“Public Security” – the Americas

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

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

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

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

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

Featured Journal Content

The Lancet
Nov 02, 2019 Volume 394Number 10209p1591-1684, e34
https://www.thelancet.com/journals/lancet/issue/current

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

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

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

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

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

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

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

Governance – Online Political Advertising

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

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

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

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

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

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

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

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

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

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

Featured Journal Content

Nature Reviews Genetics
Volume 20 Issue 11, November 2019
https://www.nature.com/nrg/volumes/20/issues/11

Roadmap | 27 August 2019
Leveraging European infrastructures to access 1 million human genomes by 2022
Gary Saunders, Michael Baudis[…] & Serena Scollen
Abstract
Human genomics is undergoing a step change from being a predominantly research-driven activity to one driven through health care as many countries in Europe now have nascent precision medicine programmes. To maximize the value of the genomic data generated, these data will need to be shared between institutions and across countries. In recognition of this challenge, 21 European countries recently signed a declaration to transnationally share data on at least 1 million human genomes by 2022. In this Roadmap, we identify the challenges of data sharing across borders and demonstrate that European research infrastructures are well-positioned to support the rapid implementation of widespread genomic data access.

Conclusions [Excerpt]
Our understanding of the human genome is recognized as a primary factor for improvement in health care. Initiatives on a national scale are being established to generate genomic data to realize the benefits of precision medicine. The most advanced — Genomics England in the UK — has now completed full genome sequencing for more than 100,000 participants22 and has already demonstrated benefits by providing a diagnosis for one in four participants of the rare disease component of the initiative. No other national sequencing initiative has reached this scale, with most being currently at the stage of inception.

Data sharing knowledge and technologies sit mostly within the research sector where, to date, most data have been generated. As the majority of genomics data generation shifts to the health-care sector4, a sector that is not used to handling data at this scale, the knowledge that already exists should be leveraged. Providing access to sensitive human data to authorized researchers within one country is challenging in itself; providing access to 1 million human genomes cross-border by 2022 (as proposed by the EU declaration5) will be even more so. Beyond the technical capabilities, such a project needs to ensure that patients are satisfied and understand how their data are shared, or willingness to participate will dwindle and future benefits will not be realized.

Efficient management of genomics data from human participants, ensuring that the privacy of individuals is preserved, will be vital to meet current aims. To truly federate services for controlled-access human data we will need to identify, develop and disseminate global interoperable and reusable standards, and these standards must be persistent, stable and fit for purpose. We have described in this paper the infrastructure that exists to build upon for transnational-scale genomics data access and our minimal recommendations for an EU-wide infrastructure for accessing and analysing genomics data…

Declaration of cooperation: towards access to at least 1 million sequenced genomes in the European Union by 2022. European Commission (2018).

Emergencies

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

No new Situation Update posted.

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Global consortium working with DRC Government to introduce second Ebola vaccine
31 Oct 2019 CEPI
A global consortium is supporting the Government of the Democratic Republic of the Congo (DRC) to introduce a second investigational Ebola vaccine as part of ongoing efforts to contain the outbreak in eastern DRC.

The large-scale clinical trial, sponsored by the London School of Hygiene & Tropical Medicine (LSHTM), is designed to help prevent the spread of the epidemic, the second worst in history, beyond the currently affected areas in eastern DRC, and if possible gather crucial information about the effectiveness of the vaccine to be better prepared to fight Ebola in the future.

The consortium is led by the DRC Ministry of Health (MOH) and Institut National de Recherche Biomédicale (INRB) and includes LSHTM, the Coalition for Epidemic Preparedness Innovations (CEPI); Médecins Sans Frontières (MSF) and Epicentre; with the Wellcome Trust contributing critical strategic guidance. Janssen Vaccines & Prevention B.V. is donating the experimental vaccine regimen for the study undertaken by the consortium.

The two-dose Ebola vaccine regimen (Ad26.ZEBOV, MVA-BN-Filo) is manufactured by the Janssen Pharmaceutical Companies of Johnson & Johnson. It was developed in collaboration with global partners, including Bavarian Nordic A/S, the U.S. Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services (HHS), the Innovative Medicines Initiative (IMI) funded through the European Union Horizon 2020 Programme, and the U.S. National Institutes of Health (NIH) at HHS.

The introduction of this second vaccine was recommended by the World Health Organization’s Strategic Advisory Group of Experts on Immunization in May 2019 to complement ongoing use of another investigational vaccine, rVSV-ZEBOV, made by Merck Pharmaceuticals. The Merck vaccine is being used in a ring vaccination strategy targeting contacts of those with Ebola virus disease and other health and frontline workers at high risk.

More than 6,500 people have taken part in multiple previous and ongoing clinical trials of the Janssen Ebola vaccine regimen. The available data indicate that the vaccine is well tolerated and induces robust immune responses to the Zaire strain of Ebola virus – the cause of the DRC outbreak. At present, there are no human data on efficacy in preventing Ebola virus infection.
In 2019 researchers in Uganda began a two-year clinical trial of the vaccine among healthcare and frontline workers. The vaccine is also undergoing evaluation along with the Merck vaccine as part of a large Phase 2 randomized, placebo-controlled trial in West Africa called PREVAC that began in 2017.

Ad26.ZEBOV, MVA-BN-Filo will be offered to adults and children aged one year or older under a clinical trial protocol that aims to evaluate the effectiveness and safety of the vaccine in an outbreak setting. The regimen includes two doses (one of Ad26.ZEBOV and the second of MVA-BN-Filo), spaced two months apart.

Janssen will donate up to 500,000 doses of the vaccine regimen for those in communities near the outbreak who are considered at risk, as determined by the DRC MOH, INRB and consortium partners, taking into account the latest epidemiological data on disease spread, as well as logistical and security concerns.

Dr Eteni Longondo, Minister of Public Health, DRC, said: “As part of our Ebola response efforts, the Government of DRC plans to introduce a second experimental Ebola vaccine within a clinical trial protocol. It’s vital that we intensify our efforts. That’s why we’re working with international partners to provide our response teams with another tool to fight and ultimately stop the spread of this terrible disease.”

The study will be implemented by the INRB and MOH, supported by MSF, Epicentre, and LSHTM under the leadership of the Principal Investigator Dr Jean-Jacques Muyembe, INRB Director General and head of the DRC multisector Ebola response committee.

Dr Muyembe said: “The current Ebola outbreak is concentrated in North Kivu and Ituri provinces, areas which have had to deal with insecurity and violent conflict. This environment has complicated response efforts and led to distrust of health care workers, which has become a major problem. Therefore, effective community engagement will be absolutely critical to the successful introduction of a second Ebola vaccine. Deploying any vaccine in these circumstances is enormously challenging and must be done alongside a range of other public health measures and interventions, such as contact tracing. But building trust and confidence within affected communities must be our priority.”…
country….

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 30 October 2019
:: With less than a month left to the GPEI pledging event in Abu Dhabi, G20 Health Ministers gathered in Okayama, Japan, on 19 – 20 October 2019 to address major global health issues where they maintained their commitment to eradicating polio. Read more on the ministers’ declaration.
:: Following the certification of eradication of WPV3, WHO Director General Dr Adhanom Ghebreyesus expressed his gratitude to all who made the achievement possible and called on all stakeholders to continue with the fight to eradicate WPV1. Read the DG’s thank-you letter.
:: The effects of polio hit hard. The disease not only causes pain and suffering to the victim and the family, but also forces relatives to quit their income-generating activities, to provide care to the afflicted child. Read about little Junaisa – the first polio patient in the Philippines since 2001.
:: Get up-to-date on the different aspects of GPEI’s status of work in 2018 through the newly released 2018 annual report.

Summary of new viruses this week:
:: Afghanistan— one WPV1 case;
:: Pakistan— one WPV1 case and 12 WPV1-positive environmental samples;
:: Central African Republic— three cVDPV2 cases and one cVDPV2 positive environmental sample. Angola— 11 cVDPV2 cases;
:: Philippines— one cVDPV2 case, one cVDPV1 and two cVDPV2 positive environmental samples.

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Okayama Declaration of the G20 Health Ministers
October 19-20, 2019
…
12. We reaffirm our commitment to eradicate polio, and we note the leadership role of WHO.
We are concerned with the rising number of vaccine-derived polio outbreaks. We call for
a strong cross-border cooperation and strict implementation of vaccine requirements for
travelers as specified in the International Health Regulations (IHR, 2005). We support the
efforts of the Global Polio Eradication Initiative (GPEI), Gavi, the Vaccine Alliance (Gavi),
WHO, UNICEF, and other stakeholders in strengthening routine and supplemental
immunization. We also support their efforts to ensure transition of relevant polio assets
into the national programs and we encourage countries to provide adequate domestic
resources to strengthen national health systems. We look forward to the replenishment of
GPEI next month.

13. We recognize that immunization is one of the most cost-effective health investments with
proven strategies that make it accessible to all segments of the population with an
emphasis on women and girls, the most hard-to-reach as well as the vulnerable and
marginalized populations. We express our concern about vaccine hesitancy as mentioned
in the WHO’s Ten threats to global health in 2019. We are committed to strengthen health
systems and accessibility of safe, effective, quality, and affordable vaccines for sustainable
immunization to achieve high vaccination coverage as well as confidence in vaccines. We
look forward to the third replenishment of Gavi next year in the United Kingdom…

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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 2 Nov 2019]

Democratic Republic of the Congo
:: 835 000 people to receive second dose of the cholera vaccine in North Kivu, Democratic Republic of the Congo Goma, 30 October 2019

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

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WHO Grade 2 Emergencies [to 2 Nov 2019]

Myanmar
:: Bi‐weekly Situation Report 21 – 24 October 2019 pdf, 639kb

Niger
:: Evaluation externe de la riposte (OBRA) à l’épidémie de poliomyélite 31 octobre 2019

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
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 2 Nov 2019]

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

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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
:: Syria ǀ Flash Update #10, Humanitarian impact of the military operation in north-eastern Syria, 26 – 28 October 2019 [EN/AR]

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
:: 01 Nov 2019 Kenya: Heavy rains impact more than 100,000 people

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 26 October 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 26 Oct 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]

Myanmar – Rohingya

UN Independent International Fact-Finding Mission on Myanmar calls on UN Member States to remain vigilant in the face of the continued threat of genocide
23 October 2019
NEW YORK (23 October 2019) – The head of the UN Independent International Fact-Finding Mission on Myanmar, Marzuki Darusman, told the General Assembly on Wednesday that Myanmar is failing in its obligations under the Genocide Convention to prevent, to investigate and to enact effective legislation criminalising and punishing genocide.

Mr. Darusman spoke to the General Assembly at the request of the Human Rights Council. He said the Mission’s findings are based on the fact that the policies, laws, individuals and institutions that laid the groundwork for the brutal “clearance operations” in 2016 and 2017 remain in place and strong.

Mr. Darusman said the Mission found that crimes under international law, which were reported on last year, continue to be committed by Myanmar’s military, called the Tatmadaw, throughout the country, impacting Myanmar’s ethnic communities.

Serious violations of human rights and humanitarian law have been committed in both northern Myanmar and in the context of the continuing conflict between the Tatmadaw and the Arakan Army in Rakhine State. “This confirms our previous conclusion that the cycle of impunity enables, and indeed fuels, this reprehensible conduct on the part of the security forces,” Mr Darusman said.

The harsh persecution of the Rohingya community in Myanmar continues unabated in defiance of the international community. The treatment of some 600,000 Rohingya remaining in Rakhine State is largely unchanged. Their situation has worsened, as they endure another year subjected to discrimination, segregation, movement restrictions and insecurity, without adequate access to livelihoods, land, basic services, including education and health care, or justice for past crimes committed against them by the Tatmadaw.

This makes the return to Rakhine State of close to one million Rohingya refugees in Bangladesh simply impossible, Mr. Darusman said…

IDPs

Joint Statement by the Special Rapporteur on the Human Rights of IDPs, IOM, OCHA and UNHCR to mark the 10th Anniversary of the Adoption of the Kampala Convention
2019-10-23 13:05
New York – Africa is marking today the 10th anniversary of the adoption of the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa. Also known as the Kampala Convention, this ground-breaking treaty has so far been ratified by 28 countries on the continent.

As the world’s first and only continent-wide legally binding instrument for the protection and assistance of internally displaced persons (IDPs), the Kampala Convention is a testament to the determination of African States to address the multiple challenges of IDPs. The treaty incorporates the basic elements of the 1998 UN Guiding Principles on Internal Displacement and outlines the responsibilities of States and other actors.

Internal displacement remains a significant problem in countries across Africa, with more than 17.8 million people being displaced by conflict and violence. Women and children constitute the vast majority of those affected.

We fully recognize the role and contribution that the Convention has made in preventing displacement across Africa, providing effective responses to displacement crises and supporting solutions for displacement situations, whether triggered by armed conflicts, violence or the effects of climate change and disasters.

We also welcome and support the decision of the Assembly of the African Union to declare 2019 as the ‘Year of Refugees, Returnees and Internally Displaced Persons: Towards Durable Solutions to Forced Displacement in Africa’. This commemorative decision is an important opportunity to take stock of progress in implementing the Convention and identify outstanding challenges.

Now is the time to fully translate the Kampala Convention into practice. We applaud all countries that have ratified the Convention and taken concrete steps to realize the spirit and letter of the treaty, including through developing relevant national laws and policies. We welcome the latest accession by the Republic of South Sudan to the Convention and call on all those that have not ratified and domesticated the Convention to do so without delay.

We also welcome the announcement earlier today of the United Nations Secretary-General to establish a High-level Panel on Internal Displacement to increase global attention on displaced persons and develop concrete recommendations to improve the response.

We furthermore call on member States of the African Union, international organizations and other partners to support the full and effective participation of both displaced and host communities in the implementation of the Convention. We also call on the international community to do more to strengthen its assistance and solidarity with countries and communities coping with internal displacement, including through a more collaborative and strategic approach and innovative financing mechanisms.

Human Rights – Uighurs / Sakharov Prize

Wall Street Journal
Opinion
Review & Outlook
A Win for the Uighurs
Europe bestows its Sakharov prize on an imprisoned economist.
By The Editorial Board
Oct. 25, 2019 7:03 pm ET
This week a human-rights activist languishing in the Chinese gulag was awarded Europe’s Sakharov Prize for Freedom of Thought, named after the famous Soviet nuclear physicist-turned-dissident. China’s response tells you why the man deserved it. A Chinese Foreign Ministry spokesman accused the European Parliament of intervening in China’s internal affairs and celebrating “a terrorist.”

The man’s name is Ilham Tohti. By profession he is an economist. Today he is one of the more than a million Uighurs—an ethnic Muslim minority in Xinjiang Province—who have been rounded up and detained in China’s internment camps.

In 2014 Mr. Tohti was arrested and charged with “separatism.” In a statement he gave to Radio Free Asia to be released upon his arrest, he said the only things he ever asked for are “human rights, legal rights, autonomous regional rights, and equality.” The Uighur people, he said, also have a right to be treated with dignity, and not have their culture erased.

It can be tempting to dismiss these awards as empty symbolic gestures, but China doesn’t make that mistake. When the Nobel Committee in 2010 awarded its peace prize to imprisoned democracy activist Liu Xiaobo, it went bananas and took its displeasure out on trade with Norway.

President Xi Jinping and his fellow Communists appreciate that with this prize Europe is directing the world’s attention to China’s larger assault on the Uighur people. Secretary of State Mike Pompeo has called this assault “reminiscent of the 1930s.” The U.S. government has begun to take a stronger line on behalf of the Uighurs, imposing sanctions on the Chinese officials who are responsible. Good to see Europe join in.

Sourcing

Seven Mining, Metals Companies Partner on Responsible Sourcing with World Economic Forum
News 25 Oct 2019
:: Leading mining and metals companies have joined forces to accelerate responsible sourcing of raw materials with the World Economic Forum.
:: The Mining and Metals Blockchain Initiative will explore the building of a blockchain platform to address transparency issues, the track and tracing of materials, the reporting of carbon emissions or to increase efficiency.
:: Antofagasta Minerals, Eurasian Resources Group Sàrl, Glencore, Klöckner & Co, Minsur SA, Tata Steel Limited, Anglo American/De Beers (Tracr), are founding members.

Geneva, Switzerland, 25 October 2019 – Seven leading mining and metals companies have partnered with the World Economic Forum to experiment, design and deploy blockchain solutions that will accelerate responsible sourcing and sustainability practices.

The Mining and Metals Blockchain Initiative will pool resources and cost, increase speed-to-market and improve industry-wide trust that cannot be achieved by acting individually. It aims to be a neutral enabler for the industry, addressing the lack of standardization and improving efficiency. The intention is to send out a signal of inclusivity and collaboration across the industry. The group will look to develop joint proof-of-concepts for an inclusive blockchain platform. Over time, this could help the industry collectively increase transparency, efficiency or improve reporting of carbon emissions.

In many cases, blockchain projects to support responsible sourcing have been bilateral. The result has been a fractured system that leaves behind parts of the ecosystem and lacks interoperability. This new initiative is owned and driven by the industry, for the industry. Members will examine issues related to governance, develop case studies and establish a working group.

Key areas of collaboration and development could include carbon emissions tracking and supply chain transparency. They will work to use blockchain technology to increase trust between upstream and downstream partners, to address the lack of industry standardization and to track provenance, chain of custody and production methods.

“Material value chains are undergoing profound change and disruption”, said Jörgen Sandström, Head of the Mining and Metals Industry, World Economic Forum. “The industry needs to respond to the increasing demands of minerals and materials while responding to increasing demands by consumers, shareholders and regulators for a higher degree of sustainability and traceability of the products.”

The World Economic Forum has offered its platform and expertise to help industry leaders better understand the impact and potential of blockchain technology. It will provide guidance on governance issues related to the delivery of a neutral industry platform and the expansion of members.

Heritage Stewardship – Forests

New $90 Million Fund to Address Global Climate Change through Catalytic Capital
October 23, 2019
Terra Silva to accelerate climate-smart practices in tropical forests worldwide
The David and Lucile Packard Foundation and the John D. and Catherine T. MacArthur Foundation today announced the launch of Terra Silva, a $90 million impact investing collaborative designed to respond to the challenges of global climate change. Terra Silva will make investments focused on the conservation, restoration, and sustainable management of critical tropical forests worldwide.

“Forests currently provide the only proven carbon-negative solution at scale,” said Susan Phinney Silver, Mission Investing Director at the Packard Foundation. “Given the urgency of climate change, we are committed to using mission investments in new ways to amplify and accelerate efforts like Terra Silva to reduce greenhouse gases as fast as possible.”

Terra Silva is launching at a pivotal time for sustainable forestry and related agriculture practices in the market. It will focus on three targets: accelerating reforestation, conservation, and afforestation in tropical forest regions; creating more environmentally and socially sustainable forest management practices at scale within critical tropical forests; and improving the sustainability of emerging climate-smart forestry and agriculture practices. In these ways, Terra Silva will mobilize private financing to conserve and restore tropical forests, promote biodiversity, and support thriving communities in and around critical tropical forests worldwide.

The ultimate goal of Terra Silva is to significantly expand opportunities for commercial investment in sustainable forestry and agriculture by pioneering new investment models, accelerating their adoption, and helping build market infrastructure for climate-smart forestry. More information can be found here.

Terra Silva will incorporate catalytic capital – investment capital that is patient, risk-tolerant, concessionary, and flexible in order to unlock impact and additional investment that would not otherwise be possible – in the form of an investment vehicle financed by the Packard Foundation, the MacArthur Foundation, and another mission-driven investor…

Development Research

The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019
14 October 2019
The Royal Swedish Academy of Sciences has decided to award the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019 to
:: Abhijit Banerjee, Massachusetts Institute of Technology, Cambridge, USA
:: Esther Duflo, Massachusetts Institute of Technology, Cambridge, USA
:: Michael Kremer, Harvard University, Cambridge, USA
“for their experimental approach to alleviating global poverty”

Their research is helping us fight poverty
The research conducted by this year’s Laureates has considerably improved our ability to fight global poverty. In just two decades, their new experiment-based approach has transformed development economics, which is now a flourishing field of research.

Despite recent dramatic improvements, one of humanity’s most urgent issues is the reduction of global poverty, in all its forms. More than 700 million people still subsist on extremely low incomes. Every year, around five million children under the age of five still die of diseases that could often have been prevented or cured with inexpensive treatments. Half of the world’s children still leave school without basic literacy and numeracy skills.

This year’s Laureates have introduced a new approach to obtaining reliable answers about the best ways to fight global poverty. In brief, it involves dividing this issue into smaller, more manageable, questions – for example, the most effective interventions for improving educational outcomes or child health. They have shown that these smaller, more precise, questions are often best answered via carefully designed experiments among the people who are most affected.

In the mid-1990s, Michael Kremer and his colleagues demonstrated how powerful this approach can be, using field experiments to test a range of interventions that could improve school results in western Kenya.

Abhijit Banerjee and Esther Duflo, often with Michael Kremer, soon performed similar studies of other issues and in other countries. Their experimental research methods now entirely dominate development economics.

The Laureates’ research findings – and those of the researchers following in their footsteps – have dramatically improved our ability to fight poverty in practice. As a direct result of one of their studies, more than five million Indian children have benefitted from effective programmes of remedial tutoring in schools. Another example is the heavy subsidies for preventive healthcare that have been introduced in many countries.

These are just two examples of how this new research has already helped to alleviate global poverty. It also has great potential to further improve the lives of the worst-off people around the world.

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The Lancet
October 26, 2019
Editorial
Where next for randomised controlled trials in global health?
The 2019 Nobel Memorial Prize in Economic Sciences was awarded to three economists—Esther Duflo, Abhijit Bannerjee, and Michael Kremer—for their experiment-based research to mitigate global poverty. The award was notable for several reasons. Esther Duflo was only the second woman to win the prize since it began in 1969, and the youngest ever winner. Previous prizes were awarded largely for contributions to theory—for example, by observing and interpreting the behaviour of markets. But this year, the Sveriges Riksbank committee’s recognition of the randomised controlled trial (RCT) elevates a method long used in medicine, but much less so in human development.

Although based in the USA, the three laureates have worked with some of the poorest people to understand their lives and the constraints that keep them poor. They made important discoveries. Those living in poverty often spend their meagre disposable income on activities to relieve tedium or bring small pleasures. In India, they found that people spent their budgets on religious festivals. In Nicaragua, it was owning a radio or television. The laureates concluded that simply providing money to the poor to alleviate poverty was not enough because there are too many competing expenditures. They decided to break down the problems into smaller manageable questions and use empirical data to examine which interventions work and which do not, and what motivates people to make the choices they make. They used RCTs to assess the causal effects of an intervention.

Together, their work has made important contributions to health care, education, agriculture, and gender issues. Understanding how demand for de-worming medicines to treat parasitic infections in Kenya is affected by price provided the case for why governments should subsidise health care. In India, vaccination uptake increased by improving service quality and providing families with small incentives. The laureates have used their findings to develop new anti-poverty programmes and influence policy. Despite their success in producing evidence for social change, many notable economists and social scientists have criticised RCTs on philosophical, epistemological, political, and methodological grounds. Of course, other study designs and approaches, such as more qualitative analyses, aid our understanding of health and development too, but the RCT remains the best means of discovering whether any proposed intervention may work.

While development economics has drawn lessons from medicine, what can medicine learn from this experimentalist turn in economics? The laureates have shown that RCTs can be done in some of the most challenging human circumstances. Importantly, the design of interventions must be based on a detailed understanding of context. Too often, a policy shown to work in one setting is transplanted to another, with scant regard for whether the situation is at all similar. This scenario is especially true for health policy, in which a community of highly paid international consultants travel business class from country to country peddling their favourite idea.

A good example of where these lessons have been learnt is the HOPE-4 trial, published last month in The Lancet. This cluster RCT of hypertension management in Malaysia and Colombia achieved impressive results. The intervention had multiple components—task shifting, peer support, free medicines, and simplified guidelines. But what was particularly important was that the intervention in each country was designed following a detailed study of the lived experience of patients and after interrogation of policy makers. This knowledge was integrated with systematic reviews of experiences elsewhere. Why would someone be expected to take a tablet for high blood pressure for life when they feel perfectly well? Only by answering this question and others might interventions be successful.

RCTs in global health must evolve to become more meaningful. Too often, trials are severely restricted, with little ability to plan for changes across the study (adaptive) and being ready for unforeseen decision making (simulation modelling) at a huge cost and effort. An upcoming Lancet Global Health Series on improving efficiency in global health clinical trials aimed both at researchers and funding bodies will focus on innovative designs and avoiding research waste.

The lesson from this year’s Nobel Prizes is that one size does not fit all. In conceiving and doing rigorous experiments to find out what really works, we need to listen to the voices of the poor and design interventions that respond to their beliefs, needs, and expectations.

Global Health – SDGs/Agenda 2030

Global Health Progress launched to drive cross-sectoral collaborations in support of the Sustainable Development Goals
25 October 2019
Geneva, 25th October 2019 – To drive new and existing collaborations to support the SDGs, with a particular focus on SDG 17: Partnership for The Goals, the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) has launched Global Health Progress. This knowledge hub collates industry efforts – from individual company programs to initiatives between multiple IFPMA member companies – to highlight contributions to the SDGs, visualize efforts, and enhance opportunities for further collaboration. Global Health Progress also shares information and best practices to support continual learning, drawing on complementary expertise to expand the reach and impact of programs.

2020 marks the 10-year countdown until the SDG deadline. The global goals were launched five years ago as the blueprint for dignity, peace and prosperity for people and our planet. Since their launch, countries have made progress towards achieving the goals. However, complex health and wellbeing issues remain – from poverty and inequality to conflict and climate change. Further, many countries are now faced with a double burden of disease – as they continue to tackle infectious disease challenges, they also battle with an increasing prevalence of non-communicable diseases (NCDs) – which present new issues in implementing effective and sustainable solutions for health. The innovative biopharmaceutical industry recognizes the need for new approaches to reach the 2030 deadline.

Global Health Progress highlights over 200 collaborations which use innovative approaches to tackle global health challenges. The collaborations are helping to bring different actors together – governments, academia, multilateral organizations, other private sector companies, local NGOs and more – to catalyze cross-sector initiatives to tackle health related challenges, as well as address gender equality and education issues. A range of program strategies are being used – including capacity building, community awareness and health service delivery – to address systemic health issues and lay foundations to sustain program gains. In consultation with local actors, IFPMA member companies are fostering local ownership and designing programs according to specific health needs and existing health system infrastructure. The collaborations are transforming traditional partnership approaches by working with a growing number of other business sectors to develop integrated solutions, including partnerships with generic manufacturers, telecommunication and insurance companies, and financial institutions.

IFPMA’s Director General, Thomas Cueni, discussed the value of innovative approaches to collaboration to address global health challenges “If we are to overcome today’s most pressing global health challenges, we need some fresh, out-of-the-box thinking and innovative alliances that bring diverse sectors together to unlock greater value for organizations involved and greater impact for the beneficiaries on the ground. Our industry is committed to sharing knowledge and Global Health Progress is one way in which we are helping to drive new collaborations to strengthen healthcare systems. Effective partnerships will help our innovations to grow, reaching more patients worldwide.”…

Humanitarian Response – Fiscal Resources

Press release
Lack of funding leaves millions of children in conflict and disaster zones at risk
$4 billion humanitarian appeal nearly 50 per cent unfunded heading into final quarter of 2019
22/10/2019
NEW YORK, 22 October 2019 – Millions of children living in areas affected by conflict and disaster are at risk because of substantial shortages in funding for lifesaving humanitarian programmes, UNICEF said today.

To date, UNICEF has only received 54 per cent of the US$4.16 billion needed to meet the basic health, education, nutrition and protection needs of 41 million children in 59 countries this year. Heading into the final quarter of 2019, the funding gap stands at 46 per cent.

“Millions of vulnerable children around the world are suffering the grievous consequences of increasingly complex humanitarian crises,” said UNICEF Executive Director Henrietta Fore. “Without additional resources, these children will not go to school, be vaccinated, receive adequate nutrition, or be protected from violence and abuse. While we continue to appeal for an end to conflicts and better readiness to emergencies, we need additional donor support to help us meet children’s most basic needs.”

Emergencies with the largest funding gaps include Pakistan (83 per cent), Cameroon (80 per cent), Burkina Faso (76 per cent) and Venezuela (73 per cent). Large-scale emergencies in Syria and neighboring countries, Yemen, Democratic Republic of the Congo and Bangladesh also remain significantly underfunded.

If these funding gaps persist through the end of the year, the consequences for children will be dire:
:: In the Democratic Republic of the Congo, US$ 61 million is urgently required to provide essential services for communities in areas that have long suffered from humanitarian and security crises, and at the same time to create an environment conducive to an effective Ebola response.

:: In Ethiopia, UNICEF needs more than US$43 million to provide children and families affected by drought and displacement with access to safe water, hygiene and sanitation.

:: In Haiti, UNICEF requires nearly US$ 2 million to provide nutritional support to over 19,000 children in need of urgent nutrition assistance and US$ 2 million to support family reunification and care services for unaccompanied and separated children.

:: In Libya, without US$ 540,000 in urgent funding, UNICEF will be unable to provide mine risk education for 50,000 children.

:: In northeast Nigeria, nearly US$ 7 million in funding is urgently needed to sustain lifesaving nutrition programmes, including US$ 3.5 million to prevent a break in the supply pipeline of ready-to-use-therapeutic food for the treatment of severe acute malnutrition in children.

:: In South Sudan, UNICEF child protection programmes are only 20 per cent funded while water, sanitation and hygiene programmes are 26 per cent funded.

:: In Sudan, UNICEF needs US$ 12 million to continue lifesaving treatment for more than 61,000 children under five suffering from severe acute malnutrition.

:: In Syria, where the funding gap is at US$ 30 million, 2.1 million children could miss out on critical formal and non-formal education activities.

:: In Syria’s neighbouring countries (Turkey, Lebanon, Jordan, Iraq, Egypt), home to 2.5 million Syrian refugees, a funding gap of US$ 249 million means that 460,000 children could also miss out on education activities.

:: In Venezuela, UNICEF requires at least US$ 6 million to help 60,000 children enroll and stay in school, through the provision of school feeding programmes. UNICEF also needs at least US$ 3 million to help vaccinate nearly 400,000 children against preventable diseases over the next three months.

:: In West and Central Africa, UNICEF humanitarian assistance to support education for children in countries affected by emergencies are 72 per cent unfunded.

“During my time on the ground in countries under crisis – countries like DRC, Mozambique, South Sudan, Syria and Yemen – I’ve seen firsthand the power of humanitarian funding to change the lives of vulnerable children for the better,” said Fore. “With increased support, together we can reach even more of the children who need us most.”

Emergencies

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

Ebola Outbreak in DRC 64: 22 October 2019
1. Situation update
In the past week, from 14 to 20 October, 21 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. The incidence of new confirmed EVD cases remains substantial in parts of North Kivu and Ituri provinces – in particular in the Biakato Mine Health Area, Mandima Health, with the majority (76%) of newly confirmed cases linked to this health area.

The deployment of additional support to the Biakato Mine Health Area has led to improvements in response efforts. The proportion of confirmed cases listed as contacts has increased in the past week from 13% to 57%. This increase was similarly witnessed in confirmed cases with a known epidemiological link to a case which augmented from 47% to 90% in the past week. While this is encouraging, there remain notable challenges in accessing and mounting the full range of public health activities in some areas.

In the 21 days from 30 September to 20 October, the number of affected health areas has decreased, with 20 health areas and nine health zones reporting new cases (Table 1, Figure 2). During this period, a total of 50 confirmed cases were reported, with the majority coming from the health zones of Mandima (54%; n=27 cases) and Mambasa (10%; n=5 cases). While many cases detected outside of these zones have travelled from these hotspots, onward local transmission has been observed in Kalunguta and Mabalako health zones, highlighting the high risk of resurgence and redispersion of cases.

As of 20 October 2019, a total of 3243 EVD cases were reported, including 3127 confirmed and 116 probable cases, of which 2171 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1821) were female, 28% (923) were children aged less than 18 years, and 5% (163) were healthcare workers…

Implementation of ring vaccination protocol
As of 20 October 2019, 240,824 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola vaccine.
The Democratic Republic of the Congo health authorities have endorsed the use of a second investigational Ebola vaccine, manufactured by Johnson & Johnson. This vaccine, which is administered as a two-dose course, 56 days apart, will be circulated in at-risk populations in areas that do not have active EVD transmission. Regular vaccination activities in EVD-affected areas will continue. The Merck/MSD vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola…

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 23 October 2019
:: Wild poliovirus type 3 (WPV3) has been declared as globally eradicated. At an event held on World Polio Day 2019, Professor David Salisbury, chair of the independent Global Commission for the Certification of Poliomyelitis Eradication (GCC), presented the official certificate of WPV3 eradication to WHO Director General Dr Adhanom Ghebreyesus. Read more about this landmark declaration.
[See Milestones above for detail]
:: Polio eradication efforts do not only involve providing vaccines. For one Abdullahi Mahamed Noor, basketball is his way of bringing people together to raise awareness about the devastating disease. Read about his journey on using the sport to combat polio in Somalia.

Summary of new viruses this week:
:: Afghanistan— two WPV1 cases and six positive environmental samples;
:: Pakistan— four WPV1 cases and six WPV1-positive environmental samples;
:: Nigeria— two cVDPV2 positive environmental samples.
:: Chad— one cVDPV2 case;
:: Benin— one cVDPV2 case;
:: the Democratic Republic of the Congo— one cVDPV2 case;
:: Ghana— one cVDPV2 case and three cVDPV2 positive environmental samples;
:: Ethiopia— one cVDPV2 case:
:: Togo— one cVDPV2 case:
:: Zambia— one cVDPV2 case.

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Philippines: Red Cross triples polio vaccination target
25 October 2019 IFRC
The Philippine Red Cross is more than tripling the number of children it aims to vaccinate in a door-to-door polio vaccination campaign, the Red Cross and the International Federation of Red Cross and Red Crescent Societies (IFRC) said today.

On 1 October 2019, the Red Cross announced support for a Department of Health campaign by activating volunteers in parts of Mindanao and Metro Manila to vaccinate 30,000 children in the hardest-to-reach communities. In fact, the Philippine Red Cross has reached nearly 60,000 children. Today, the target was increased to 100,000.

Announcing the increase, Philippine Red Cross Chairman Richard Gordon said:
“We’re particularly worried about children under five in urban slums, rural areas, migrant families and indigenous communities who have missed out on life-saving vaccinations. It’s simply not right that these children are at risk of death or lifelong disability in the 21st century. The tripling of our target reflects the commitment of Red Cross volunteers and staff, who are literally climbing mountains and crossing rivers to ensure no child is left behind. What’s more, they will do this again in a month when children need a booster, and a month after that too.”

Apart from low immunization rates, factors that contribute to the spread of polio, dengue and measles include low health literacy, unsafe water, poor sanitation, poor living conditions, high rates of chronic childhood malnutrition and poor access to healthcare. The Red Cross is also planning to reach 1 million people with life-saving health, hygiene and sanitation information…

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The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 19 October 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 19 Oct 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]

Syria

WHO gravely concerned about humanitarian situation in northeast Syria
13 October, Cairo, Egypt —
WHO is gravely concerned about the humanitarian health situation in northeast Syria, where up to 200,000 people have been displaced as a result of increased military operations since 9 October, and almost 1.5 million people are in need of health aid. Many of those affected by the recent hostilities have already experienced immense physical and mental stress as a result of years of conflict and repeated displacement.

People in need of essential health care services face challenges related to insecurity and limited access to health care. Already weakened health services in northeast Syria have been severely impacted by the latest security developments. The national hospital in Ras Al-Ain is currently out of service, and the national hospital and two health centers in Tel Abyad are also currently non-functional. The three field hospitals in Al-Hol camp have limited their services since 12 October as a result of the escalation of hostilities which has impeded access of health staff to the camp. All health facilities in camps hosting displaced people in Ain Issa and Ras al Ain have also been evacuated, with additional facilities under threat as the conflict rapidly escalates.

A number of health partners have already suspended services due to insecurity, further disrupting access to essential health care services. On 12 October, a trauma stabilization point located south of Ras Al Ain was evacuated after being reportedly attacked, resulting in two health staff injured and two ambulances destroyed. On the same day, the hospital in Ras Al-Ain was also reportedly attacked. There were no casualties as the facility had already been evacuated.

Across northeast Syria, shortages of health workers is widespread as they too have been among those displaced by the ongoing insecurity, aggravating an already critical situation and further depriving underserved populations of access to medical care.

Damages to the pumping station in Ras Al Ain, the main water source for most of Al Hassakeh governorate, has increased the risk of outbreaks of infectious diseases. Even before the current escalation in conflict, acute diarreah and typhoid were two of the most reported diseases among people in northeast Syria in August 2019. Ongoing displacements, overcrowded living conditions, and limited access to safe water and sanitation services, will likely lead to an increase in the number of people affected by water-borne diseases.

Amid this chaotic and fast-moving situation, WHO and health partners are working hard to respond to urgent health needs. Almost 314,000 medical treatments, vaccines, in addition to trauma medicines for 500 trauma patients have already been prepositioned in Qamishly hub. An additional shipment of more than 100,000 treatments and medicines for 640 trauma patients will be airlifted to Qamishly in the coming week. Medicines for diarrheal diseases, have also been prepositioned for delivery to health facilities as needed. Despite the challenges, many health NGOs continue to operate or shift to new locations. Some casualty cases requiring hospitalization are referred to a WHO-supported facility in Al-Hassakeh, and WHO is in the process of contracting two additional hospitals in Al-Hassakeh and Al-Raqqa to support referral services.

As the situation evolves, WHO and partners will continue to assess health needs and scale up their response as needed.

WHO calls on all parties to the conflict to preserve the right to health for hundreds of thousands of innocent civilians in northeast Syria, and comply with International Humanitarian Law to protect all civilians, including health care workers and patients, as well as health facilities.

Organization of American States – Democracy, Destabilization

Statement of the OAS General Secretariat
October 16, 2019
The recent currents of destabilization of the political systems of the hemisphere have their origins in the strategy of the Bolivarian and Cuban dictatorships, which seek to reposition themselves once again, not through a process of re-institutionalization and re-democratization, but through their old methodology of exporting polarization and bad practices, to essentially finance, support and promote political and social conflict.

The “Bolivarian breezes” to which the president of the illegitimate Bolivarian constituent national assembly has referred, have brought destabilization, violence, drug trafficking, death and corruption. The Venezuelan people themselves have paid the highest cost, but the other countries of the hemisphere are also now paying a high price for the crisis caused by the Venezuelan dictatorship.

“Bolivarian breezes” are not welcome in this hemisphere. We strongly condemn the threat of exporting bad practices and destabilization to Colombia made by that person in the Bolivarian dictatorship.

The strategy of destabilization of democracy through the financing of political and social movements has distorted political dynamics in the Americas. For years, the Venezuelan dictatorship, with the support of the Cuban dictatorship, institutionalized sophisticated co-optation, repression, destabilization and media propaganda structures in the region. For example, the financing of the Venezuelan dictatorship to political campaigns has been one of the effective ways to increase capacities to generate conflict.

The crisis in Ecuador is an expression of the distortions that the Venezuelan and Cuban dictatorships have installed in the political systems of the hemisphere. However, what recent events have also shown is that the intentional and systematic strategy of the two dictatorships to destabilize democracies is no longer as effective as in the past.

The OAS General Secretariat reaffirms its obligation to protect democratic principles and human rights, and to defend them where they are threatened. It also remains available to member states in their efforts to address the destabilization factors organized by the Venezuelan and Cuban dictatorship.

Children – Rights, Health, Welfare

The State of the World’s Children 2019 :: Children, food and nutrition: Growing well in a changing world
UNICEF :: Flagship Report – October 2019 258 pages
PDF: https://www.unicef.org/media/60806/file/SOWC-2019.pdf
Highlights
For the first time in 20 years, UNICEF’s flagship report examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge. This 2019 edition of The State of the World’s Children (SOWC) examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge. Despite progress in the past two decades, one third of children under age 5 are malnourished – stunted, wasted or overweight – while two thirds are at risk of malnutrition and hidden hunger because of the poor quality of their diets. At the center of this challenge is a broken food system that fails to provide children with the diets they need to grow healthy. This report also provides new data and analyses of malnutrition in the 21st century and outlines recommendations to put children’s rights at the heart of food systems.

Key Messages
At least 1 in 3 children under 5 is undernourished or overweight and 1 in 2 suffers from hidden hunger, undermining the capacity of millions of children to grow and develop to their full potential.
:: Globally, at least 1 in 3 children under 5 is not growing well due to malnutrition in its more visible forms: stunting, wasting and overweight.
:: Globally, at least 1 in 2 children under 5 suffers from hidden hunger due to deficiencies in vitamins and other essential nutrients.
:: Undernutrition continues to exert a heavy toll. In 2018, almost 200 million children under 5 suffered from stunting or wasting while at least 340 million suffered from hidden hunger.
:: Overweight and obesity continue to rise. From 2000–2016, the proportion of overweight children (5 to 19 years old) rose from 1 in 10 to almost 1 in 5.
:: The number of stunted children has declined in all continents, except in Africa while the number of overweight children has increased in all continents, including in Africa.

The triple burden of malnutrition – undernutrition, hidden hunger and overweight – threatens the survival, growth and development of children, young people, economies and nations.
:: Stunting – a clear sign that children in a country are not developing well – is both a symptom of past deprivation and a predictor of future poverty.
:: Wasting can be lethal for children, particularly in its most severe forms. Contrary to common belief, most wasted children around the world live in Asia and not in emergency settings.
:: Hidden hunger harms children and women. Iron deficiency reduces children’s ability to learn and iron deficiency anaemia increases women’s risk of death during or shortly after childbirth.
:: Child overweight can lead to early onset of type-2 diabetes, stigmatization and depression, and is a strong predictor of adult obesity, with serious health and economic consequences.
:: The greatest burden of all forms of malnutrition is shouldered by children and young people from
the poorest and most marginalized communities, perpetuating poverty across generations.

The triple burden of malnutrition is driven by the poor quality of children’s diets: 2 in 3 children are not fed the minimum recommended diverse diet for healthy growth and development.
:: Only 2 in 5 infants under six months of age are exclusively breastfed, as recommended. Breastfeeding could save the lives of 820,000 children annually worldwide.
:: Use of breastmilk substitutes is of concern. Sales of milk-based formula grew by 41 per cent globally and by 72 per cent in upper middle-income countries such as Brazil, China and Turkey from 2008-2013.
:: Poor diets drive malnutrition in early childhood: 44 per cent of children aged 6 to 23 months are not fed fruits or vegetables and 59 per cent are not fed eggs, dairy, fish or meat.
:: Only 1 in 5 children aged 6 to 23 months from the poorest households and rural areas is fed the minimum recommended diverse diet for healthy growth and brain development.
:: Many school-going adolescents consume highly processed foods: 42 per cent drink carbonated soft drinks at least once a day and 46 per cent eat fast food at least once a week.

Globalization, urbanization, inequities, humanitarian crises and climate shocks are driving Unprecedented negative changes in the nutrition situation of children around the world.
:: Globalization is shaping food options and choices: 77 per cent of processed food sales worldwide are controlled by just 100 large firms.
:: In cities, many poor children live in “food deserts”, facing an absence of healthy food options, or in “Food swamps”, confronted with an abundance of high-calorie, low-nutrient, processed foods.
:: Poor families tend to select low-quality food that costs less. Because of poverty and exclusion, the most disadvantaged children face the greatest risk of all forms of malnutrition.
:: Climate shocks, loss of biodiversity, and damage to water, air and soil are worsening the nutritional prospects of millions of children and young people, especially among the poor.
:: UNICEF and its partners treated more than 3.4 million children with severe malnutrition in humanitarian settings in 2018, from Afghanistan and Yemen to Nigeria and South Sudan.

Improving children’s nutrition requires food systems to deliver nutritious, safe, affordable and sustainable diets for all children.
:: Millions of children are eating too little of what they need, and millions are eating too much of what they don’t need: poor diets are now the main risk factor for the global burden of disease.
:: National food systems must put children’s nutrition at the heart of their work because their nutritional needs are unique and meeting them is critical for sustainable development.
:: Financial incentives should be used to reward actors who increase the availability of healthy and affordable foods in markets and other points of sale especially in low-income communities.
:: Financial disincentives on unhealthy foods can improve children’s diets. For example, taxes on sugary foods and beverages can reduce their consumption by children and adolescents.
:: Fortification of complementary foods and staple foods with micronutrients can be a cost-effective intervention to combat hidden hunger in children, young people and women.

Food environments are crucial. When healthy options are affordable, convenient and desirable, children and families make better food choices.
:: Children, adolescents, young people, parents and families need support to demand nutritious foods, but food environments need to promote and support healthy diets.
:: Innovative, fun, memorable and engaging communication strategies to promote healthy eating can leverage the cultural and social aspirations of children, adolescents and families.
:: Legislation plays a key role in promoting good diets for children, such as by regulating the marketing of breastmilk substitutes to mothers and families, and of unhealthy food to children.
:: The marketing of unhealthy foods and sugarsweetened beverages is directly linked to growing overweight and obesity in children.
:: Front of package labelling – visible, accurate and easy to understand – helps children, young people and families make healthier food choices and incentivizes suppliers to deliver healthy food.
:: Governments need to promote healthy food environments in schools, including healthy meals and limiting the sale and advertising of ‘junk food’ in proximity to schools and playgrounds.
:: The health, water and sanitation, education and social protection systems also have crucial roles to play in promoting and supporting good nutrition for children, adolescents and women.

Investing in nutrition for children and young people is a cornerstone investment if the world is to achieve the Sustainable Development Goals by 2030.
:: Investing in child nutrition is key to human capital formation because nutrition is central to children’s growth, cognitive development, school performance and future productivity.
:: A large and young labour force – with a great creativity and productivity potential – is emerging in Africa and Asia. However, malnutrition risks limiting this demographic dividend.
:: Returns from investment in nutrition are high. For example, every dollar invested in reducing Stunting generates an economic return equivalent to about US$18 in high-burden countries.

One word must be at the heart of our response to children’s malnutrition – action. We need action that reflects the core role of food systems, that strengthens the supply of – and demand for – better food, that improves children’s food environments, and leverages the role of key supportive systems.

With action comes another imperative: accountability. Progress must be measured, shared, acted on and celebrated. Sound nutrition is fundamental to children’s well-being and the achievement of the Sustainable Development Goals. It needs to be put at the heart of government policy and supported by key stakeholders, including civil society and the private sector.

The State of the World’s Children 2019 report concludes with the following Agenda to Put Children’s Nutrition Rights First:
1 Empower families, children and young people to demand nutritious food.
2 Drive food suppliers to do the right thing for children.
3 Build healthy food environments for all children.
4 Mobilize supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children.
5 Collect, analyse and use good-quality data and evidence regularly to guide action and track progress.

Digital Technology – Social Welfare Systems – Human Rights

World stumbling zombie-like into a digital welfare dystopia, warns UN human rights expert
NEW YORK (17 October 2019) – A UN human rights expert has expressed concerns about the emergence of the “digital welfare state”, saying that all too often the real motives behind such programs are to slash welfare spending, set up intrusive government surveillance systems and generate profits for private corporate interests.

“As humankind moves, perhaps inexorably, towards the digital welfare future it needs to alter course significantly and rapidly to avoid stumbling zombie-like into a digital welfare dystopia,” the Special Rapporteur on extreme poverty and human rights, Philip Alston, says in a report to be presented to the General Assembly on Friday.

The digital welfare state is commonly presented as an altruistic and noble enterprise designed to ensure that citizens benefit from new technologies, experience more efficient government, and enjoy higher levels of well-being. But, Alston said, the digitization of welfare systems has very often been used to promote deep reductions in the overall welfare budget, a narrowing of the beneficiary pool, the elimination of some services, the introduction of demanding and intrusive forms of conditionality, the pursuit of behavioural modification goals, the imposition of stronger sanctions regimes, and a complete reversal of the traditional notion that the state should be accountable to the individual.

“Digital welfare states thereby risk becoming Trojan Horses for neoliberal hostility towards social protection and regulation,” said the UN Special Rapporteur. “Moreover, empowering governments in countries with significant rule of law deficits by endowing them with the level of control and the potential for abuse provided by these biometric ID systems should send shudders down the spine of anyone even vaguely concerned to ensure that the digital age will be a human rights friendly one”.

Alston said governments justified the introduction of expensive and complex biometric digital identity card systems on the grounds that they would improve welfare services and reduce fraud.

“The process is commonly referred to as ‘digital transformation’ by governments and the tech consultancies that advise them, but this somewhat neutral term should not be permitted to conceal the revolutionary, politically-driven, character of many such innovations,” Alston said. “Systems of social protection and assistance are increasingly driven by digital data and technologies that are used for diverse purposes, including to automate, predict, identify, surveil, detect, target and punish.”

The dominant role of the private sector in designing, constructing and even operating significant parts of the digital welfare state is a major reason for concern, according to Alston. “Most Governments have stopped short of requiring Big Tech companies to abide by human rights standards, and because the companies themselves have steadfastly resisted any such efforts, the companies often operate in a virtually human rights free-zone,” said Alston…