future generations. This case underscores the seriousness of such crimes, and the necessity to hold perpetrators accountable. My Office is determined to continue to do its part to counter the scourge of such reprehensible crimes.

This is the first time that a suspect has expressed his intention to plead guilty to criminal conduct for which he is being prosecuted by my Office; a serious crime for which we had gathered overwhelming evidence. Such an admission of guilt, provided for in article 65 of the Rome Statute, will be a milestone in the history of the ICC.

This case is also unprecedented in terms of its expeditiousness and efficiency. The arrest warrant against Mr Al Mahdi was issued in September 2015. The arrest took place in the ensuing days, facilitated by the impressive cooperation of the States involved. The initial appearance hearing was held on 30 September 2015. The charge and the legal and factual submissions in support of the charge were filed on 17 and 18 December 2015. The confirmation of charges hearing was held on 1 March 2016…

Giving an identity to the 230 million children without a civil status: One of the major challenges of the humanitarian crisis in the 21st century

Giving an identity to the 230 million children without a civil status: One of the major challenges of the humanitarian crisis in the 21st century
Resolution adopted unanimously by the 134th IPU Assembly
(Lusaka, 23 March 2016)

The 134th Assembly of the Inter-Parliamentary Union,
Alarmed by the existence, according to UNICEF estimates, of more than 230 million children under five years of age without a legal identity because they were not registered at birth and by the fact that one in every seven children registered in the world does not have a birth certificate attesting to his/her legal identity,

Observing that without a civil status, these children are severely hampered throughout their lives (unable to go to school, vote, marry, receive welfare benefits, inherit, etc.) and fall victim to trafficking (illegal adoption, prostitution and criminal networks), which is further exacerbated in situations of humanitarian crisis,

Considering that having a reliable, comprehensive and lasting civil registry is a necessary prerequisite for drawing up credible electoral lists and, as a consequence, the legitimacy of electoral processes,

Concerned about the “black holes” in statistics caused by the absence of registration of these children, which disrupts the planning and the management of public services for children,

Recalling different provisions and instruments under international law, in particular:
– Article 24, paragraph 2, of the International Covenant on Civil and Political Rights adopted on 16 December 1966 by the UN General Assembly,
– Article 7, paragraph 1 of the Convention on the Rights of the Child adopted by the UN General Assembly on 20 November 1989,
– Goal 16 of the Sustainable Development Goals, which the IPU fully supports, including target 16.9, “By 2030, provide legal identity for all, including birth registration”,
– the Geneva Conventions of 1949 and their Protocols, especially the Fourth Convention relative to the Protection of Civilian Persons in Time of War,
– the 1977 Protocol relating to the Protection of Victims of International Armed Conflicts,

Also alarmed by the tremendous impact of humanitarian crises, particularly in situations of conflict, on the most vulnerable groups, especially women and children,

Convinced of the absolute need to fully meet the needs of those children in terms of assistance and protection through the mandates of peacemaking, peacekeeping and peacebuilding operations,

1. Calls on parliaments to request their governments to put in place measures to inform parents of the need to register children at birth and remove all barriers to the registration of children in registry offices regardless of nationality, race, ethnicity, language, religion or social status;

2. Requests parliaments to adopt laws to ensure the issuance of birth certificates free of charge or, at least, to reduce to a minimum the cost of birth registration;

3. Calls for registry offices to be set up as close as possible to homes by distributing them throughout the country with as a wide coverage as possible;

4. Recommends that parliaments take measures to allow women to register births;

5. Calls for support for the implementation of applications for mobile devices that allow authorized persons (e.g. midwives, village leaders and school principals) to register births;

6. Invites parliaments to promote campaigns on regularizing the status of children without a legal identity through roving public hearings that move from village to village;

7. Calls on parliaments ensure adequate funding for civil registry, including moving towards the digitization of registration where possible;

8. Urges in particular parties to armed conflict to respect schools and hospitals and to provide unrestricted access for humanitarian assistance and to give humanitarian personnel all the facilities required to carry out their work;

9. Calls on governments and parties to conflict to meet their obligations in conformity with international law, including international human rights law and international humanitarian law, in particular the obligations set forth in the 1949 Geneva Conventions and their Additional Protocols of 1977 and 2005;

10. Strongly urges the IPU to commit to monitoring developments on this issue.

Water and Jobs – 2016 UN World Water Development Report

Water and Jobs – 2016 UN World Water Development Report
UNESCO
March 2016 :: 164 pages
ISBN 978-92-3-100146-8 ePub ISBN 978-92-3-100155-0
Pdf: http://unesdoc.unesco.org/images/0024/002439/243938e.pdf
Abstract
Three out of four of the jobs worldwide are water-dependent. In fact, water shortages and lack of access may limit economic growth in the years to come, according to the 2016 United Nations World Water Development Report, Water and Jobs, which was launched on 22 March, World Water Day, in Geneva.

From its collection, through various uses, to its ultimate return to the natural environment, water is a key factor in the development of job opportunities either directly related to its management (supply, infrastructure, wastewater treatment, etc.) or in economic sectors that are heavily water-dependent such as agriculture, fishing, power, industry and health.

Furthermore, good access to drinking water and sanitation promotes an educated and healthy workforce, which constitutes an essential factor for sustained economic growth.

In its analysis of the economic impact of access to water, the report cites numerous studies that show a positive correlation between investments in the water sector and economic growth. It also highlights the key role of water in the transition to a green economy.

The 2016 Report will provide the content and basis for debate throughout the year on the global theme ‘Water and Jobs’ of this year’s World Water Day. The Report illustrates that nearly 3 out of 4 jobs of the global workforce (3.2 billion people) are moderately or highly dependent upon access to water and water-related services and therefore states that “Water is essential to decent jobs and sustainable development”. Water stress and the lack of decent work can exacerbate security challenges, force migration and undo the progress made in the fight to eradicate poverty.

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Joint UNESCO and UN – Water Press Release
Water drives job creation and economic growth, says new UN report
22 March 2016
An estimated three out of four jobs that make up the global workforce are either heavily or moderately dependent on water. This means that water shortages and problems of access to water and sanitation could limit economic growth and job creation in the coming decades, according to a UN report…

UN urges stronger, coordinated international response to address El Niño impacts

UN urges stronger, coordinated international response to address El Niño impacts
Climate event has affected 60 million people; impacts set to increase at least until end of 2016

23 March 2016, Rome – The United Nations has called for a stronger response by governments, aid organizations and the private sector to address the devastating impact the El Niño climate event is having on the food security, livelihoods, nutrition and health of some 60 million people around the world.

The appeal came at a meeting organized in Rome by four UN agencies, the Food and Agriculture Organization of the United Nations, the International Fund for Agricultural Development (IFAD), the Office for Coordination of Humanitarian Affairs (OCHA) and the World Food Programme (WFP). Participants, including representatives from governments, non-governmental organizations and other UN agencies, took stock of the growing impacts of the current El Niño, which is considered as one of the strongest in history.

They noted that more than $2.4 billion are needed for current El Niño emergency and recovery-responses and currently there is a $1.5 billion gap in funding…

A global crisis
El Niño-related impacts have been felt across the globe since mid 2015. Among these are severe or record droughts in Central America, the Pacific region, East Timor, Vietnam, Ethiopia, and in Southern Africa. In addition, floods have affected certain parts of Somalia and the Tanzania, devastating forest fires have once again resurfaced in Indonesia while some regions has witnessed storms, as in the case of Fiji with Tropical Cyclone Winston.

These disasters have resulted in a wide range of consequences, most importantly, severe increases in hunger, malnutrition, water- and vector-borne diseases and the prevalence of animal and plant pests and diseases. Increasingly, populations are on the move: families across the globe are being forced into distress migration, both within and across borders, as their sources of livelihood disappear.

The meeting ended with a series of commitments by FAO, IFAD, OCHA and WFP aimed at urgently scaling up responses to the current El Niño crisis while also ensuring a more effective response to similar events in the future…

UNESCO and L’Oréal Foundation launch manifesto to promote gender parity in the sciences

UNESCO and L’Oréal Foundation launch manifesto to promote gender parity in the sciences
25 March 2016
A manifesto for women in science was launched in Paris at the close of Thursday’s L’Oréal-UNESCO For Women in Science award ceremony, which recognized five outstanding scientists and 15 your researchers. The Manifesto aims to draw attention to the need to ensure gender parity in science.

The Manifesto sets out to improve women’s access to science at all levels and in all disciplines. Its first signatories were Irina Bokova, the Director-General of UNESCO, Jean-Paul Agon, Chairman and Chief Executive Officer of L’Oréal and head of the L’Oréal Foundation, and Elizabeth Blackburn, President of the L’Oréal-UNESCO Jury…

The Manifesto @4womeninscience promotes a six-point agenda:
:: Encourage girls to explore scientific career paths,
:: Break down the barriers that prevent women scientists from pursuing long term careers in research,
:: Prioritize women’s access to senior positions and leadership positions in the sciences,
:: Celebrate with the general public the contribution that women scientists make to scientific progress and to society,
:: Ensure gender equality through participation and leadership in symposiums and scientific commissions, such as conferences, committees and board meetings,
:: Promote mentoring and networking for young scientists to enable them to plan and develop careers that meet their expectations.

To sign the Manifesto: http://www.fwis.fr/en/manifesto

United Nations – Secretary General, Security Council, General Assembly [to 26 March 2016]

United Nations – Secretary General, Security Council, General Assembly  [to 26 March 2016]
http://www.un.org/en/unpress/
Selected Press Releases/Meetings Coverage

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23 March 2016
SC/12300
Security Council Press Statement on Announcement of Cessation of Hostilities in Yemen

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22 March 2016
SC/12298
Special Representative of Secretary-General for Children and Armed Conflict Briefs on Situation of Children in South Sudan
The members of the Security Council welcomed the announcement on 23 March 2016 by the Special Envoy of the Secretary-General for Yemen, Ismail Ould Cheikh Ahmed, of a nationwide cessation of hostilities in Yemen, scheduled to begin at midnight on 10 April 2016, and peace talks scheduled to begin on 18 April 2016 in Kuwait. The members of the Security Council welcomed the commitment of all parties both to the cessation of hostilities and to the peace talks…

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22 March 2016
SC/12297
Security Council Press Statement on Terrorist Attacks in Brussels

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22 March 2016
SG/SM/17621-AFR/3351-L/3254
Congolese Ex-Rebel Commander’s Guilty Verdict for War Crimes Sends Strong Signal that Impunity ‘Will Not Be Tolerated’, Secretary-General Says