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

Ebola Outbreak in DRC 66: 05 November 2019
1. Situation update
In the past week, from 28 October to 3 November 2019, 10 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. Though the number of new confirmed EVD cases reported is lower this week, compared to the 20 cases reported last week, security issues and poor access continue to slow response activities in certain health zones. This can prevent the detection of cases in these hard to reach areas.
Violence this week in Lwemba Health Area in the Mandima Health Zone, caused the death of an Ebola response community health worker, and left his spouse critically injured with multiple wounds. WHO and partners condemned the attack, adding that acts of violence against individuals involved with the response are unacceptable and compromise the ability of health workers to provide assistance to communities impacted by the devastating effects of Ebola…

Implementation of ring vaccination protocol
As of 3 November 2019, 246,824 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola Vaccine with 2,865 vaccinated in the past week


Public Health Emergency of International Concern (PHEIC)

Polio this week as of 06 November 2019
:: The GPEI is pleased to announce that the UK Government has confirmed its commitment to eradicating polio by pledging a £400 million contribution for the next four years, which will help vaccinate more than 400 million children a year. Read more on the remarkable announcement.
:: In Pakistan, a circulating vaccine-derived poliovirus type 2 has been confirmed.  A detailed investigation into the origin of the outbreak is ongoing, with circulation confirmed in a geographically-limited area, and outbreak response is being planned and implemented.
:: Are you an immunization expert interested in serving on the Strategic Advisory Group of Experts (SAGE) on polio? The call for nominations for membership on the working group has now been issued, targeting individuals to submit their nominations.
: Want to know the future of polio eradication efforts in Africa? Then stay tuned for a Facebook live interview with Dr Pascal Mkanda, chief polio expert in the WHO African Region, on 08 November 2019 at 10:00am, West Africa Time.

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan— one WPV1 case and one WPV1 positive environmental sample;
:: Pakistan— three WPV1 cases and 19 WPV1-positive environmental samples;
:: Angola— 7 cVDPV2 cases and one cVDPV2 positive environmental sample;
:: Central African Republic— one cVDPV2 case and one cVDPV2 positive environmental sample;
:: Cote d’Ivoire one cVDPV2 positive environmental sample;
:: Ghana two cVDPV2 cases;
:: Philippines— one cVDPV2 case and four cVDPV2 positive environmental samples.


UK aid to help vaccinate more than 400 million children a year against polio
Press release Published 5 November 2019
International Development Secretary Alok Sharma has pledged new UK aid support to help vaccinate more than 400 million children a year against polio.
:: UK support will help vaccinate more than 750 children a minute against polio in developing countries around the world
:: The UK package of up to £400 million will help support 20 million health workers and volunteers
:: Polio was wiped out in UK in the 1980s, but three countries – Pakistan, Afghanistan and Nigeria – are still not officially wild polio free


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

WHO Grade 3 Emergencies [to 9 Nov 2019]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 66: 05 November 2019

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


WHO Grade 2 Emergencies [to 9 Nov 2019]

:: Yellow fever campaign launches in Khartoum State as final phase of countrywide immunization drive 7 November 2019
:: WHO scales up cholera vigilance in Khartoum, Sudan 5 November 2019

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



WHO Grade 1 Emergencies [to 9 Nov 2019]

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified


UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syria ǀ Flash Update #11, Humanitarian impact of the military operation in north-eastern Syria, 29 – 31 October 2019 [EN/AR]

Yemen – No new digest announcements identified


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth
:: 08 Nov 2019 South Sudan: CERF allocates up to $15 million for flooding response

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified


The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 2 November 2019

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

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

PDF: The Sentinel_ period ending 2 Nov 2019

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

Joint EU-IOM-UNHCR Communique: International Solidarity Conference on the Venezuelan Refugee and Migrant Crisis


Joint EU-IOM-UNHCR Communique: International Solidarity Conference on the Venezuelan Refugee and Migrant Crisis
2019-10-29 17:12
Joint Communique by the co-chairs António Vitorino, Federica Mogherini, Filippo Grandi
The International Solidarity Conference on the Venezuelan Refugee and Migrant Crisis held in Brussels on 28-29 October 2019 sent a strong message of support to the Venezuelan refugees and migrants as well as to their host countries and communities in Latin America and the Caribbean.

The Conference was co-chaired by Federica Mogherini, High Representative/Vice-President of the European Commission, UN High Commissioner for Refugees Filippo Grandi, and IOM Director General António Vitorino. The event aimed to raise global awareness about the Venezuelan refugee and migrant crisis and the efforts of hosting countries and communities. It also reviewed best practices and achievements of host countries, confirmed international support for a regional and coordinated response, and called for a global and inclusive partnership, where solidarity and responsibility are shouldered by the entire international community but also shared between public and private sectors.

120 delegations attended, including EU Institutions and Member States, the most affected Latin American and Caribbean countries, donor countries, UN agencies, private sector, NGOs, civil society organisations and development actors including international financial institutions.

The Conference acknowledged that the serious and deteriorating political, human rights and socio-economic crisis in Venezuela has produced one of the most severe displacement situations in the world. The outflow continues unabated, while resources and financing fall considerably short of the needs. According to official figures, some 4.5 million Venezuelans have left their country and most of them are in Latin American or Caribbean countries. This figure could reach 6.5 million people by end of 2020 worldwide.

The Conference commended the remarkable solidarity of countries in the region and acknowledged the substantial challenges they face. Participants reaffirmed their strong commitment to continue protecting and assisting Venezuelan refugees and migrants and to support the efforts of the governments of the receiving countries, notably in ensuring a sustainable integration in host communities.

The Conference also expressed appreciation for the coordinated response of countries in Latin America and the Caribbean. The Quito Process constitutes a significant step forward in harmonizing policies and practices, thereby scaling up the humanitarian response and integrating refugees and migrants across the region.

While recognizing the sovereign right of States to manage their borders, the co-chairs stressed the importance of preserving access to asylum, strengthening the mechanisms that allow the identification of people in need of international protection, maintaining flexible entry policies, continuing regularizing and providing documents to Venezuelan refugees and migrants, as well as facilitating family reunification. Any acts of hatred, intolerance and xenophobia – even if isolated and unrepresentative – need to be forcefully rejected…

US $14 billion needed to achieve universal literacy in countries with lowest literacy rates and E-9 countries

Education – Literacy

US $14 billion needed to achieve universal literacy in countries with lowest literacy rates and E-9 countries
9 September 2019
Paris, France: A new UNESCO cost analysis shows that US $14 billion(1) will be needed if the 20 countries with the lowest literacy rates(2) and the E-9 countries(3) are to achieve functional literacy and numeracy skills by 2030. The analysis highlights a funding gap of US $10 billion in the 20 countries with adult literacy rates below 50 per cent and US $4 billion among the E-9 countries, where the majority of the youth and adults with low literacy levels live.

David Atchoarena, Director of the UNESCO Institute for Lifelong Learning, says: ‘Of the approximately 750 million illiterate adults worldwide, 565 million live in 29 countries. Even if an increase in domestic resources with 5 per cent of the GDP being allocated to education and 3 per cent of the education budget invested in literacy is taken into account, these countries will only achieve universal literacy by 2030 with the support of the international community. This analysis shows how far we still have to go in meeting this target, in line with commitments made by world leaders as part of the Sustainable Development Goals. I call on donors worldwide to contribute to closing the current funding gap of US $14 billion.’

…The study is authored by UIL, the UNESCO Division for Policies and Lifelong Learning Systems, the UNESCO Institute for Statistics, in collaboration with the Global Education Monitoring Report team.

The study shows that the majority of youth and adults with poor literacy live in the Asia-Pacific region, with approximately 80 per cent of all illiterate youth and adults living in the E-9 countries. However, most non-E-9 countries such as Afghanistan, Haiti, South Sudan and others require significant external funding support since they will not be able to cover the costs from national budgets.

The authors of the study also underline that while basic data on literacy related costs exists there is a strong need for further data collection and research in order to enable well-informed decision-making in regards to the expansion of literacy programmes…

Technical notes
:: The calculated costs above comprise the annual salary for instructors and are based on the estimation of 500 contact hours per learner, as estimated by the expert panel of the study.
:: The 20 countries with literacy rates below 50 per cent are Afghanistan, Benin, Burkina Faso, Central African Republic, Chad, Comoros, Côte d’Ivoire, Ethiopia, the Gambia, Guinea, Guinea-Bissau, Haiti, Iraq, Liberia, Mali, Mauritania, Niger, Senegal, Sierra Leone, and South Sudan.
:: The E-9 countries are Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Nigeria, and Pakistan.

Download: 2019 UNESCO literacy cost analysis


OAS – Statement of the Ministers Responsible for Public Security in the Americas

“Public Security” – the Americas

Statement of the Ministers Responsible for Public Security in the Americas
OAS – Adopted at the fourth plenary session held on October 31, 2019
We, the Ministers Responsible for Public Security in the Americas and Heads of Delegation, gathered in Quito, Ecuador, on October 30 and 31, 2019, at the Seventh Meeting of Ministers Responsible for Public Security in the Americas (MISPA VII), hereby issue the following statement, pursuant to paragraph 3.a of the “Document of Port-of-Spain: Institutionalization of the MISPA Process”:

We commit to consolidation, strengthening, and international cooperation in public security, while at the same time voicing our concern at the violent events occurring in the region, which undermine democratic institutions and have resulted in the disruption of public order through pillaging, unrest, and the destruction of public and private property, without prejudice to the legitimate right to demonstrate and to peaceful protest in accordance with the law.

Consequently, we declare our opposition to said acts of violence, crime, and insecurity, including those perpetrated as an organized attack on peace, and we reiterate our support for democratic institutions, the rule of law, human rights, the right to freedom of expression, assembly, demonstration, and protest, while underscoring the importance of boosting actions to prevent, confront, investigate, and prosecute those criminal activities and conspiracies to commit crime, which threaten public security.

Likewise we reject any form of violence and call for guarantees to protect the integrity of everyone and for full observance of human rights.

We consider that dialogue is the best mechanism for settling disputes.

Comment – Achieving health equity: democracy matters

Featured Journal Content

The Lancet
Nov 02, 2019 Volume 394Number 10209p1591-1684, e34

Achieving health equity: democracy matters
Johanna Hanefeld, Aaron Reeves, Chris Brown, Piroska Östlin
Progress on health equity in the European region in the past two decades has been slower than expected. Indeed, some countries have even seen health inequalities widen.1 This slow progress is, to some extent, surprising because there is almost unanimous political commitment to addressing health inequities and many countries have made great strides in implementing policies to reduce the health gap.1, 2 Europe, as a region, is on track to achieving the Sustainable Development Goals (SDGs) overall, but countries are not attaining SDG 10 and SDG 3 because ensuring healthy lives for all is impossible without reducing health inequities.

The report of the WHO European Health Equity Status Report Initiative (HESRI), launched on Sept 10, 2019, reviews achievements on the road to health equity to understand how to further accelerate action, and to discuss how to influence decisions related to fiscal policy and industrial strategy in order to deliver healthy, prosperous lives for all.3 The findings of the HESRI report3
show that the evidence on how to best tackle health inequity is clear and overwhelming, even more so in Europe, where we can draw on a wealth of health inequalities research.4 We know the size of the gaps in life expectancy, the social gradients in the burden of disease across the European region, and the root causes of these health inequalities, the social determinants of health.

The root causes of health inequities are driven by policies that structure access to the social determinants of health. Five conditions are necessary to reduce health inequity: good-quality and accessible health services; income security and an appropriate, fair level of social protection; decent living conditions; good social and human capital; and decent work and employment conditions.3 Of these, the two most important determinants are precarious housing and living conditions,5 and low income and weak social protection.6 When people live in unaffordable, cold, and unsafe housing on insecure contracts, their health is worse and they die prematurely.7 When people cannot make ends meet and when social protection systems are stigmatising and inadequate, their health suffers.8 Inadequate access to health services, conditions of employment, and personal and community capabilities are all important too. Health outcomes improve when people can access the care they think they need; when people work in secure employment with a living wage; and when people have someone to turn to for help and feel they have a voice in decision-making processes.9,10

The drivers of health inequity are all too prevalent across the region. This situation is not inevitable. These determinants of health inequalities are all modifiable through policies focused on the five areas identified in the report:3 health services, social protection, decent living conditions, social and human capital, and decent employment. Why, then, has progress been so slow?

Emerging evidence indicates that policies to address health inequalities do not emerge out of thin air, rather they are the result of a country’s or region’s wider political economy.11, 12
Policies are the product of people in particular socioeconomic contexts interacting with political institutions that shape the political process in a given location—be that a community, city, region, or country. Where these institutions are not accountable, transparent, participatory, or coherent, we will be far less likely to see the policy change necessary to deliver health equity. Governments and other stakeholders must actively work to alter how we incorporate the voices, lived experiences, and passions of the child, the young person, or adult who is not able to thrive and prosper because of health inequities. Democratic institutions, such as free and fair elections, are part of establishing the conditions that empower individuals and communities, ensure participation is meaningful, and establish decision-making processes that are accountable. Furthermore, accountable and transparent decision-making processes generate coherent policies by making participation inclusive. Beyond consulting people, participation can only be inclusive where economic barriers to participation are alleviated and where we alter the governance structures of policy processes to ensure the communities affected by policy decisions have a meaningful voice that influences outcomes in these processes.

There are countervailing forces, however. Vested interests, such as commercial actors or those who oppose health-enhancing policies, will seek to subvert efforts to address health equity.13m
Crucially, the influence of these groups depends on how our political systems are organised.14
Addressing health inequity requires a restructuring of our political systems so that we can deepen democracy through making our decision-making processes more inclusive.15, 16

To allow all people in Europe to prosper and flourish in health and in life, we need to recognise both the centrality of equity in health to the sustainable development of Europe and that political institutions are one of the essential conditions that make health equity possible.

Online political ads are in urgent need of regulation – Fin Times Editorial

Governance – Online Political Advertising

Online political ads are in urgent need of regulation
As elections loom, the risks from paid disinformation remain high
The Editorial Board
Financial Times, November 1, 2019

Online political advertising, with troves of personal data allowing messages to be highly targeted, has become one of the most powerful tools in the electoral arsenal. The scope for disinformation or outright lies — and the fact the advertising often falls outside the regulations applied to television, radio and newspapers — calls for urgent oversight.

Twitter’s move to ban political advertising on its platform this week is a welcome sign of a company taking a proactive approach. It is also an implicit challenge to rival Facebook.

Twitter said it would ban most political ads, excluding those aiming to increase voter registration. Twitter’s chief executive Jack Dorsey argued that political ads offer a larger megaphone to those with deeper pockets than their opponents and that they have helped spread harmful content.

By contrast, Facebook exempted political ads from its usual fact-checking procedures, sparking outrage among its critics. Allowing politicians and parties to make statements without scrutiny makes Facebook’s anti-disinformation efforts look hollow. Questioned recently by congresswoman Alexandria Ocasio-Cortez on whether she could run false stories on the network, Facebook chief executive Mark Zuckerberg said she “probably” could.

Mr Zuckerberg says people would not want tech companies to be arbiters of truth in politics. These companies have long claimed to be platforms rather than publishers under the US Communications Decency Act. But the spread of political advertising on social media requires companies fact-check political ads in collaboration with trusted, independent organisations.

The very nature of online advertising also requires further investigation. Compared to television, social media companies have far greater control over what specific audiences see. Platforms have made some efforts to allow third parties to assess who is paying to advertise on them. Yet these tools can be rudimentary. Tech companies should make sure metrics such as the audience segments that have been targeted are clear and publicly available.

Official political advertising is only part of the problem, however. Sites including Twitter are still grappling with fake accounts which can boost the reach of messages, in some cases directed from foreign states. Efforts to detect and remove these accounts should be stepped up, requiring social media companies to engage more with academics and law enforcement.

While online advertising has clear differences from its traditional counterparts, existing regulation still offers a blueprint to bring it under control. In the UK, bodies such as Ofcom and the Advertising Standards Agency have clear rules on material that can be shown on television and radio. By updating and expanding the power of national regulators — perhaps with funding provided by a social media levy — more transparency around political ads could be created. In Facebook’s case, increasing regulation could also push up the costs of running political ads without verification. Tech companies have often shown that commitments to free speech are secondary to commercial imperatives.

Governments and regulators should provide clarity on how politicians and parties can promote themselves on social media platforms. National regulators should keep the threat of imposing a full-scale ban on political advertising in their arsenal. Social media companies have often proved resistant to change. With a divisive UK general election campaign now beginning and the US presidential election a year away, the stakes are exceptionally high.