Health

Lack of new antibiotics threatens global efforts to contain drug-resistant infections
17 January 2020 WHO News release
Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections, says the World Health Organization (WHO).

Two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria).

While pre-clinical candidates (those in early-stage testing) are more innovative, it will take years before they reach patients.

“Never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”

The reports (Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline and its companion publication, Antibacterial agents in preclinical development) also found that research and development for antibiotics is primarily driven by small- or medium-sized enterprises with large pharmaceutical companies continuing to exit the field…

Emergencies

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

Ebola Outbreak in DRC 75: 14 January 2020
Situation Update
From 6 to 12 January 2020, eight new confirmed cases of Ebola virus disease (EVD) were reported from Mabalako, Beni, and Musienene Health Zones in North Kivu Province in the Democratic Republic of the Congo. Of these cases, three were reported in Beni Health Zone, where no cases had been reported for 29 days, and one was reported in Musienene Health Zone, where no cases had been reported for 132 days. These four cases are linked to the transmission chain that originated in Aloya Health Area, Mabalako Health Zone, and were not unexpected given known links between Mabalako and Beni…

…Vaccines
:: From 8 August 2018 to 12 January 2020, 265 309 people were vaccinated with the rVSV-ZEBOV-GP Ebola vaccine.
:: Vaccination with the Ad26.ZEBOV/MVA-BN-Filo vaccine continued in Karisimbi Health Zone, with 5684 people vaccinated since its introduction on 14 November 2019.

…Risk communication, social mobilization and community engagement
:: Traditional healers and managers of private structures which had contact with suspected EVD cases participated in response activities after community dialogue in Aloya, Mabalako Health Zone.
:: A forum for popular expression was also organized with village chiefs and civil society leaders to address questions related to vaccination activities in Métal and Aloya Health Zones.
:: Teams continue to involve local actors in communication and vaccination activities in Lwemba and Biakato.

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DR Congo: Red Cross volunteers attacked during Ebola burial
Goma/Nairobi/Geneva, 15 January 2020 – Two volunteers from the Democratic Republic of Congo (DR Congo) Red Cross were seriously injured following an attack during a safe and dignified burial of a suspected Ebola case near Mambasa, in eastern DR Congo on Monday, 13 January. The volunteers are now in hospital, receiving medical care and psychosocial support.

DR Congo Red Cross teams have faced incidents of violence and aggression from communities resisting safe and dignified burial protocols since the start of the Ebola outbreak in North Kivu and Ituri.  In this most recent attack, the family had consented to the burial but rumours and panic quickly spread among the community resulting in a violent assault against the Red Cross team.

Grégoire Mateso Mbuta, President of the DR Congo Red Cross Society said: “This incident is a stark reminder of the serious risks our volunteers face when they carry out the dangerous task of safe and dignified burials. While we deplore any violence towards our volunteers or staff, we understand first hand, the fear and frustration that communities harbour and shall continue to render the needed services to the affected populations.”

The current Ebola outbreak, which began on 1 August 2018, is unfolding in an area affected by a two decades-long conflict that has claimed countless lives and raised fear and hostility towards responders.

Building community trust and acceptance has been at the core of the Red Cross’ Ebola response operations. This investment has paid off. Since the beginning of the outbreak nearly 20,000 successful safe and dignified burials have been conducted with a consistently high success rate.
Red Cross volunteers continue to work within affected communities, listening to concerns and gathering feedback that is then analysed and used to provide improved support to people in need. As a result, community resistance for safe and dignified burials has drastically declined over the course of the operation.

Nicole Fassina, Ebola Operations Manager for the International Federation of Red Cross and Red Crescent Societies (IFRC) said: “While we experienced an overall improvement in community’s acceptance of burials, this attack underscores why we cannot become complacent. The Red Cross will continue to engage and involve communities in the Ebola response if we want to bring this outbreak to end.”

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POLIO
Public Health Emergency of International Concern (PHEIC)
http://polioeradication.org/polio-today/polio-now/this-week/

Polio this week as of 14 January 2020
:: Pakistan intensifies cVDPV2 response efforts, focusing on comprehensive outbreak response, strengthened routine immunization, communication and enhanced surveillance.

Summary of new viruses this week (AFP cases and ES positives):
:: Pakistan:  seven WPV1 cases; and, five WPV1-positive environmental samples
:: Angola:  two cVDPV2 cases
:: Benin:  one cVDPV2 case
:: Central African Republic (CAR):  two cVDPV2 cases
:: Ghana:  one cVDPV2 case; and, six cVDPV2-positive environmental samples
:: Malaysia:  one cVDPV1-positive environmental sample; and, one cVDPV2-positive environmental sample
:: Philippines:  two cVDPV2 cases
:: Togo:  two cVDPV2 cases

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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 18 Jan 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 75: 14 January 2020
[See Ebola above for detail]

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

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WHO Grade 2 Emergencies [to 18 Jan 2020]
Iraq
:: WHO assesses capacity and preparedness of Al Jumhury Teaching Hospital for influenza
Erbil, Iraq, 14 January 2020

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

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WHO Grade 1 Emergencies [to 18 Jan 2020]

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

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::::::

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
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 6 – As of 15 January 2020

Yemen – No new digest announcements identified

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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.
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 11 January 2020

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

David R. Curry
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 11 Jan 2020

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

“Upholding the United Nations Charter”

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Secretary-General Highlights ‘Trust Deficit’ amid Rising Global Turbulence, in Remarks to Security Council Debate on ‘Upholding United Nations Charter’
9 January 2020
SG/SM/19934
Following are UN Secretary-General António Guterres’ remarks at the Security Council open debate on “Upholding the United Nations Charter to Maintain International Peace and Security”, in New York today:

I thank the Vietnamese presidency of the Council for organizing this timely debate and I congratulate Viet Nam for the presidency of the Security Council at the beginning of your tenure in the Security Council itself. I also welcome the presence of the Chair of the Elders, Mary Robinson. And I am pleased that we begin the year of the seventy-fifth anniversary of the United Nations with a discussion on its founding document.

Peace is our most precious value and the essence of our work. All that we strive for as a human family depends on peace. But peace depends on us. Unfortunately, the new year has begun with fresh turmoil and long-standing suffering. Geopolitical tensions have reached dangerous levels, most recently in the Gulf, as well as from traditional military threats to the economy to cyberspace. Conflicts that no one is winning grind on and on and on, from Libya and Syria to Afghanistan and the Sahel.

With turbulence on the rise, trust within and among nations is on the decline. We see this trust deficit also in streets across the world, as people vent their frustrations and voice their feeling that political establishments are out of touch, incapable or unwilling to deliver. We see it in the work of the United Nations, including the Security Council, when Member States struggle or fail to find reasonable common ground. And in this vacuum, the climate crisis is now upon us with ever-growing fury, sparing no one.

International cooperation is at a crossroads. All of this presents a grave test to multilateralism. It poses a challenge for the Security Council, which under the Charter has primary responsibility for the maintenance of international peace and security. And it underscores, more than ever, the focus of today’s meeting: upholding the United Nations Charter.

At this time of global divisions and turmoil, the Charter remains our shared framework of international cooperation for the common good. In an era of spreading hatred and impunity, the Charter reminds us of the primacy of the rule of law and human dignity. And in a time of rapid transformation and technological change, the Charter’s values and objectives endure: the peaceful settlement of disputes; the equal rights of men and women; non-intervention, self-determination and the sovereign equality of Member States; and clear rules governing the use of force, as set out in Article 2, paragraph 4, and Chapter VII of the Charter.

These principles are not favours or concessions. They are the foundation of international relations and they are core to peace and international law. They have saved lives, advanced economic and social progress and, crucially, avoided a descent into another world war. But when these principles have been flouted, put aside or applied selectively, the result has been catastrophic: conflict, chaos, death, disillusion and mistrust. Our shared challenge is to do far better in upholding the Charter’s values and fulfilling its promise to succeeding generations.

While the Charter and its purposes and principles remain as relevant as ever, our tools must adapt to new realities. And we must use them with greater determination and creativity. This includes ensuring implementation of the Security Council’s decisions by Member States pursuant to Article 25 of the Charter.

One of the most effective ways to demonstrate our impact is to invest in prevention. We spend far more time and resources managing and responding to crises than on preventing them. Our approach needs to be rebalanced. The founders of the United Nations had a crystal-clear focus on prevention when drafting the Charter, from the opening words of its preamble to dedicating an entire chapter to the “Pacific Settlement of Disputes”.

Chapter VI outlines many available tools, including negotiation, enquiry, mediation, conciliation, arbitration and judicial settlement. We have ample evidence that these can be effective when applied with purpose and unity. I call on the Council to further utilize the powers granted to it by the Charter, including investigation of disputes in accordance with Chapter VI and the referral of legal questions to the International Court of Justice for advisory opinions, in accordance with Article 96 of the Charter.

Let us also recognize that the Sustainable Development Goals, which are objectives in their own right, are among our best tools for prevention. I urge all Member States to make greater investments in the 2030 Agenda, in particular in gender equality, inclusion, social cohesion, good governance and a fair globalization that advances the rights of all, unleashes the talents of all, and gives all a stake in society.

In addition to prevention, the Charter was visionary in imagining a world in which the United Nations worked dynamically with regional organizations to maintain international peace and security. While Chapter VIII predates most of our regional partners, it sets a framework for cooperation and division of labour. We are investing in regional partnerships in crucial new ways. I have put significant emphasis on a strategic partnership with the African Union, including through its “Silencing the Guns” initiative and its Agenda 2063. The European Union continues to provide strong support across our agenda. At the same time, we are working to strengthen ties with all other regional organizations. Among them, of course, is the Association of Southeast Asia Nations, ASEAN, so ably chaired this year by this Council’s President, Viet Nam.

Throughout its history, the Security Council has adapted its work based on the changing nature of conflict and enhanced multilateral cooperation in peace and security. Peacekeeping is not mentioned in the Charter, but it is firmly rooted in its ideals and epitomizes the kind of collective action for peace that the Charter envisaged. Today some 100,000 [United Nations] peacekeepers protect civilians and promote peace in several of the most troubled regions of the world. [United Nations] peacekeeping remains a vital and cost-effective investment in global peace and security. But effective peacekeeping requires strong international support. The Action for Peacekeeping initiative stresses our shared commitment to make our peacekeeping missions stronger, safer and fit for the future.

Finally, Mr. President, as we commemorate the seventy-fifth anniversary of the United Nations, I wish to direct a special message to this Council. The privilege of membership carries vital responsibilities to uphold the Charter’s tenets and values, particularly in preventing and addressing conflict. Present and past disagreements must not be an obstacle to action on today’s threats. We must avoid double standards. But also, perceptions of double standards must not be an excuse for no standards at all.

War is never inevitable; it is a matter of choice – and often it is the product of easy miscalculations. Peace, too, is never inevitable; it is the product of hard work and we must never take it for granted. At this time when global fault-lines risk exploding, we must return to fundamental principles; we must return to the framework that has kept us together; we must come home to the [United Nations] Charter.

Strengthening our commitment to that resilient, adaptable and visionary document – and thus to the very notion of international cooperation itself – remains the most effective way to collectively face the global challenges of this grave moment, and the decade before us.

The Charter compels us to do everything in our power to save people from the scourge of war and injustice. As we face new threats but also new opportunities for a better world, that is the work that must define this seventy-fifth anniversary year.

Thank you.

Venezuela: OAS Resolution

CP/RES. 1143 (2269/20) 10 January 2020
REGARDING RECENT EVENTS IN VENEZUELA
(Adopted by the Permanent Council at its special meeting of January 10, 2020)

THE PERMANENT COUNCIL OF THE ORGANIZATION OF AMERICAN STATES,
CONSIDERING that the Charter of the Organization of American States recognizes that representative democracy is indispensable for the stability, peace, and development of the region;

REAFFIRMING the right of the peoples of the Americas to democracy and the obligation of their governments to promote and defend it as reflected in Article 1 of the Inter-American Democratic Charter;

NOTING THAT resolution CP/RES. 1117 (2200/19), adopted on January 10, 2019, resolved: “[t]o not recognize the legitimacy of Nicolas Maduro’s new term as of the 10th of January of 2019,” and called “for new Presidential elections with all necessary guarantees of a free, fair, transparent, and legitimate process to be held at an early date attended by international observers.”

CONSIDERING that the National Assembly is the only democratic institution remaining in Venezuela;

UNDERSCORING that Resolution CP/RES. 1133 (2244/19), adopted by the Permanent Council on August 28, 2019, firmly condemned the grave and systematic violations of human rights in Venezuela, including the use of torture, illegal and arbitrary detentions, extrajudicial executions, forced disappearances and the denial of the most basic rights and necessities, especially those related to health, food, and education.

RESOLVES:
To condemn the use of force and intimidating tactics by the regime of Nicolas Maduro to try to prevent the deputies of the National Assembly from freely accessing the session convened for January 5, 2020 to democratically elect their Governing Board.

To welcome the re-election of Juan Guaidó as the President of the Venezuelan National Assembly.

To renew the call for a prompt return to democracy in Venezuela and, in that regard, reaffirm the need to hold inclusive, free, fair, and transparent presidential elections, conducted by a renewed and independent National Electoral Council and a renewed and independent Supreme Court of Justice and with the presence of independent international observers.

FOOTNOTE
… Antigua and Barbuda considers that the Bolivarian Republic of Venezuela is not a member state of the Organization of American States since, on 27 April 2017, the Government of the Bolivarian Republic of Venezuela properly notified the Secretary-General of its denunciation of the Charter in accordance with Article 143 of the Charter of the Organization of American States and the Charter ceased to be in force with respect to the Bolivarian Republic of Venezuela which ceased to belong to the organization on 27 April 2019.

Antigua and Barbuda did not support resolution CP/RES 1124 (2217/19) of April 9, 2019 which sought to appoint Mr. Gustavo Tarre as the National Assembly’s Representative to the OAS and did not accept the credentials of the officials intending to represent the Bolivarian Republic of Venezuela at the 49th Regular Session of the General Assembly.

At that 49th Regular Session of the General Assembly, Antigua and Barbuda notified all member states and the General Secretariat of the Organization of American States that until further notice, it will not consider itself bound by any future declarations or resolutions of any Council or organ of the Organization that includes the participation of any person or entity purporting to speak for or act on behalf of the Bolivarian Republic of Venezuela and in which 18 votes are attained with the participation of a purported representative of the Bolivarian Republic of Venezuela.

Heritage and Armed Conflict

Statement on the threats to cultural heritage in case of armed conflicts
International Council of Museums (ICOM) and the International Council on Monuments and Sites (ICOMOS)
06/01/2020

In armed conflicts and political upheavals since the turn of the millennium, cultural heritage has been increasingly targeted. It has been looted or deliberately destroyed, in order to finance warfare or to affect the identity and the confidence of adversaries. Museums as well as cultural sites are affected in many countries around the world.

The International Council of Museums (ICOM) and the International Council on Monuments and Sites (ICOMOS), as representatives of the heritage community in the world, are very much concerned about this evolution and in particular recent developments. ICOM and ICOMOS remind all parties of armed conflicts of the 1954 Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict.

There, States Parties agree that “any damage to cultural property, irrespective of the people it belongs to, is a damage to the cultural heritage of all humanity, because every people contributes to the world’s culture.” The United States of America ratified the Hague Convention in 2009, Iran in 1959.
Both countries are also States Parties to the 1972 World Heritage Convention, which the United States of America was the first country to ratify in 1973 and played a key role in promoting. Iran is home to 24 UNESCO World Heritage Sites of great cultural and natural importance – not only to Iranians, but to humanity and its collective memory.

Moreover, in 2017, the UN Security Council unanimously adopted Resolution 2347 that states: “directing unlawful attacks against sites and buildings dedicated to religion, education, art, science or charitable purposes, or historic monuments may constitute, under certain circumstances and pursuant to international law a war crime and that perpetrators of such attacks must be brought to justice”.

ICOM and ICOMOS jointly and strongly condemn any deliberate destruction of cultural heritage. We call upon all parties to respect the international agreements that rule armed conflicts, and to protect the world’s cultural heritage wherever it is, regardless of religious beliefs or political intentions.

“Digital Rights”

45 Cities to endorse digital rights in cities
Tuesday 7 January, 2020
To date 45 cities have formally confirmed to endorse the 5 principles of the Cities Coalition for Digital Rights. The new cities include Athens, Bratislava, Cary, Chicago, Grenoble, Helsinki, Kansas City, London, Los Angeles, Lyon, Milan, Moscow, Philadelphia, Portland, San Jose, Tirana, Torino, Vienna and Zaragoza.

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Declaration of Cities Coalition for Digital Rights
We, the undersigned cities, formally come together to form the Cities Coalition for Digital Rights, to protect and uphold human rights on the internet at the local and global level.

The internet has become inseparable from our daily lives. Yet, every day, there are new cases of digital rights abuse, misuse and misinformation and concentration of power around the world: freedom of expression being censored; personal information, including our movements and communications, monitored, being shared and sold without consent; ‘black box’ algorithms being used to make unaccountable decisions; social media being used as a tool of harassment and hate speech; and democratic processes and public opinion being undermined.

As cities, the closest democratic institutions to the people, we are committed to eliminating impediments to harnessing technological opportunities that improve the lives of our constituents, and to providing trustworthy and secure digital services and infrastructures that support our communities. We strongly believe that human rights principles such as privacy , freedom of expression , and democracy must be incorporated by design into digital platforms starting with locally-controlled digital infrastructures and services.

As a coalition, and with the support of the United Nations Human Settlements Program ( UN-Habitat ), we will share best practices, learn from each other’s challenges and successes, and coordinate common initiatives and actions. Inspired by the Internet Rights and Principles Coalition ( IRPC ), the work of 300 international stakeholders over the past ten years, we are committed to the following five evolving principles:

1. Universal and equal access to the internet, and digital literacy
Everyone should have access to affordable and accessible internet and digital services on equal terms, as well as the digital skills to make use of this access and overcome the digital divide.

2. Privacy, data protection and security
Everyone should have privacy and control over their personal information through data protection in both physical and virtual places, to ensure digital confidentiality,
security, dignity and anonymity, and sovereignty over their data, including the right to know what happens to their data, who uses it and for what purposes.

3. Transparency, accountability, and non-discrimination of data, content and algorithms
Everyone should have access to understandable and accurate information about the technological, algorithmic and artificial intelligence systems that impact their lives, and the ability to question and change unfair, biased or discriminatory systems.

4. Participatory Democracy, diversity and inclusion
Everyone should have full representation on the internet, and the ability collectively to engage with the city through open, participatory and transparent digital processes. Everyone should have the opportunities to participate in shaping local digital infrastructures and services and, more generally, city policy-making for the common good.

5. Open and ethical digital service standards
Everyone should be able to use the technologies of their choice, and expect the same level of interoperability, inclusion and opportunity in their digital services. Cities should define their own technological infrastructures, services and agenda, through open and ethical digital service standards and data to ensure that they live up to this
promise.

Evidence Informed Development – Fragile States

Data Collection in Fragile States : Innovations from Africa and Beyond
World Bank January 09, 2020 Publication
PDF: https://openknowledge.worldbank.org/bitstream/handle/10986/32576/9783030251208.pdf?sequence=1&isAllowed=y
Fragile countries face a triple data challenge. Up-to-date information is needed to deal with rapidly changing circumstances and to design adequate responses. Yet, fragile countries are among the most data deprived, while collecting new information in such circumstances is very challenging. This open access book presents innovations in data collection developed with decision makers in fragile countries in mind. Looking at innovations in Africa from mobile phone surveys monitoring the Ebola crisis, to tracking displaced people in Mali, this collection highlights the challenges in data collection researchers face and how they can be overcome.

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Media Release
Data Collection in Fragile States
Highlights
:: Decision makers in fragile countries need quality data; obtaining such data is challenging.
:: This book presents innovations, methodological as well as in data collection, to meet this challenge. The innovations presented in this book are relevant beyond fragile situations.
:: With effort, quality data can be produced for many fragile situations, effectively eliminating the notion that data cannot be collected in certain difficult circumstances.

Quality statistics are critical for development interventions to be effective. However, they are hard to obtain in fragile situations as fragility affects the ability to collect data in many ways. From exposure to violence or to other dangers, such as disease, collecting information isn’t possible using traditional means without putting enumerators at risk. There is also the association of conflict with poor-quality roads, inadequate telecommunication infrastructure and, at times, populations that are hostile to representatives of the central government.

Fragile situations can also complicate data collection in other ways such as people being displaced or the lack of sampling frames. A new report, Data Collection in Fragile States, presents innovations developed to deal with common challenges. The report presents innovations, both methodological as well in data collection, to address the data gaps in fragile situations. Through examples, the book shows that it is possible to collect high-quality data in fragile settings and such data collection need not be expensive but also warns that technology is not a panacea for all data collection issues.

Additional Findings
:: The proliferation of mobile phone networks and inexpensive handsets has opened new possibilities for data collection. Although they cannot replace face-to-face household surveys in all contexts, mobile phone surveys offer substantial benefits in specific circumstances and for specific data collection needs. For locations where mobile phone surveys are not an option, locally recruited, resident enumerators who live in the community can be used. Mobile phone surveys were used to collect information during the Ebola crisis in Sierra Leone, the drought in Nigeria, Somalia, South Sudan and Yemen, and were used to track the welfare of people displaced by the crisis in northern Mali.

:: Technological advances in geospatial data have the potential to change how survey data are collected. As geospatial technology has improved and become more widespread, costs have come down and the number of available tools has increased, making Geographic Information Systems (GIS)-based sampling approaches accessible to more users. To deal with the absence of sampling frames in the Democratic Republic of Congo and Somalia, satellite images and sophisticated machine learning algorithms were used to estimate population density and demarcate enumeration areas.

:: Sampling in chaotic and fluid locations, where people are displaced or live In Internally Displaced Peoples (IDP) settlements requires a rethinking of traditional sampling approaches. Attention should also be paid to elicit truthful information from respondents. Approaches such as endorsement experiments, list experiments, and behavioral approaches can be used to ask questions about sensitive issues such as loyalty to controversial groups along with how to avoid strategic responses when respondents might expect benefits to be associated with certain answers. For instance, in South Sudan, different sampling approaches were tested in an IDP camp to shed light on their precision.

:: Video testimonials provide a cost-effective way to give outside audiences a perspective on the lives of survey respondents. The collection of household data is usually a passive process where respondents are asked pre-formulated questions. This constrains the respondents in sharing their own narratives and emphasizing what they feel is important. The video testimonials give a voice to the poor and help better understand the concerns of the poor as well as empower them to create a narrative that they own. In South Sudan, in addition to estimating the poverty data, video testimonials revealed what it was like to live in poverty.

:: A light-touch approach to generating periodic feedback can help provide information about the performance of donor projects. A new approach called Iterative Beneficiary Monitoring (IBM) provides a feedback system that focuses on a select set of issues to measure outcomes of projects. By keeping data collection focused, IBM facilitates timely data analysis and the rapid preparation of reports. The approach was introduced in Mali to provide feedback on projects about feeding in schools to distribution of e-vouchers and cash transfers.

Governance – Biotechnology

New Report Proposes Global DNA Synthesis Screening System to Counter Biotech Terror
News 08 Jan 2020
:: Advances in biotechnology, including DNA synthesis (the creation of DNA sequences and genomes), are driving improvements in the energy, food, agriculture, health and manufacturing industries

:: But accidental or deliberate misuse of DNA synthesis could result in the spread of dangerous agents, potentially resulting in risks to public health or global health security

:: Widespread access to DNA synthesis and new synthesis methods, in the absence of global biotechnology norms and screening practices, enhances the threat

:: The World Economic Forum and Nuclear Threat Initiative propose a new mechanism to develop, standardize and strengthen screening practices
:: Read the full report here

Geneva, Switzerland, 7 January 2020 – Rapid advancements in commercially available DNA synthesis technologies – used for example to artificially create gene sequences for clinical diagnosis and treatment – pose growing risks, with the potential to cause a catastrophic biological security threat if accidentally or deliberately misused.

A new World Economic Forum and Nuclear Threat Initiative report, “Biosecurity Innovation and Risk Reduction: A global Framework for Accessible, Safe and Secure DNA Synthesis,” gathers opinion from a group of global public- and private-sector experts who propose standardized screening practices to counter the threat.

Since scientists demonstrated the means to create a full viral genome in 2002, DNA synthesis technologies have become increasingly available and frequently used by scientists and engineers around the world. These technologies support myriad advancements in synthetic biology, enhancing the efficiency and sustainability of industries including energy, food, agriculture, health and manufacturing. Further advances in technology hold great promise for sustainable development and a safer and more secure society.

At the same time, new approaches to DNA editing and synthesis have made it easier to manipulate biological agents and systems, increasing the risk of a catastrophic accidental or deliberate biological event. These technologies make it possible to create pathogen or toxin DNA that could be misused. For example, in 2018 researchers published work detailing the synthesis of horsepox virus, an extinct virus related to smallpox, using synthetic DNA fragments purchased from a commercial provider. This demonstrated the potential for creating other viruses via commercially available technologies.

Although many DNA providers practice screening procedures, this approach is voluntary and is becoming increasingly expensive. As access expands and the cost of DNA synthesis declines, more DNA is likely to reach the market via additional providers, significantly expanding the user base. In the next two to three years, a new generation of benchtop DNA synthesis machines, enabled by enzymatic DNA synthesis methods, could become available without guidance or norms to prevent misuse.

This report, endorsed by an international expert Working Group, recommends a global system for synthetic DNA screening practices by developing an international, cost-effective, and sustainable mechanism to prevent illicit practices and misuse. The new framework improves the existing voluntary guidelines because it standardizes screening processes, is accessible to new players in the market, and provides valuable feedback data to evaluate the screening – all at lower cost.

“Biotechnology is at the centre of the Fourth Industrial Revolution. To deliver on the promise of the biotechnology revolution, we must seize opportunities to develop and deliver life-advancing innovations while simultaneously and urgently addressing potential risks associated with a growing and democratized bio-economy,” said Arnaud Bernaert, Head of Shaping the Future of Health and Health Care at the World Economic Forum.

The report also proposes that companies, international organizations and governments should explore options for the sustainable oversight and the maintenance of this proposed DNA sequence screening mechanism. DNA synthesis capabilities, in addition to other emerging technologies, can benefit from a larger system of common global life-science norms overseen by a globally recognized entity.

“Global DNA synthesis screening can be a critical tool to reduce the risk that life-science technologies could be deliberately misused to carry out biological attacks or accidentally result in a high-consequence or catastrophic biological event. The time is now,” said Ernest J. Moniz, Co-Chair and Chief Executive Officer of the Nuclear Threat Initiative.

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Biosecurity Innovation and Risk Reduction: A global Framework for Accessible, Safe and Secure DNA Synthesis
World Economic Forum – Insight Report – In collaboration with the Nuclear Threat Initiative (NTI)
January 2020 :: 18 pages
PDF: http://www3.weforum.org/docs/WEF_Biosecurity_Innovation_Risk_Reduction.pdf
[Excerpt]
Recommendations
Developing a Common DNA Sequence Screening Mechanism
1) By early 2020, establish a global, standing, multi-stakeholder, technical consortium (“the Consortium”) to develop a common DNA sequence screening mechanism that is accessible at low cost,
secure and easy to use by all providers of DNA and providers of benchtop DNA synthesis machines.
This mechanism would include an internationally recognized set of sequences of pathogen and toxin
DNA (see Appendix B for additional details) and algorithms to screen ordered DNA sequences against
that set of sequences. The Consortium should work to develop a version of the screening mechanism that is fully automated for ease of use and integration as a built-in feature of benchtop DNA synthesis machines.

2) As the common DNA sequence screening mechanism is developed, the Consortium should consider security precautions and built-in technical safeguards to prevent its misuse.

3) By 2021, the common DNA sequence screening mechanism should be supplied to all DNA providers
to incorporate into their operations. Regular updates should be established thereafter.

4) By 2021, the common DNA sequence screening mechanism and its updates should be supplied to all
developers and providers of benchtop DNA synthesis machines to incorporate into their machines and/or operations.
a. The Consortium should work with providers of benchtop machines to implement procedures to
screen each DNA sequence before it is synthesized.
b. The Consortium should consider the potential to prohibit some sequences from being created by benchtop machines. In this case, benchtop machines could have a built-in version of the common mechanism and would be unable to synthesize DNA sequences that are a hit.

Oversight, policies and partnerships for establishing synthetic DNA screening as a global norm
1) The Consortium should be funded as an independent technical entity for at least two years so that it can immediately start work to meet the goal of developing the common DNA sequence screening mechanism and providing it to DNA providers and providers of benchtop DNA synthesis machines by 2021.

2) In early-to-mid 2020, NTI and the World Economic Forum should convene senior leaders from
governments, companies and international organizations to explore options for the sustainable oversight of the Consortium and maintenance of the proposed DNA sequence screening mechanism.
These options may include developing synthetic DNA screening as a new mandate for an existing
international entity or the creation of a new organization to take on this mandate.

3) In partnership with the new or existing organization focusing on this work, the technical Consortium
should work with states, international organizations, industry groups, universities and others to pursue
opportunities to strengthen synthetic DNA screening as a global norm and standard among governments, researchers, institutions, and providers of DNA and benchtop DNA synthesis machines.

Featured Journal Content

PNAS – Proceedings of the National Academy of Sciences of the United States
of America
http://www.pnas.org/content/early/
[Accessed 11 Jan 2020]

.
What music makes us feel: At least 13 dimensions organize subjective experiences associated with music across different cultures
Alan S. Cowen, Xia Fang, Disa Sauter, and Dacher Keltner
PNAS first published January 6, 2020. https://doi.org/10.1073/pnas.1910704117
Significance
Do our subjective experiences when listening to music show evidence of universality? And if so, what is the nature of these experiences? With data-driven methodological and statistical approaches, we examined the feelings evoked by 2,168 music excerpts in the United States and China. We uncovered 13 distinct types of experiences that people across 2 different cultures report in listening to music of different kinds. Categories such as “awe” drive the experience of music more so than broad affective features like valence. However, emotions that scientists have long treated as discrete can be blended together. Our results provide answers to long-standing questions about the nature of the subjective experiences associated with music.
Abstract
What is the nature of the feelings evoked by music? We investigated how people represent the subjective experiences associated with Western and Chinese music and the form in which these representational processes are preserved across different cultural groups. US (n=1,591) and Chinese (n=1,258) participants listened to 2,168 music samples and reported on the specific feelings (e.g., “angry,” “dreamy”) or broad affective features (e.g., valence, arousal) that they made individuals feel. Using large-scale statistical tools, we uncovered 13 distinct types of subjective experience associated with music in both cultures. Specific feelings such as “triumphant” were better preserved across the 2 cultures than levels of valence and arousal, contrasting with theoretical claims that valence and arousal are building blocks of subjective experience. This held true even for music selected on the basis of its valence and arousal levels and for traditional Chinese music. Furthermore, the feelings associated with music were found to occupy continuous gradients, contradicting discrete emotion theories. Our findings, visualized within an interactive map (https://www.ocf.berkeley.edu/∼acowen/music.html) reveal a complex, high-dimensional space of subjective experience associated with music in multiple cultures. These findings can inform inquiries ranging from the etiology of affective disorders to the neurological basis of emotion.

Featured Journal Content

Journal of Adolescent Health
December 2019 Volume 65, Issue 6, Supplement, S1-S62
https://www.jahonline.org/issue/S1054-139X(19)X0005-1
Adolescent Sexual and Reproductive Health and Rights: Progress in the 25 Years Since the International Conference on Population and Development and Prospects for the Next 25 years
Edited by Caroline W. Kabiru
.
Review Articles
The State of Adolescent Sexual and Reproductive Health
Mengjia Liang, Sandile Simelane, Guillem Fortuny Fillo, Satvika Chalasani, Katherine Weny, Pablo Salazar Canelos, Lorna Jenkins, Ann-Beth Moller, Venkatraman Chandra-Mouli, Lale Say, Kristien Michielsen, Danielle Marie Claire Engel, Rachel Snow
S3–S15
Published in issue: December 2019
Abstract
In the 25 years since the 1994 International Conference on Population and Development, significant progress has been made in adolescent sexual and reproductive health and rights (ASRHR). Trend analysis of key ASRHR indicators at global, national, and subnational levels indicates that adolescent girls today are more likely to marry later, delay their first sexual experience, and delay their first childbirth, compared with 25 years ago; they are also more likely to use contraceptives. Despite overall progress, however, unequal progress in many ASRHR outcomes is evident both within and between countries, and in some locations, the state of adolescents’ lives has worsened. Population growth in countries with some of the worst shortfalls in ASRHR mean that declining rates, of child marriage, for example, coexist with higher absolute numbers of girls affected, compared with 25 years ago. Emerging trends that warrant closer attention include increasing rates of ovarian and breast cancer among adolescent girls and sharp increases in the proportion of adolescents who are overweight or obese, which has long-term health implications.

The Political, Research, Programmatic, and Social Responses to Adolescent Sexual and Reproductive Health and Rights in the 25 Years Since the International Conference on Population and Development
Venkatraman Chandra-Mouli, B. Jane Ferguson, Marina Plesons, Mandira Paul, Satvika Chalasani, Avni Amin, Christina Pallitto, Marni Sommers, Ruben Avila, Kalisito Va Eceéce Biaukula, Scheherazade Husain, Eglé Janušonytė, Aditi Mukherji, Ali Ihsan Nergiz, Gogontlejang Phaladi, Chelsey Porter, Josephine Sauvarin, Alma Virginia Camacho-Huber, Sunil Mehra, Sonja Caffe, Kristien Michielsen, David Anthony Ross, Ilya Zhukov, Linda Gail Bekker, Connie L. Celum, Robyn Dayton, Annabel Erulkar, Ellen Travers, Joar Svanemyr, Nankali Maksud, Lina Digolo-Nyagah, Nafissatou J. Diop, Pema Lhaki, Kamal Adhikari, Teresa Mahon, Maja Manzenski Hansen, Meghan Greeley, Joanna Herat, Danielle Marie Claire Engel
S16–S40
Published in issue: December 2019
Abstract
Among the ground-breaking achievements of the International Conference on Population and Development (ICPD) was its call to place adolescent sexual and reproductive health (ASRH) on global health and development agendas. This article reviews progress made in low- and middle-income countries in the 25 years since the ICPD in six areas central to ASRH—adolescent pregnancy, HIV, child marriage, violence against women and girls, female genital mutilation, and menstrual hygiene and health. It also examines the ICPD’s contribution to the progress made. The article presents epidemiologic levels and trends; political, research, programmatic and social responses; and factors that helped or hindered progress. To do so, it draws on research evidence and programmatic experience and the expertise and experiences of a wide number of individuals, including youth leaders, in numerous countries and organizations. Overall, looking across the six health topics over a 25-year trajectory, there has been great progress at the global and regional levels in putting adolescent health, and especially adolescent sexual and reproductive health and rights, higher on the agenda, raising investment in this area, building the epidemiologic and evidence-base, and setting norms to guide investment and action. At the national level, too, there has been progress in formulating laws and policies, developing strategies and programs and executing them, and engaging communities and societies in moving the agenda forward. Still, progress has been uneven across issues and geography. Furthermore, it has raced ahead sometimes and has stalled at others. The ICPD’s Plan of Action contributed to the progress made in ASRH not just because of its bold call in 1994 but also because it provided a springboard for advocacy, investment, action, and research that remains important to this day.

Forward, Together: A Collaborative Path to Comprehensive Adolescent Sexual and Reproductive Health and Rights in Our Time
Marina Plesons, Claire B. Cole, Gwyn Hainsworth, Ruben Avila, Kalisito Va Eceéce Biaukula, Scheherazade Husain, Eglė Janušonytė, Aditi Mukherji, Ali Ihsan Nergiz, Gogontlejang Phaladi, B. Jane Ferguson, Anandita Philipose, Bruce Dick, Cate Lane, Joanna Herat, Danielle Marie Claire Engel, Sally Beadle, Brendan Hayes, Venkatraman Chandra-Mouli
S51–S62
Abstract
The 1994 International Conference on Population and Development established a basis for the advancement of adolescent sexual and reproductive health and rights (ASRHR) that endures today. Twenty-five years later, our vision for the future warrants reflection based on a clear understanding of the opportunities and challenges before us. Inclusion of adolescents on global, regional, and national agendas; increased investment in ASRHR policies and programs; renewed commitments to universal health coverage; increased school enrollment; and advances in technology are all critical opportunities we can and must leverage to catalyze progress for adolescents. At the same time, a range of significant challenges remain, have newly emerged, or can be seen on the horizon, including persistent denial of adolescent sexuality; entrenched gender inequality; resistance to meaningfully engaging adolescents and young people in political and programmatic processes; weak systems, integration, and multisectoral coordination; changes in population dynamics; humanitarian and climate crises; and changes in family and community structures. To achieve as much progress toward our vision for ASRHR as possible, the global ASRHR community must take strategic and specific steps in the next 10 years within five areas for action: (1) mobilize and make full use of political and social support for ASRHR policies and programs; (2) increase and make effective use of external and domestic funding for ASRHR; (3) develop, communicate, apply, and monitor enabling and protective laws and policies for ASRHR; (4) use and improve available ASRHR data and evidence to strengthen advocacy, policies, and programs; and (5) manage the implementation of ASRHR strategies at scale with quality and equity.

Emergencies

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

Ebola Outbreak in DRC 74: 07 January 2020
Situation Update
Since the last Situation Report 73 issued on 24 December 2019, 28 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo between 23 December 2019 to 5 January 2020. The new confirmed cases in the past 14 days are from Butembo, Katwa, Kalunguta, Mabalako and Mambasa. The source of exposure for the four new cases reported from Mambasa Health Zone, Ituri Province is currently under investigation. Mambasa Health Zone had previously not had a confirmed case for 66 days. Similarly, the source of exposure of the initial case reported in Kalunguta at the end of December is still under investigation…

…As of 5 January 2020, a total of 3390 EVD cases, including 3272 confirmed and 118 probable cases have been reported, of which 2233 cases died (overall case fatality ratio 66%). Of the total confirmed and probable cases, 56% (1903) were female, 28% (956) were children aged less than 18 years, and 5% (168) were healthcare workers.

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

POLIO
Public Health Emergency of International Concern (PHEIC)
http://polioeradication.org/polio-today/polio-now/this-week/

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan — two WPV1 cases and two WPV1 positive environmental samples;
:: Pakistan — 11 WPV1 cases, 13 WPV1 positive environmental samples and two cVDPV2 positive environmental samples;
:: Malaysia — one cVDPV2 and one positive environmental samples;
:: Zambia — one cVDPV2 case.

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::::::

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 11 Jan 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 74: 07 January 2020
[See Ebola above for detail]

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 11 Jan 2020]
Measles in Europe
:: Strengthening national laboratories’ oversight capacity to support measles and rubella elimination 08-01-2020
[See Milestones above for detail]

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
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 11 Jan 2020]

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
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 5 – As of 8 January 2020

Yemen – No new digest announcements identified

::::::

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth – No new digest announcements identified
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 4 January 2020

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

David R. Curry
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 4 Jan 2020

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

The Sentinel resumes publication after an end-of-year holidays break.
This edition of 4 January 2020 begins the seventh year of weekly publication.

Happy 75th Birthday, United Nations!
United Nations Department of Economic and Social Affairs
2 January 2020, New York
The United Nations makes a difference in the lives of everyone, everywhere. From providing food and assistance to 91.4 million people in 83 countries, supplying vaccines to 45 per cent of the world’s children, to working with 196 countries to keep global temperature rise well below 2 degrees Celsius. The examples are many of how this 193-Member-State strong global organization makes an impact on the ground. This year, we will commemorate and reflect on the organization’s first 75 years of existence by inviting YOU to join the largest-ever global conversation.

The United Nations saw the light of day in 1945, when it was created in the wake of the devastating World War II, with pledges to save future generations from the atrocities of war and reiterate faith in fundamental human rights. Since then, the organization has played a vital role on the world stage, bringing countries together in addressing problems that transcend national boundaries and which no country can solve on their own…

Through this UN75 initiative, the United Nations is embarking on the largest, most inclusive conversation on the role of global cooperation in building the future we want. The organization is calling on people from all walks of life to join dialogues hosted both online and offline, throughout the year. By bringing together people’s voices and views in this way, the organization seeks to find out how enhanced international cooperation can help realize a better world by 2045, when the UN will celebrate its 100th birthday…
Through this worldwide listening exercise, the UN75 initiative aims to foster a greater sense of global citizenship and to empower a critical mass of international actors to address global issues. The views and ideas generated, will be presented by the Secretary-General to world leaders and senior UN officials on 21 September 2020 at a high-level event to mark the anniversary…

For more information: UN75 – Shaping our future together

::::::

In First Annual Budget Since 1973, Fifth Committee Approves $3.07 Billion for 2020, Concluding Main Part of Seventy-Fourth Session
Delegates Clash over Funding for Mechanism Investigating Serious Crimes in Syria
General Assembly Fifth Committee
GA/AB/4350 27 December 2019
21st Meeting (AM)
The Fifth Committee (Administrative and Budgetary) concluded the main part of its seventy fourth session on Friday, approving resources totalling $3.07 billion for 2020, its first annual budget since 1973 and $200 million more than the $2.87 billion outlay proposed by Secretary General António Guterres in early October.

With the new one year fiscal cycle for its regular budget, the Organization temporarily leaves behind more than four decades of biennium budgets and a year in which it grappled with a severe liquidity crunch. The cash crisis has forced the Organization to limit staff hiring and travel, the hours of operation at the New York Headquarters and carry out other cost saving emergency measures.

At the close of the day long and at times contentious meeting, Fifth Committee Chairman Andreas D. Mavroyiannis (Cyprus) thanked the delegates and the Secretariat staff for their dedication and hard work. The Secretariat handled more than 1,300 questions submitted in writing by Fifth Committee members scrutinizing an initial proposed programme budget resolution with more than 500 paragraphs…

Featured Journal Content

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current
Personal View
The public health crisis of underimmunisation: a global plan of action
Lawrence O Gostin, James G Hodge Jr, Barry R Bloom, Ayman El-Mohandes, Jonathan Fielding,
Peter Hotez, Ann Kurth, Heidi J Larson, Walter A Orenstein, Kenneth Rabin, Scott C Ratzan, Daniel Salmon
[Excerpts]
Summary
Vaccination is one of public health’s greatest achievements, responsible for saving billions of lives. Yet, 20% of children worldwide are not fully protected, leading to 1·5 million child deaths annually from vaccine-preventable diseases. Millions more people have severe disabling illnesses, cancers, and disabilities stemming from underimmunisation. Reasons for falling vaccination rates globally include low public trust in vaccines, constraints on affordability or access, and insufficient governmental vaccine investments. Consequently, an emerging crisis in vaccine hesitancy ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low immunisation rates. Local outbreaks can spread rapidly, however, transcending borders. Following an assessment of underlying determinants of low vaccination rates, we offer an action based on scientific evidence, ethics, and human rights that spans multiple governments, organisations, disciplines, and sectors.

.

Introduction
Vaccination is among public health’s greatest achievements, saving billions of lives. Global scourges such as smallpox have been eradicated, with polio nearing eradication. Childhood diseases (such as measles, mumps, and pertussis) have substantially diminished through modern vaccination practices. Yet, one in five children worldwide are not fully protected, resulting in 1·5 million child deaths annually from diseases that are preventable by vaccination, including diarrhoea and pneumonia, equating to one death every 20 s.1 Millions more people have severe disabling illnesses, cancers, and disabilities from infections caused by underimmunisation. Ten highly populous countries with suboptimal immunisation systems account for over 70% of the world’s unvaccinated children.1

Despite vast benefits, immunisation levels are falling among specific populations in countries at all wealth levels. Reasons vary, ranging from low public trust in vaccines to constraints on affordability or access. The WHO rates vaccine hesitancy—reluctance or refusal to vaccinate despite vaccine availability—as among the top ten global health threats for 2019.2 Overall, both WHO and UNICEF report in 2019 that global immunisation rates for common childhood vaccines have flat-lined at 86% over the past decade.2, 3 Country rates vary widely, from 25% in Equatorial Guinea to 96% in Norway.3 Vaccinations in many countries are falling below levels needed for so-called herd immunity, or community protection, resulting in outbreaks. The global incidence of measles increased by 30% over the previous year in 2017 alone, with major diphtheria outbreaks in multiple regions.4

The vaccination crisis ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low vaccination rates. Yet, local outbreaks can spread rapidly, transcending borders. Mass migration and international travel propel infectious diseases across the globe. Anti-vaccine messaging targets local communities, but is also disseminated widely on internet platforms and social media. Multiple forces driving the resurgence of childhood diseases also threaten immunisation campaigns, such as for polio and malaria.

The remarkable promise of immunisation has stubbornly stalled, with losses measured in deaths and human suffering.5 In 2018, 20 million children missed out on lifesaving measles, diphtheria, and tetanus vaccines.3 Underlying this public health crisis is a striking paradox—vaccines are victims of their own success. Immunisations are remarkably effective, closely monitored, and very safe. Consequently, many clinicians and parents have not seen the consequences of vaccine-preventable diseases and underestimate their harms. Governments also fail to adequately invest in vaccines, from research to cold storage and delivery.

There are no simple solutions to this problem, but innovative policies and programmes working in concert would substantially increase vaccination rates. We offer an action plan based on scientific evidence, ethics, and human rights. Crucially, an effective response must be multidisciplinary and multisectoral, spanning governments, international organisations, the private sector, and civil society. Our plan begins with an examination of underlying determinants of low vaccination rates…

.

Generating sustainable solutions
Underimmunisation is a global crisis requiring sustainable solutions. We offer a three-pronged strategy: innovative financing for vaccine affordability, accessibility, and availability; evidence-based health communication campaigns at local, national, and global levels; and law reform that has public acceptance and is fairly implemented.

:: Vaccine affordability, accessibility, and availability
Projected global funding shortfalls of $7·2 billion (between 2016 and 2020) undermine immunisation goals.36
WHO’s 2013 Global Vaccine Action Plan estimated $60 billion needed for 94 LMICs from 2011 to 2020,37 nearly half of which is unsecured through government or philanthropic sources. WHO also seeks an additional $10 billion for its own operations by 2023, including $667 million to “strengthen routine vaccination and health systems” and $1·6 billion for polio eradication.38
Most costs focus on immunisation services, including management, training, social mobilisation, and surveillance. Rapid deployment of vaccines in response to emerging threats is also essential to save lives and reduce costs.

WHO’s Action Plan partners focus on the entire vaccine pipeline—from research, price, storage, and delivery to robust health systems. Dedicated funding for national immunisation programmes is an essential driver for national and global initiatives. Gavi, for example, generates long-term resources through the international finance facility for immunisation and advanced market commitments to support pneumococcal vaccines. A global campaign to raise financing to scale should be a major priority, especially for low-income countries that are unable to pay for or administer vaccines across their populations. Solidarity for universal vaccine availability is warranted because deficiencies in any country threaten populations worldwide. Each government must assure robust national immunisation systems, but the international community also shares responsibility to fill gaps in capacity through enhanced coordination, forecasting, and manufacturer incentives. Global partnerships like the Coalition for Epidemic Preparedness Innovations (CEPI) align public and private actors to fund, develop, and equitably distribute vaccines.

:: Trustworthy information environment
Resources alone, of course, cannot ensure high immunisation rates if the public distrusts the quality, safety, or effectiveness of vaccines. Gaining trust has become difficult with the rise of nationalist populism, which often questions science and casts doubt on expert opinions. The public cannot rely on the media to provide unbiased or accurate messages. Although some parents remain vehemently opposed to vaccinations, most are open to non-judgmental messages and want the best for their children. Altering the informational environment to afford greater salience to accurate, science-based messages could assuage parental concerns. WHO, governments, and partners (eg, philanthropists, industry, and civil society) should sustainably fund evidence-based engagement and health communication strategies that are proactive, timely, and credible, and tailored to specific audiences. WHO is generating a hub for vaccination acceptance and demand to provide reliable information and tools. Governments should similarly develop national and regional campaigns, including an emphasis on behavioural changes. Key components of effective communication campaigns include objective messaging in traditional and social media designed to assuage fears and promote accurate health information and immunisation outcomes. Campaigns should recruit well trusted spokespeople such as leaders in sport, entertainment, and religion. Health engagement is often the most effective at the community level through local leaders, teachers, and religious figures.

Governments should also adopt transparent, lawful, and measured regulations to correct or remove disinformation from the internet and social media. In the same way that states limit malicious hate speech and violent images, they can sensibly regulate patently false or misleading vaccine information. Social media enterprises should be held accountable for rooting out irresponsible vaccine rumours pervading their platforms. For example, searches for vaccine-related terms on Pinterest are automatically diverted to trustworthy vaccine sources like WHO and CDC.39 Furthermore, internet search engines should prioritise reliable scientific sources over anti-vaccine websites.

Traditional and social media play a special role in open and free societies, and their independence is highly valued. Encouraging self-regulation and ethical corporate responsibility could avoid formal regulation. Governments at the 2019 G20 Summit, for example, asked social media companies to remove violent, terrorism-related messages and images. Facebook agreed to assess its policies governing anti-vaccination information and advertising on its site. YouTube has begun taking down misleading videos and images. Moreover, Amazon is removing anti-vaccination videos, books, and documentaries.

:: National or regional law reform
Governments can use legal tools successfully to increase vaccination rates. Efficacious vaccination laws can lead to higher immunisation coverage.30 Vaccination mandates passed in France and Italy are associated with increased vaccine rates.40 A meta-analysis of European laws, however, did not find a strong link between vaccination laws and coverage.24 These disparate findings might suggest that legal approaches tailored to local cultures work best.

Vaccination laws must exempt people for legitimate medical reasons, such as infants and immunosuppressed individuals. Yet, overzealous reliance on non-medical exemptions can result in preventable outbreaks.27 Multiple US studies conclude that school vaccination laws with fewer exemptions lowered the incidence of childhood diseases. Governments should consider repealing or restricting permissive religious and philosophical exceptions. Such reforms are consistent with freedoms of religion and conscience because they do not target particular religious or other communities, but are applied fairly and equally throughout society. Parents are responsible for not placing their own, and other, children at risk of serious infections. Well tailored laws can also help reduce the number of people objecting to vaccinations due to misinformation.

,

Conclusion
The global crises of underimmunisation risks hard-won gains in preventing infectious diseases. Resurging childhood diseases and fragile global vaccination campaigns necessitate concerted action. Our action plan focuses on the prime causes of underimmunisation: vaccine availability, public distrust, and lax immunisation laws. Immunisation is a potent public health tool. Finding the political will and holding governments accountable are essential. Countless lives can be saved if the international community sustainably funds vaccination systems, assures reliable information, and safeguards the common good through meaningful law reform.

Featured Journal Content

The Lancet Child & Adolescent Health
Volume 4, ISSUE 1, P1, January 01, 2020
https://www.thelancet.com/journals/lanchi/issue/current
Editorial
Youth without freedom
The 30th anniversary of the UN Convention on the Rights of the Child (UNCRC) on Nov 20, 2019, is a chance to reflect on the global status of children’s rights. A report by UNICEF addresses the progress made in the past three decades, including reduced child mortality rates and increased global access to education, but notes many outstanding challenges such as increasing poverty, dangers posed by climate change, and declining vaccination rates. A Viewpoint by Jeff Goldhagen and colleagues discusses these threats to children’s health through a rights, justice, and equity lens.

One focus of the convention is a child’s right to an appropriate justice system, protection from danger and conflict, and provision of humane detention when necessary. It stresses that deprivation of a child’s liberty should only be used as a measure of last resort, and for the shortest appropriate period of time. The UN Global Study on Children Deprived of Liberty, published on Nov 20, 2019, is therefore timely because it provides the first comprehensive data determining the magnitude of the issue of children deprived of liberty, its possible justifications and root causes, as well as conditions of detention and their harmful effect on the health and development of children.

The UN study indicates that at least 1·3 million children are globally deprived of liberty per year; an estimated 410 000 in the administration of justice, 330 000 in migration-related detention, 35 000 in armed conflict situations, and 1500 for national security reasons. An additional 19 000 children are living with their primary caregivers in prisons and a further 1 million children are in temporary police custody. Lesbian, gay, bisexual, transgender, and intersex children and adolescents, boys, and those with a disability are at increased risk, and constitute a disproportionate share of institutionalised youth. External risk factors also contribute—eg, ineffective child welfare systems, insufficient support for family environments, low minimum age of criminal responsibility, harsh sentencing, discrimination, socioeconomic hardships, and a lack of resources for the administration of justice.

The UNCRC specifies that when children cannot live with their families, “the State should endeavour to provide a family-like environment where they can develop their personality, their emotional relationships with others, their social and educational skills and their talents”. Due to the formative nature of childhood, deprivation of liberty during development can have highly detrimental effects on a child’s physical and mental health. Although there is little evidence that detention alone is a primary cause of health problems, living in overcrowded conditions increases the risk of communicable diseases, unnecessary restrictions on movement and physical activity negatively affect development, and abuse or neglect while in detention often cause or compound mental and cognitive health problems, such as anxiety, depression, or regression of language. Often, health problems in children deprived of liberty are further exacerbated by limited accessibility to and low quality of health care.

On Nov 21, WHO released a status report on prison health in Europe detailing the health status of those incarcerated in the region. The data present a dire situation, showing enormous health disparities between people detained in prison and those living in the community, and highlighting the increased risk of suicide and self-harm. The report suggests that prisons and other institutions should be considered as public health opportunities, where existing health conditions can be treated and improved, and interventions to promote healthy lifestyles and positive behavioural changes can be administered. Such approaches are particularly appealing in the context of youth detention. While adolescence is a period of unique vulnerability, it also offers great potential because many children and young people are receptive to behavioural change and interventions are applied early enough for any lifestyle modifications to make enormous gains in future health outcomes.

The UN study shows that sentencing children to custodial prison sentences remains widespread, despite recommendations that even when a child has committed a crime, alternative solutions such as probation, foster care, or education and vocational training programmes should be considered. Where alternatives to custodial prison sentences cannot be found, it is imperative that detained youth are able to access the same standard of health care as available in the community. The UNCRC declares that all children and adolescents have a right to the highest attainable standard of health. We must not accept anything less for those young people deprived of their liberty.

Emergencies

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

Ebola Outbreak in DRC 73: 24 December 2019
Situation Update
In the week of 16 to 22 December 2019, 14 new confirmed Ebola virus disease (EVD) cases were reported from four health areas within two health zones in North Kivu province in the Democratic Republic of the Congo. The new confirmed cases in the past week are from Mabalako Health Zone (12/14; 86%) and Butembo Health Zone (2/14; 14%)…

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DRC Ebola outbreaks
Military presence leads MSF to stop activities in Ebola-affected Biakato
Press Release 24 Dec 2019
Following security incidents in Biakato, Democratic Republic of Congo, an increase in security – including armed military forces – have been deployed around and within health structures. The presence of arms and weapons in hospitals and clinics has resulted in Médecins Sans Frontières (MSF) taking the difficult decision to stop medical activities – including those related to Ebola – in Biakato.
“We are no longer able to work in accordance with our principles of neutrality and impartiality,” said Ewenn Chenard, Emergency Coordinator for MSF. “We regret this decision, but the presence of armed forces around and within the health structures of Biakato goes against our principles.”
MSF has been working with the people of Biakato, located in DRC’s northeastern Ituri province, since 2016, supporting the Ministry of Health. Initially, our activities were dedicated to assisting victims of sexual violence…

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POLIO
Public Health Emergency of International Concern (PHEIC)

Statement of the Twenty-Third IHR Emergency Committee Regarding the International Spread of Poliovirus
20 December 2019
[Excerpts; Editor’s text bolding]
The twenty-third meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director General on 11 December 2019 at WHO headquarters with members, advisers and invited Member States attending via teleconference, supported by the WHO secretariat.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV).  The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations.  The following IHR States Parties provided an update on the current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 16 September 2019: Afghanistan, Angola, Benin, Central African Republic (CAR), Chad, Cote d’Ivoire, Democratic Republic of Congo (DR Congo), Ethiopia, Ghana, Nigeria, Pakistan, Philippines, Togo and Zambia…

Wild poliovirus
The Committee remains gravely concerned by the significant increase in WPV1 cases globally to 113 as at 11 December 2019, compared to 28 for the same period in 2018, with no significant success yet in reversing this trend. 

In Pakistan transmission continues to be widespread, as indicated by both AFP (acute flaccid paralysis) surveillance and environmental sampling. Khyber Pakhtunkhwa province continues to be of particular concern.  The issues noted previously by the committee, including refusal by individuals and communities to accept vaccination, and problems with politicization of the national polio program are still being addressed.  Added pressure is now on the program due to confirmation of detection of cVDPV2 in several provinces (see below).
In Afghanistan, the security situation remains very challenging.  Inaccessible and missed children particularly in the Southern Region represent a large cohort of susceptible children in this part of Afghanistan.  The risk of a major upsurge of cases is growing, with other parts of the country that have been free of WPV1 for some time now at risk of outbreaks. This would again increase the risk of international spread.  Major efforts must be made to improve access if eradication efforts are going to progress.

The committee noted that based on sequencing of viruses, there were recent instances of international spread of viruses from Pakistan to Afghanistan and also from Afghanistan to Pakistan.  The recent increased frequency of WPV1 international spread between the two countries suggests that rising transmission in Pakistan and Afghanistan correlates with increasing risk of WPV1 exportation beyond the single epidemiological block formed by the two countries…

Vaccine derived poliovirus
The multiple cVDPV outbreaks in four WHO regions (African, Eastern Mediterranean, South-east Asian and Western Pacific Regions) are very concerning, with seven new countries reporting outbreaks since the last meeting (Chad, Cote d’Ivoire, Malaysia, Pakistan, Philippines, Togo and Zambia).  Since the last meeting, cVDPV2 has spread through West Africa and the Lake Chad area, reaching Cote d’Ivoire, Togo and Chad, and cVDPV1 has spread from the Philippines to Malaysia.

The rapid emergence of multiple cVDPV2 strains in several countries is unprecedented and very concerning, and not yet fully understood. 

The committee noted that the GPEI was developing a strategy to address cVDPV2 outbreaks but was extremely concerned that the monovalent OPV2 stockpile was becoming depleted.  The committee strongly supports the development and proposed Emergency Use Listing of the novel OPV2 vaccine which should become available mid-2020, and which it is hoped will result in no or very little seeding of further outbreaks.

Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  The committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing risk of international spread and ongoing need for coordinated international response…

Additional considerations  
Preparedness – The committee urged all countries, particularly those in Africa, be on high alert for the possibility of cVDPV2 importation and respond to such importations as a national public health emergency.  This means countries should ensure polio surveillance can rapidly detect cVDPV2, and plans are in place to respond rapidly with well planned and executed mOPV2 campaigns, and with strict procedures to ensure unused vials are returned and managed so that inappropriate or accidental use is avoided.

International Coordination – Unprecedented levels of international spread of cVDPV require urgent coordinated control measures at regional and sub-regional levels.  The committee strongly encourages countries to do more in support of cross border actions, such as sharing of surveillance and other data, synchronizing campaigns and where possible ensure vaccination of international travelers.

Emergency Response – The committee noted the endorsement of SAGE for the accelerated clinical development of novel OPV2 and its assessment under the WHO Emergency Use and Listing (EUL) procedure, which can be used in a public health emergency of international concern (PHEIC), and added its support to ensure the supply of monovalent OPV2.

Financing – The number of outbreaks is proving to be costly to manage, and the committee urged affected countries to prioritize polio control as a public health emergency and ensure adequate domestic funding is available for an effective response.  The committee urged affected countries to mobilize domestic funding to complement the GPEI resources which are being stretched by the large number of outbreaks being fought globally.

Communication – Vaccine hesitancy is a significant factor in the spread of these outbreaks particularly certain countries including Pakistan and Angola.  The committee urged countries to invest time and resources into pro-actively circumventing and countering myths and misinformation regarding vaccination is general, and rumors that arise during the course of campaigns in particular.  Campaign communications need to address issues around avoiding spreading excreted Sabin-like viruses through good hygiene.

Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 19 December 2019 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV.  The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 19 December 2019.

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Three African countries halt polio outbreaks
Kenya, Mozambique and Niger have curbed polio outbreaks that erupted in different episodes over the past 24 months, allowing them to regain their polio-free status, World Health Organization (WHO) announced
Brazzaville, 19 December 2019 – Kenya, Mozambique and Niger have curbed polio outbreaks that erupted in different episodes over the past 24 months, allowing them to regain their polio-free status, World Health Organization (WHO) announced.
Transmission of vaccine-derived poliovirus was detected in the three countries in 2018, affecting 12 children. No other cases have since been detected.
“Ending outbreaks in the three countries is proof that the implementation of response activities and ensuring that three rounds of high-quality immunization campaigns are conducted can stop the remaining outbreaks in the region,” said Dr Modjirom Ndoutabe, Coordinator of the WHO-led polio outbreaks Rapid Response Team for the African Region.
“We are strongly encouraged by this achievement and determined in our efforts to see polio eradicated from the continent. It is a demonstration of the commitment by Governments, WHO and our partners to ensure that future generations live free of this debilitating virus,” added Dr Ndoutabe…

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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 4 Jan 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 73: 24 December 2019

Syrian Arab Republic
:: WHO deeply concerned about deteriorating health conditions in northwest Syria
25 December 2019, Geneva-Cairo-Copenhagen –  The World Health Organization today expressed its deepening concern about the situation in northwest Syria and the impact hostilities are having on the health of a population that has endured sustained hardships, in what is now harsh weather conditions.
“The recent military escalation in this area has resulted in loss of lives, injuries and exacerbated suffering of civilians, displacing more than 130,000, including women, children and elderly,” said Dr Richard Brennan, Director of Health Emergencies for WHO’s Eastern Mediterranean Region. “Some have been displaced three times during the nine years of the Syrian conflict,” he added.
Among the 12 million people in need of health services in Syria, over 2.7 million are in the northwest and half 0.5 million live in the areas south of Idleb, where disruption of fragile health services continues…

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
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 4 Jan 2020]
Myanmar
:: Bi‐weekly Situation Report 25 – 19 December 2019
HIGHLIGHTS
:: Tuberculosis(TB) performance for the third quarter for Cox’s Bazar District was reviewed at a meeting held with a view to strengthening TB programme activities in the district.
:: Oral Cholera Vaccine (OCV)campaign in Rohingya camps has ended on 14 December. However, the campaign for the host community will continue for the period of 8 to 31 December 2019.
:: A total of 127 Community Health Worker(CHW) supervisors have received a two-day training on risk factors of Non-Communicable Diseases (NCD) and behavioral interventionsin Cox’s Bazar.
:: The government of Bangladesh through National Expanded Program on Immunization(EPI), is going to conduct a month-long Measles Outbreak Response Immunization (ORI) activity from 12 January to 12 February 2020 in the Rohingya camps.
SITUATION OVERVIEW
As per Inter-Sector Coordination Group (ISCG)report of September 2019, there are 914,998 Rohingya refugees in Cox’s Bazar. This includes 34,172 refugees from Myanmar who registered before 31st August 2017. All refugees, including new arrivals, face compounding vulnerabilities, including in health. WHO has been responding to this crisis since September 2017. A summary of response actions from epidemiological weeks 49 and 50 of 2019 is presented below…

Niger
:: L’OMS offre un important lot de médicaments et matériels médicaux au Gouvernement du…
27 décembre 2019
Le Niger fait régulièrement face à des urgences de plus en plus complexes avec un impact négatif sur la santé des populations. Parmi ces urgences « les maladies à potentiel épidémique », telles que le choléra, la méningite, entre autres, mais aussi « les conséquences sanitaires liées à l’activisme de groupes armées non étatiques (GANE) » le long du périmètre des quatre frontières Mali-Burkina Faso-Nigéria-Niger impliquant dix (10) districts sanitaires (DS) dans la région de Tillabéry, 2 dans celle de Tahoua, cinq (5) dans celle de Diffa et 2 dans celle de Maradi, engendrant de grands mouvements de populations.

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
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 4 Jan 2020]

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

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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
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 4 – As of 2 January 2020

Yemen – No new digest announcements identified

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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 – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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Editor’s Note:
We rarely include editorials/opinions in our coverage each week, but thought to share this as we close the year.

Financial Times
The editorial board
Opinion
The spirit of endeavour has not dimmed in 2019
Power of the human mind, body and creativity was on display this year
December 23 2019

These can seem unsettling times. Populism is on the rise; liberal democracy is under pressure. Protectionism is threatening to stifle free trade. China and the US are locked in what seems ever more like a new cold war. Leaders are struggling to agree on how to cut carbon emissions. Extreme weather events are increasing. Yet amid the uncertainty, stories of extraordinary people have been the bright spot.

Countless citizens across the world have shown the power of the human body, mind and spirit to achieve remarkable things in 2019. The Financial Times chose Satya Nadella as its person of the year for reviving Microsoft while instilling a new purpose and sense of humility. Many others deserve to be honoured.

In April, a team of scientists developed the first picture of a black hole, an astronomical phenomenon from which no light can escape. Katie Bouman, a young computer scientist, became the symbol of the achievement for using her knowhow to craft an algorithm that could stitch together the images from a network of telescopes. Outer space witnessed other new human firsts. Fifty years after the moon landing, astronauts Christina Koch and Jessica Meir took part in the first all-female spacewalk while China’s Chang’e 4 mission completed the first successful “soft” landing on the far side of the moon.

Many of the greatest individual achievements this year have been internal: victories over our own limits. Eliud Kipchoge was the first human to run a marathon in under two hours. He achieved the milestone in a time trial in Vienna in October, helped by a laser routemarker, a team of support staff and 41 pacemakers. Jasmin Paris became the first woman to win the 268-mile Montane Spine Race, breastfeeding her 14-month old daughter on the way. Nepalese mountain climber Nirmal “Nims” Purja, a former Gurkha, scaled the 14 highest peaks in the world in six months, beating the existing speed record by more than seven years.

Others have depended on teamwork: Siya Kolisi, captain of the world cup winning rugby team, became the first black South African to lift the trophy. Megan Rapinoe, captain of the US team that won the women’s football world cup, used her platform to call for equal pay. Ben Stokes, the English cricketer, secured the world cup for his nation in highly dramatic style.

This was the year when humans began to harness the power of quantum computers: a team at Alphabet, Google’s parent, declared they had achieved “quantum supremacy”, as their device beat a traditional computer. Others focused on making sure that technological advances did not mean abandoning morality: Meredith Whittaker, an artificial intelligence worker who had led protests about her employer Google’s policies in 2018, resigned from her job this year.

Others have demonstrated the human power for creativity. Bernadine Evaristo became the first black woman to win the Booker prize this year. She shared it with Margaret Atwood, who first won the prestigious prize close to two decades ago. Stormzy, a British rapper, not only crafted stunning imagery in his headline set at Glastonbury, but a scholarship he funds was credited with an increase in the number of black students applying to the elite University of Cambridge.

Those listed here are just the tip of the iceberg. Many of the most extraordinary people go unsung in unglamorous jobs, doing the work of caring for others day in, day out. They are a reminder that no matter how dark the news appears to be, the spirit of human endeavour remains undimmed. The FT salutes them.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 21 December 2019

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

David R. Curry
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 21 Dec 2019

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

The Sentinel will resume publication on 4 January 2020 after an end-of-year holidays break.

COP25 :: UN Climate Change Conference – December 2019

UN Climate Statement / 19 Dec, 2019
Statement by the Executive Secretary of UN Climate Change, Patricia Espinosa, on the Outcome of COP25
Several days have passed since the closing of the UN Climate Change Conference COP25 in Madrid, and it is important to conduct an honest and realistic assessment of what happened so that appropriate measures can be taken by the international community in guiding the next crucial steps in the multilateral climate process next year.

We need to be clear that the conference did not result in agreement on the guidelines for a much-needed carbon market – an essential part of the toolkit to raise ambition that can harness the potential of the private sector and generate finance for adaptation. Developed countries have yet to fully address the calls from developing countries for enhanced support in finance, technology and capacity building, without which they cannot green their economies and build adequate resilience to climate change. High-emitting countries did not send a clear enough signal that they are ready to improve their climate strategies and ramp up ambition through the Nationally Determined Contributions they will submit next year.

At the same time, in the final decision texts, governments did express the need for more ambition by Parties and non-State actors alike, and they agreed to improve the ability of the most vulnerable to adapt to climate change. Many decisions that emerged from the conference in Madrid at least acknowledge the role of climate finance, essential for concrete action. And decisions were taken in areas including technology, oceans and agriculture, gender and capacity building. A large group of countries, regions, cities, businesses and investors signaled their intention to achieve net-zero CO2 emissions by 2050, as part of the Climate Ambition Alliance led by Chile. Also rallying under the Climate Ambition Alliance, 114 nations have meanwhile signaled their intention to submit an enhanced climate action plan next year. The caveat here is that not enough major economies have signaled that they are ready to shift the needle on climate ambition through improved plans.

Commitments from many sectors of society showed an overwhelming agreement on the only way forward: that we need to follow what science is telling us, with the sense of urgency and seriousness that this requires. What we need now is to focus our undivided attention on the next steps to further strengthen the trust in the multilateral process. As we head towards the UN Climate Change Conference COP26 in Glasgow, we must be united and work in a true spirit of inclusive multilateralism in order to realize the promises of the Paris Agreement and the UN Framework Convention on Climate Change. I thank the governments of Chile and Spain for their enormous efforts to organize COP25, and I thank all observer organizations, including the private sector, youth and scientists, for reminding us every day of the need to raise ambition. I look forward to working with the governments of Chile, the UK and Italy to achieve the best possible results at COP26 in Glasgow. Together, with all sectors of the economy and societies at large, we must work tirelessly to address the greatest challenge of our generation.

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Global Community Must Not Give Up Tackling Climate Crisis, Secretary-General Says, Expressing Disappointment with Results of Twenty-Fifth Conference
SG/SM/19914-ENV/DEV/2034
15 December 2019
The following statement by UN Secretary General António Guterres was issued today:

I am disappointed with the results of [the twenty fifth Conference of the Parties (COP25) to the United Nations Framework Convention on Climate Change (UNFCC)].

The international community lost an important opportunity to show increased ambition on mitigation, adaptation and finance to tackle the climate crisis.

We must not give up and I will not give up. I am more determined than ever to work for 2020 to be the year in which all countries commit to do what science tells us is necessary to reach carbon neutrality in 2050 and a no more than 1.5°C temperature rise.