COVID-19 – UN Appeal

UN issues US$6.7 billion appeal to protect millions of lives and stem the spread of coronavirus in fragile countries
07 May 2020
The UN’s Humanitarian Chief, Mark Lowcock, has called for swift and determined action to avoid the most destabilizing effects of the COVID-19 pandemic as he releases a US$6.7 billion appeal and an updated global plan to fight coronavirus in fragile countries.

COVID-19 has now reached every country, with nearly 3,596,000 confirmed cases and over 247,650 deaths worldwide. The peak of the disease in the world’s poorest countries is not expected until some point over the next three to six months. However, there is already evidence of incomes plummeting and jobs disappearing, food supplies falling and prices soaring, and children missing vaccinations and meals.

The humanitarian system is taking action to avert a sharp rise in conflict, hunger, poverty and disease as a result of the pandemic and the associated global recession. Today’s updated Global Humanitarian Response Plan has been expanded in response. It includes nine additional vulnerable countries: Benin, Djibouti, Liberia, Mozambique, Pakistan, the Philippines, Sierra Leone, Togo and Zimbabwe, and programmes to respond to the growth in food insecurity.

Today’s new appeal and updated humanitarian response plan were released at a virtual event hosted by Mark Lowcock, alongside the Executive Director of WHO Health Emergencies, Mike Ryan; the President and CEO of Oxfam America, Abby Maxman; the UN High Commissioner for Refugees, Filippo Grandi; and the Executive Director of WFP, David Beasley. The plan was first launched by the UN Secretary-General in March.

UN Under-Secretary-General for Humanitarian Affairs Mark Lowcock said: “The COVID-19 pandemic is hurting us all. But the most devastating and destabilizing effects will be felt in the world’s poorest countries. In the poorest countries we can already see economies contracting as export earnings, remittances and tourism disappear. Unless we take action now, we should be prepared for a significant rise in conflict, hunger and poverty. The spectre of multiple famines looms.

“If we do not support the poorest people – especially women and girls and other vulnerable groups – as they battle the pandemic and impacts of the global recession, we will all be dealing with the spillover effects for many years to come. That would prove even more painful, and much more expensive, for everyone.

“This pandemic is unlike anything we have dealt with in our lifetime. Business as usual will not do. Extraordinary measures are needed. As we come together to combat this virus, I urge donors to act in both solidarity and in self-interest and make their response proportionate to the scale of the problem we face.”

The COVID-19 Global Humanitarian Response Plan is the international community’s primary fundraising vehicle to respond to the humanitarian impacts of the virus in low- and middle- income countries and support their efforts to fight it. The plan brings together appeals from WHO and other UN humanitarian agencies. Non-governmental organizations (NGOs) and NGO consortiums have been instrumental in helping shape the plan. They are key partners in delivering it and can access funding through it.

The plan provides help and protection that prioritize the most vulnerable. This includes older people, people with disabilities, and women and girls, given pandemics heighten existing levels of discrimination, inequality and gender-based violence. The plan includes programmes that respond to the growth in food insecurity.

Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “The caseload in most countries in the Global Humanitarian Response Plan may seem small, but we know that the surveillance, laboratory testing and health systems’ capacity in these countries are weak. It is therefore likely that there is undetected community transmission happening. At the same time, confinement and other measures are having a major impact on essential health services. It’s extremely important to maintain these services, from vaccination to sexual and reproductive health, WASH and mental health.”

…Since the plan was first launched on 25 March, US$1 billion in generous donor funding has been raised. This includes US$166 million from OCHA’s pooled funds to support efforts across 37 countries, with US$95 million from the UN Central Emergency Response Fund and US$71 million from 12 Country-based Pooled Funds.

This has enabled:
:: The installation of handwashing facilities in vulnerable places like refugee camps; and the distribution of gloves, surgical masks, N95 respirators, gowns and goggles, and testing kits to help vulnerable countries respond to the pandemic.
:: The creation of new transport hubs from which supplies can be transported by air.
:: More than 1.7 million people around the world, including health workers, to be trained in virus identification and protection measures through WHO’s online COVID-19 training portal.

Everything achieved so far has only been possible because of the generous funding from donors. It can only continue if additional funding is made available that is proportionate to the scale of the problem we face.

Analysis by the UN’s Office for the Coordination of Humanitarian Affairs shows that the cost of protecting the most vulnerable 10 per cent of people in the world from the worst impacts is approximately US$90 billion. This is equivalent to 1 per cent of the current global stimulus package put in place by OECD and G20 countries.

It calculates that two thirds of those costs could be met by the World Bank and the International Monetary Fund if they are supported to change the terms on which they help the most vulnerable countries. The remainder will need to come from increased official development assistance over the next 12 months.

Prison Conditions: The Americas

COVID-19: Americas / prison conditions
UN High Commissioner for Human Rights
Rupert Colville, Spokesperson
Geneva, 5 May 2020
[Editor’s text bolding]
Conditions in many prisons in the Americas region are deeply worrying. Pre-existing structural problems, such as chronic overcrowding and unhygienic conditions, coupled with the lack of proper access to healthcare have enabled the rapid spread of COVID-19 in many facilities.

Thousands of inmates and prison officials have already been infected across North and South America. In many countries, the increasing fear of contagion and lack of basic services — such as the regular provision of food due to the prohibition of family visits — have triggered protests and riots.

Some of these incidents in detention centres have turned extremely violent. The latest happened on 1 May, in Los Llanos penitentiary in Venezuela, where a revolt by prisoners reportedly resulted in 47 inmates losing their lives. Four days earlier, on 27 April, a riot broke out in the Miguel Castro Castro prison in Peru leaving nine inmates dead. On 21 March, 23 inmates died after security forces intervened to supress rioting in La Modelo prison in Colombia. Other incidents, including attempts to escape, have been registered in detention centres in Argentina, Brazil and Colombia, Mexico and the U.S.

The scale and gravity of the incidents mentioned above seem to indicate that in some cases states have not taken appropriate measures to prevent violence in detention facilities, and that state agents may have committed use of force violations in attempts to re-gain control of these facilities. We remind authorities that the use of force must strictly comply with the principles of legality, necessity, proportionality and non-discrimination, and that States have the duty to protect inmates’ physical and mental health and well-being, as set out in the UN Standard Minimum Rules for the Treatment of Prisoners (also known as the Nelson Mandela Rules).

We call on States to conduct thorough, prompt, independent and impartial investigations into the circumstances of the deaths and injuries during riots, including any allegation of use of force violations by state agents.

We have also seen with concern how some States have routinely detained people for allegedly violating mandatory quarantines, thereby increasing the risk of infection.

In El Salvador, extremely harsh security measures were recently imposed in prisons, which could amount to cruel, inhuman or degrading treatment, and could also exacerbate the already precarious hygiene conditions.

We call on States to take appropriate measures to prevent further spread of the virus by ensuring sanitary conditions, widespread access to testing and access to necessary healthcare for detainees, as well as personal protective equipment and testing for prison personnel. Authorities should guarantee a minimum level of personal contacts with family members and proper access to food and drinkable water, as well as providing regular and transparent information about the impact of the disease on prisoners and staff. Conditions in detention centres and prisons, and the treatment of detainees should be regularly monitored by independent bodies, and prisoners who fall ill should be placed in non-punitive isolation or quarantine in facilities where they can receive appropriate medical care.

We welcome measures taken by some States to release those most vulnerable to COVID-19, including people with underlying medical conditions, pregnant women, older people, people living with HIV, as well as people with disabilities. However, broader measures are needed to reduce the extreme levels of overcrowding by releasing other categories of prisoners serving short sentences for non-violent crimes, as well as children held in detention and people detained for immigration offences.

In doing so, it is essential that States ensure that those measures do not contribute to impunity for violent crimes. People convicted of crimes recognised under international law after a fair and public trial by an independent and impartial tribunal should be considered for temporary release from custody only under exceptional circumstances.

In the context of the pandemic, it is urgent to reduce the use of pre-trial detention – a measure that should always be exceptional, but has been chronically over-used in the Americas. The Inter-Agency Standing Committee Interim Guidance on COVID-19 and persons deprived of their liberty offers practical suggestions to States wishing to implement measures to reduce overcrowding in places of detention.

People detained arbitrarily, without sufficient legal basis, or for crimes that are incompatible with international law, as well as all those incarcerated for exercising their human rights, including expression of dissenting opinions, should also be released.

Authorities should ensure that people who have been released receive proper health care.

Commemorating Smallpox Eradication – a legacy of hope, for COVID-19 and other diseases
8 May 2020 News release
On 8 May 1980, the 33rd World Health Assembly officially declared: ‘The world and all its peoples have won freedom from smallpox.’

The declaration marked the end of a disease that had plagued humanity for at least 3 000 years, killing 300 million people in the 20th century alone.

It was ended, thanks to a 10-year global effort, spearheaded by the World Health Organization, that involved thousands of health workers around the world to administer half a billion vaccinations to stamp out smallpox.

The US$ 300m price-tag to eradicate smallpox saves the world well over US$ 1 billion every year since 1980.

Speaking at a virtual event hosted at WHO-HQ, involving key players in the eradication effort, WHO Director-General, Dr Tedros Adhanom Ghebreyesus said, “As the world confronts the COVID-19 pandemic, humanity’s victory over smallpox is a reminder of what is possible when nations come together to fight a common health threat.”

…At the event, Dr Tedros unveiled a commemorative postal stamp to recognize the global solidarity that drove the initiative and honour the efforts of health workers who ensured its success.

The stamp, developed by the United Nations Postal Administration (UNPA), in collaboration with WHO, signifies what national unity and global solidary can achieve. Numerous countries, such as Guinea, India, Nigeria, Philippines, Togo and others issued smallpox stamps to show support for, and raise awareness about WHO’s Intensified Smallpox Eradication Programme launched in 1967.

…Following smallpox eradication, WHO and UNICEF launched the Expanded Programme on Immunization, under which 85% of the world’s children are vaccinated and protected from debilitating diseases.

With the potential of a COVID-19 vaccine ahead, ensuring sufficient supplies and reaching people in hard to reach places is a high priority. Addressing vaccine hesitancy poses a significant challenge to stop the virus. Access to accurate public health information and education is critical to ensure that the public has the facts to keep themselves and others safe.

To permanently commemorate the eradication of smallpox and the lessons learned on a global scale, rather than every 10-years, WHO is calling museums, exhibition companies, designers, curators and associations to develop an immersive, interactive and educational exhibition on smallpox and its relevance for COVID-19 and global health security.  The exhibition, which will be unveiled later this year, will promote a better understanding of public health and empower people to keep informed and safe during a pandemic.

COVID-19 – Africa

New WHO estimates: Up to 190 000 people could die of COVID-19 in Africa if not controlled
07 May 2020
Brazzaville – Eighty-three thousand to 190 000 people in Africa could die of COVID-19 and 29 million to 44 million could get infected in the first year of the pandemic if containment measures fail, a new study by the World Health Organization (WHO) Regional Office for Africa finds. The research, which is based on prediction modelling, looks at 47 countries in the WHO African Region with a total population of one billion.

The new estimates are based on modifying the risk of transmission and disease severity by variables specific to each country in order to adjust for the unique nature of the region. The model predicts the observed slower rate of transmission, lower age of people with severe disease and lower mortality rates compared to what is seen in the most affected countries in the rest of the world. This is largely driven by social and environmental factors slowing the transmission, and a younger population that has benefitted from the control of communicable diseases such as HIV and tuberculosis to reduce possible vulnerabilities.

The lower rate of transmission, however, suggests a more prolonged outbreak over a few years, according to the study which also revealed that smaller African countries alongside Algeria, South Africa and Cameroon were at a high risk if containment measures are not prioritized.

Containment measures, which include contact tracing, isolation, improved personal hygiene practices and physical distancing aim to slow down the transmission of the virus so its effects happen at a rate manageable by the health system. Physical distancing is not about the confinement of people but rather avoiding unnecessary contacts as people live, work and socialize as a means to interrupt transmission.

“While COVID-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa. “COVID-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat.”

The predicted number of cases that would require hospitalization would overwhelm the available medical capacity in much of Africa. There would be an estimated 3.6 million–5.5 million COVID-19 hospitalizations, of which 82 000–167 000 would be severe cases requiring oxygen, and 52 000–107 000 would be critical cases requiring breathing support. Such a huge number of patients in hospitals would severely strain the health capacities of countries…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 06 May 2020
:: The GPEI released a special edition of PolioNews which contains the latest on nOPV2 development, the upcoming World Health Assembly in the context of COVID-19, and other updates on the programme. Take a look at the publication.
:: A new training to help build knowledge on the standard operating procedures for effective polio outbreak response has been launched. With topics like risk assessment and surveillance, the Polio Outbreak Response training is available for free and the content is aligned with the most recent version of the Polio Outbreak SOPs (v3.1).

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan: six WPV1 cases, two cVDPV2 cases and four cVDPV2 positive environmental samples
:: Pakistan: two WPV1 cases, 18 WPV1 positive environmental samples and two cVDPV2 cases
:: Malaysia: One cVDPV2 positive environmental sample
:: Chad: One cVDPV2 case and two cVDPV2 positive environmental samples
:: Cote d’Ivoire: Four cVDPV2 positive environmental samples
:: Niger: One cVDPV2 case
:: Nigeria: Three cVDPV2 positive environmental samples

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WHO Grade 3 Emergencies [to 9 May 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 91: 05 May 2020
[Website link broken at inquiry – 404 message]

Yemen
:: Statement by WHO’s Regional Office for the Eastern Mediterranean on COVID-19 in Yemen
2 May 2020

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

::::::

WHO Grade 2 Emergencies [to 9 May 2020]
Angola – No new digest announcements identified
Afghanistan – 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
Iran – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi – 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

::::::

WHO Grade 1 Emergencies [to 9 May 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: COVID-19 Response Update No.02 (As of 6 May 2020)
:: Syrian Arab Republic: Recent Developments in Northwest Syria – Flash Update – As of 08 May 2020

Yemen
:: 06 May 2020 Yemen Humanitarian Update Issue 4 (April 2020)
HIGHLIGHTS
. Aid agencies ramp up efforts to contain COVID-19, as UN warns of possible surge in cases
. Humanitarians respond to widespread devastation caused by torrential rains and flooding
. Over 5 million children face the threat of cholera
. Civilian casualties increase from 467 to 506 in the first quarter of 2020
. Attacks on medical facilities increase while medical needs will soar if COVID-19 spreads
. Partners scale up aid and COVID-19 preparedness to over a million people in displacement sites

::::::

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
:: 07 May 2020 Zimbabwe Situation Report, 7 May 2020

:: 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 2 May 2020 :: Number 314

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 2 May 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 a

Governance, Accountability : Haiti, Cholera, UN

UN inaction denies justice for Haiti cholera victims, say UN experts
ENEVA (30 April 2020) – A group of independent UN rights experts today called on Secretary-General António Guterres to urgently step up efforts to fulfill a United Nations pledge to help victims of a cholera epidemic in Haiti that killed over 10,000 victims.

“The importance of relief is even more urgent in light of the COVID-19 pandemic, which could deal a double blow to victims of the cholera outbreak and their families,” the experts said. “We recognise the immense challenges all actors face in responding to the coronavirus, but this new threat cannot mask past failures and ongoing violations.”

The experts said more than three years ago, the UN acknowledged the role played by its peacekeepers in causing the epidemic. It has since failed to pay any compensation and its subsequent underfunded aid effort has amounted to little more than a spate of symbolic development projects.

“Serious shortfalls in funding and expenditures make the UN’s promises illusory. Despite initially seeking $400 million over two years, the UN has raised a mere $20.5 million in about three years and has spent a pitiful $3.2 million. This is a deeply disappointing showing following the loss of 10,000 lives,” they said.

The experts also raised concerns about the UN’s decision to help people affected by cholera through community assistance rather than direct support. “Some victims prefer monetary payments, an option that was once on the table, but the UN has foreclosed that possibility seemingly without carrying out consultations or producing a detailed feasibility assessment,” said the experts. “Compensation is ordinarily a central component of the right to an effective remedy, and development projects are simply not a replacement for reparations”.

The experts have received reports that victims have not been adequately involved in the design and development of community assistance projects. “While the UN says it is consulting with multi-stakeholder ‘community platforms’ to develop projects, it is not clear how those most affected by cholera are being prioritised in these exercises.”..

The experts conveyed their concerns in writing to the UN Secretary-General and the Government of Haiti.

*The experts:
Mr. Philip Alston, Special Rapporteur on extreme poverty and human rights;
Ms E. Tendayi Achiume, Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance;
Ms. Leilani Farha, Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context;
Mr. Léo Heller, Special Rapporteur on the human rights to water and sanitation;
Mr. Obiora C. Okafor, Independent Expert on human rights and international solidarity;
Mr. Dainius Pūras, Special Rapporteur on the right to physical and mental health;
Mr. Ahmed Reid (Chair), Ms. Dominique Day, Mr. Michal Balcerzak, Mr. Ricardo A. Sunga III, and Mr. Sabelo Gumedze, Working Group of experts on people of African descent;
Mr. Livingstone Sewanyana, Independent Expert on the promotion of a democratic and equitable international order;
Mr. Baskut Tuncak, Special Rapporteur on the implications for human rights of the environmentally sound management and disposal of hazardous substances and wastes, and
Mr. Fabián Salvioli, Special Rapporteur on the promotion of truth, justice, reparation and guarantees of non-recurrence

Governance – Justice/Poland

Rule of Law: European Commission launches infringement procedure to safeguard the independence of judges in Poland
Press release 29 April 2020 Brussels
Today, the European Commission launched an infringement procedure by sending a Letter of Formal Notice to Poland regarding the new law on the judiciary of 20 December 2019, which entered into force on 14 February 2020.

The new law on the judiciary undermines the judicial independence of Polish judges and is incompatible with the primacy of EU law. Moreover, the new law prevents Polish courts from directly applying certain provisions of EU law protecting judicial independence, and from putting references for preliminary rulings on such questions to the Court of Justice. After carrying out an analysis of the legislation concerned, the Commission concluded that several elements of the new law violate EU law:

First, the Commission notes that the new law broadens the notion of disciplinary offence and thereby increases the number of cases in which the content of judicial decisions can be qualified as a disciplinary offence. As a result, the disciplinary regime can be used as a system of political control of the content of judicial decisions. The new law violates Article 19(1) of the Treaty on European Union read in connection with Article 47 of the Charter of Fundamental Rights of the European Union, which establish a right to an effective remedy before an independent and impartial court. It is incompatible with the requirements of judicial independence as established by the EU Court of Justice.

Second, the Commission notes that the new law grants the new Chamber of Extraordinary Control and Public Affairs of the Supreme Court the sole competence to rule on issues regarding judicial independence. This prevents Polish courts from fulfilling their obligation to apply EU law or request preliminary rulings from the EU Court of Justice. The new law is incompatible with the principle of primacy of EU law, the functioning of the preliminary ruling mechanism as well as with requirements of judicial independence.

Third, the Commission notes that the law prevents Polish courts from assessing, in the context of cases pending before them, the power to adjudicate cases by other judges. This impairs the effective application of EU law and is incompatible with the principle of primacy of EU law, the functioning of the preliminary ruling mechanism and requirements of judicial independence.

Finally, the Commission notes that the new law introduces provisions requiring judges to disclose specific information about their non-professional activities. This is incompatible with the right to respect for private life and the right to the protection of personal data as guaranteed by the Charter of Fundamental Rights of the EU and the General Data Protection Regulation.

Next step
The Polish Government has two months from this date to reply to the Letter of Formal Notice..

COVID-19 :: Global Impact

IRC: World risks up to 1 billion cases and 3.2 million deaths from COVID-19 across fragile countries
April 28, 2020
:: Based on potential response scenarios, the International Rescue Committee (IRC) estimates between 500 million and 1 billion infections, leading to between 1.7 to 3.2 million deaths, in 34 conflict-affected and fragile countries.
:: There remains a small window of time to mount a robust response to COVID-19 while it is still in early stages in fragile countries; urgent funding to frontline responses is needed.
:: Extreme social distancing unsustainable in most humanitarian contexts, local approaches are needed – as outlined in new IRC report “One Size Does Not Fit All: Mitigating COVID-19 in Humanitarian Settings.

New York, NY, April 28, 2020 — Alarming new analysis by the International Rescue Committee (IRC) reveals that without swift action in coming weeks to mitigate the spread of Covid-19, the world could see up to 1 billion infections[1] and 3.2 million deaths due to COVID-19 over the course of the pandemic in 34 crisis-affected countries served by the IRC[2], including warzones like Afghanistan, Syria, and Yemen.

David Miliband, President and CEO of the International Rescue Committee, said: “These numbers should serve as a wake-up call: the full, devastating and disproportionate weight of this pandemic has yet to be felt in the world’s most fragile and war-torn countries. We are still in the critical window of time to mount a robust preventative response to the early stages of COVID-19 in many of these countries and prevent a further perpetuation of this epidemic globally.”

Preliminary estimates compiled by IRC are based on epidemiological modelling and data produced by Imperial College London and the World Health Organization. This model takes into account the age structure, household size, and social contact patterns of different countries, as well as mortality patterns from the early outbreak in China. IRC’s calculations for the 34 countries in which we work highlight the extent of the burden on fragile countries of the COVID-19 outbreak, and the importance of immediate actions in coming weeks to influence the trajectory of the epidemic.

Scientists are still studying the drivers of the pandemic in lower-income contexts, including factors such as population health risks which may drive infection rates up, or others such as younger population age structure which may drive mortality rates down; these figures are nevertheless sufficient to spark significant alarm on the international trajectory of COVID-19.

However, three significant limitations of the current data suggest that estimates for fragile countries may be conservative at best:

:: Healthcare capacity and virus reproductive rate (R0): The ICL/WHO model uses the best available mortality data, from China, which pre-supposes that levels of medical care available therein would be available elsewhere. As the IRC has previously warned, fragile states have nowhere near the healthcare capacity provided in China. In Venezuela alone, the long-standing economic and humanitarian crisis has forced more than half of doctors to leave the country and 90% of hospitals already faced shortages of medicine and critical supplies. In addition, refugee camps in countries included in the analysis like Syria, Greece and Bangladesh represent some of the most densely-populated areas in the world — up to 8.5 times more densely populated than the Diamond Princes cruise ship, where transmission of the virus was up to four times faster than in Wuhan, China[3]. Beyond demonstrating the infeasibility of extreme social distancing in these contexts and the scarcity of basic health capacity, this suggests that the reproduction rate of the virus in significant pockets of these states are likely to be far higher than the current projections suggest.

:: Pre-existing humanitarian vulnerability: These mortality figures do not account for excess deaths caused by underlying humanitarian vulnerability (including co-morbidity due to pre-existing health issues such as malnutrition) or by the economic and political instability which constitute a “double emergency” for fragile contexts. While strict lockdowns and social distancing will unquestionably save lives in wealthier nations, direct consequences such as market closures and income losses (without robust social safety nets) risk driving impoverishment, hunger, and domestic violence in humanitarian settings. Without sufficient social safety nets or relief packages in place to prevent people from spiraling further into poverty and hunger, these same measures risk harming populations already caught in weak states or unstable humanitarian contexts…

:: Disruptions to humanitarian aid delivery: Movement restrictions and disruptions to supply chains are already impacting the ability of agencies like the IRC to deliver life-saving humanitarian aid to people in need. South Sudan, a country with only 4 ventilators and 24 ICUs and where almost 65% of the population relies on humanitarian assistance, may for instance face famine with a toxic mix of restricted movement, economic instability, reduction in agricultural labor and pre-existing high levels of malnutrition and chronic food insecurity.

COVID-19 : Customs, Supply Chains

COVID-19: WCO and ICC issue joint statement and call for increased action on Customs and trade facilitation
27 April 2020
The heads of the World Customs Organization (WCO) and the International Chamber of Commerce (ICC) Secretariats issued a joint statement on 23 April 2020 and called for increased action on Customs and trade facilitation to ensure an effective response to the COVID-19 pandemic, and agreed to coordinate efforts…

“Effective trade facilitation – based on international standards – will play a central role in supporting businesses, including Micro, Small and Medium Sized Enterprises, towards enabling business resumption and renewed economic growth in the months and years to come”, they declared.
The text of the joint statement is below.

Joint WCO-ICC Statement
In late 2019, the first outbreak of what has now become known globally as the Coronavirus Disease 2019 (COVID-19) was reported. On 11 March 2020, the COVID-19 outbreak was categorized by the Director-General of the World Health Organization (WHO) as a pandemic.

The speed with which the pandemic crosses borders demands an urgent and agile response in relation to the international movement of goods in general and essential medical equipment and food supplies, in particular. The World Customs Organization (WCO) and the International Chamber of Commerce (ICC) call for a coordinated Customs response to the COVID-19 crisis, including through active participation in multilateral efforts and an open dialogue with neighboring countries.

We call on Customs administrations and other government agencies to keep trade flowing by maintaining the continuity of the international supply chain and simplifying and facilitating the Customs processes for essential medical equipment, medicines and food supplies – as well as key support personnel – so as to ensure an effective response to the pandemic and to protect lives throughout the world.

This crisis is resulting in an unprecedented threat to supply chains in many sectors, with significant implications for the supply of goods and for employment. Effective trade facilitation – based on international standards – will play a central role in supporting businesses, including Micro, Small and Medium Sized Enterprises, towards enabling business resumption and renewed economic growth in the months and years to come.

In order to support its Members and relevant stakeholders, the WCO has created a dedicated section in its website and included several existing and newly developed instruments and tools relevant to the integrity and facilitation of the supply chain in the context of the COVID-19 pandemic.

ICC is working at both global and local levels to: shape public policy responses to both the health and economic impacts of COVID-19; forge vital partnerships between the private sector, governments and international organizations; and provide practical tools and resources to enable businesses continuity and enable enterprises to take effective action to limit the spread of the virus.

The WCO and ICC are partnering to explore potential opportunities to increase the coordination of efforts in response to COVID-19, aiming at keeping trade flows open around the world and at supporting a strong recovery of the global economy.

COVID-19 & Global Immunization

Geneva Palais briefing note on the impact of COVID-19 mitigation measures on vaccine supply and logistics
GENEVA, 1 May 2020 – “UNICEF is calling for support to unlock a massive backlog in vaccine shipments due to unprecedented logistical constraints related to COVID-19 mitigation measures including lockdowns in some countries.

“In 2019, UNICEF procured 2.43 billion doses of vaccines for 100 countries, to reach approximately 45 per cent of all children below five years old.

“Since the week of March 22, UNICEF has seen a 70 – 80 per cent reduction in planned vaccine shipments due to the dramatic decline in commercial flights and limited availability of charters.

“As of today, dozens of countries are at risk of stock-out due to delayed vaccine shipments. At most risk are 26 countries that are difficult to reach due to limited commercial and cargo options. Among these, at least five countries experienced measles outbreaks in 2019 and many more remain at risk.

“Compounding the challenge is the exorbitant cost of securing flights, with freight rates at 100 – 200 per cent above normal and charter flights even more costly.

“Countries with limited resources will struggle to pay these higher prices, leaving children vulnerable to vaccine-preventable diseases such as measles and polio.

“Even before the COVID-19 pandemic, measles, polio and other vaccines were out of reach for 20 million children below the age of one every year.

“Disruptions in routine immunization, particularly in countries with weak health systems, could lead to disastrous outbreaks in 2020 and well beyond.

“A substantial proportion of the vaccines that are not reaching countries as planned are for routine immunization programmes. Because of the delays, countries have been using buffer stocks, which typically consists of a three-month supply that is intended for unplanned and urgent needs including responding to sudden outbreaks. As transport challenges persist, countries are at increasing risk of a vaccine stock-out.

“The extended delays in shipments also pose a huge risk to manufacturers, who must store the excess vaccine stocks, and may be required to postpone future production if their warehouse storage space is exceeded.

“UNICEF is working to find solutions with manufacturers and partners, including WHO, GAVI, the vaccine alliance, PAHO and the Bill and Melinda Gates Foundation. Some manufacturers have offered to support with their freight forwarding services, and GAVI has provided additional funding to support charter flights. And we continue to work with governments to monitor their stock levels, prioritize the most critical vaccine shipments to avoid stockouts and respond to the needs of their immunization programmes.

“However, the logistical situation remains severely constrained. And many countries require additional funding support.

“UNICEF is appealing to governments, the private sector, the airline industry, and others, to free up freight space at an affordable cost for these life-saving vaccines. And to work with us to find ways around the transport disruptions we face. Children’s lives are at stake.”

COVID-19 :: Travel, Tourism Impacts

100% of Global Destinations Now Have COVID-19 Travel Restrictions, UNWTO Reports
28 Apr 2020
The COVID-19 pandemic has prompted all destinations worldwide to introduce restrictions on travel, research by the World Tourism Organization (UNWTO) has found. This represents the most severe restriction on international travel in history and no country has so far lifted restrictions introduced in response to the crisis.

Following up on previous research, the latest data from the United Nations specialized agency for tourism shows that 100% of destinations now have restrictions in place. Of these, 83% have had COVID-19-related restrictions in place already for four or more weeks and, as of 20 April, so far no destination has lifted them.

UNWTO Secretary-General Zurab Pololikashvili said: “Tourism has shown its commitment to putting people first. Our sector can also lead the way in driving recovery. This research on global travel restrictions will help support the timely and responsible implementation of exit strategies, allowing destinations to ease or lift travel restrictions when it is safe to do so. This way, the social and economic benefits that tourism offers can return, providing a path to sustainable recovery for both individuals and whole countries.”

Tracking Restrictions by Time and Severity
The social and economic benefits that tourism offers can return, providing a path to sustainable recovery for both individuals and whole countries.

As well as a general overview, the UNWTO research breaks down the type of travel restrictions that have been introduced by destinations in all of the global regions, while also plotting the evolution of these restrictions since 30 January – when the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern.

The latest analysis shows that, of 217 destinations worldwide:
:: 45% have totally or partially closed their borders for tourists – “Passengers are not allowed to enter”
:: 30% have suspended totally or partially international flights – “all flights are suspended”
:: 18% are banning the entry for passengers from specific countries of origin or passengers who have transited through specific destinations
:: 7% are applying different measures, such as quarantine or self-isolation for 14 days and visa measures…

COVID-19 :: Global Employment Impacts

COVID-19: Stimulating the economy and employment
ILO: As job losses escalate, nearly half of global workforce at risk of losing livelihoods
29 April 2020
The latest ILO data on the labour market impact of the COVID-19 pandemic reveals the devastating effect on workers in the informal economy and on hundreds of millions of enterprises worldwide.

GENEVA (ILO News) – The continued sharp decline in working hours globally due to the COVID-19 outbreak means that 1.6 billion workers in the informal economy – that is nearly half of the global workforce – stand in immediate danger of having their livelihoods destroyed, warns the International Labour Organization.

According to the ILO Monitor third edition: COVID-19 and the world of work , the drop in working hours in the current (second) quarter of 2020 is expected to be significantly worse than previously estimated.

Compared to pre-crisis levels (Q4 2019), a 10.5 per cent deterioration is now expected, equivalent to 305 million full-time jobs (assuming a 48-hour working week). The previous estimate was for a 6.7 per cent drop, equivalent to 195 million full-time workers. This is due to the prolongation and extension of lockdown measures.

Regionally, the situation has worsened for all major regional groups. Estimates suggest a 12.4 per cent loss of working hours in Q2 for the Americas (compared to pre-crisis levels) and 11.8 per cent for Europe and Central Asia. The estimates for the rest of the regional groups follow closely and are all above 9.5 per cent.

Informal economy impact
As a result of the economic crisis created by the pandemic, almost 1.6 billion informal economy workers (representing the most vulnerable in the labour market), out of a worldwide total of two billion and a global workforce of 3.3 billion, have suffered massive damage to their capacity to earn a living. This is due to lockdown measures and/or because they work in the hardest-hit sectors.

The first month of the crisis is estimated to have resulted in a drop of 60 per cent in the income of informal workers globally. This translates into a drop of 81 per cent in Africa and the Americas, 21.6 per cent in Asia and the Pacific, and 70 per cent in Europe and Central Asia.

Without alternative income sources, these workers and their families will have no means to survive…

COVID-19 :: Immigrant Detention

COVID-19 & Immigration Detention: What Can Governments and Other Stakeholders Do?
United Nations Network on Migration: WORKING GROUP ON ALTERNATIVES TO IMMIGRATION DETENTION
Undated/Accessed 2 May 2020 :: 13 pages
PDF: https://migrationnetwork.un.org/sites/default/files/docs/un_network_on_migration_wg_atd_policy_brief_covid-19_and_immigration_detention_0.pdf
OVERVIEW
The United Nations Network on Migration is committed to supporting all partners in pursuit of the implementation of the Global Compact for Migration, recognizing that this cooperative framework provides an invaluable tool for ensuring all in society can contribute to a collective response to COVID-19 and are protected equally against its impact.
To that end this briefing is part of a series by the Network looking at different aspects of the COVID-19 pandemic and how they relate to migrants and their communities. The present document aims to provide practical guidance to States and other stakeholders in preventing and responding to COVID-19 in the context of immigration detention, highlighting instances of promising practices as useful models to draw from. We look forward to feedback from all partners, and to updating these recommendations on an ongoing basis.

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COVID-19 & Immigration Detention: What Can Governments and Other Stakeholders Do?
Statement by the United Nations Network on Migration
GENEVA / NEW YORK, 29 April 2020 – Around the world today, we are witnessing the severe impacts of the use of migration-related detention on migrants, asylum-seekers and refugees during the COVID-19 pandemic – indefinite detention in overcrowded facilities for some, prolonged situations of irregularity and fear of detention for others, heightened risk of infection for all: migrants, staff, their families, and their communities.

Yesterday, the United Nations Network on Migration released urgently needed practical recommendations with guidance for States and stakeholders on preventing and responding to COVID-19 in the context of immigration detention. By focusing on the development of non-custodial alternatives based in the community, the brief highlights steps that several governments have already taken to swiftly release migrants from detention and to provide access to healthcare, housing and other services regardless of migration status. The Network looks forward to feedback from all partners and to updating these recommendations on an ongoing basis.

The Network’s Working Group on Alternatives to Detention – co-led by UNICEF, UNHCR and the International Detention Coalition – has developed this guidance in partnership amongst UN agencies and civil society. The recommendations have been informed by the broad and diverse experience of Working Group members, including UN agencies, civil society organizations and networks, young people, local governments and technical experts working on immigration detention and alternatives all over the globe.

The Network calls on States to introduce a moratorium on the use of immigration detention; to scale up and implement non-custodial community-based alternatives; to release all migrants in detention into alternatives, following strict safeguards and prioritizing children, families and other migrants in vulnerable situations; and to urgently improve overall conditions in places of immigration detention while we transition to alternatives.

In releasing this guidance, the Network reminds States of their commitment in the Global Compact for Safe, Orderly and Regular Migration to prioritize alternatives to immigration detention, using detention as a measure of last resort only and working towards ending child immigration detention. The COVID-19 pandemic has created momentum for alternatives to immigration detention as a viable solution to mitigate public health concerns while ensuring access to human rights and essential services for migrants. Together, let’s seize this opportunity to redouble our collaborative efforts, look beyond the current crisis, and showcase concretely how migration can be governed without resorting to immigration detention.

The United Nations Network on Migration is committed to supporting all partners in pursuit of the implementation of the Global Compact for Safe, Orderly and Regular Migration, recognizing that this cooperative framework provides an invaluable tool for ensuring all in society can contribute to a collective response to COVID-19 and are protected equally against its impact.

EMERGENCIES

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)

Statement on the third meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)
1 May 2020 Statement
Geneva, Switzerland
[Excerpts]
The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva time (CEST)…

The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes a public health emergency of international concern (PHEIC) and offered advice to the Director-General.

The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work…

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Editor’s Note:
We certainly recognize the velocity of global developments in the COVID-19 pandemic. While we have concentrated the most current key reports just below, COVID-19 announcements, analysis and commentary will be found throughout this issue, in all sections.
Beyond the considerable continuing coverage in the global general media, the WHO’s authoritative guidance is available here:
:: Daily WHO situation reports here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
:: WHO Coronavirus disease (COVID-2019) daily press briefings here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

Situation report – 103 [WHO]

Novel Coronavirus (COVID-19)
2 May 2020
[Excerpts]
Situation in numbers (by WHO Region)
Total (new cases in last 24 hours)
Globally 3 267 184 cases (91 977) 229 971 deaths (5799)
Africa 27 973 cases (1310) 1013 deaths (40)
Americas 1 340 591 cases (48 674) 72 196 deaths (3109)
E Mediterranean 194 991 cases (6406) 7741 deaths (143)
Europe 1 492 024 cases (30 620) 140 586 deaths (2386)
South-East Asia 60 490 cases (3402) 2256 deaths (82)
Western Pacific 150 403 cases (1565) 6166 deaths (39)

HIGHLIGHTS
:: No new country/territory/area reported cases of COVID-19 in the past 24 hours.

:: WHO and the European Investment Bank yesterday signed a collaboration agreement to accelerate investment in health preparedness and primary healthcare in countries most vulnerable to the COVID-19 pandemic. The first phase will strengthen primary healthcare in ten African countries. The Director-General Dr. Tedros, in his regular media briefing yesterday said that, with the signing of the agreement, “We are deepening our relationship with the European Union”. He also reminded all that the European Commission will host a pledging conference on 4 May to raise funds for investment in vaccine research.

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Ethics and COVID-19: resource allocation and priority-setting
WHO Working Group on Ethics and COVID-19
20 April 2020 :: 5 pages
Overview
Governments, international agencies and health systems have an obligation to ensure, to the best of their ability, adequate provision of health care for all. However, this may not be possible during a pandemic, when health resources are likely to be limited. Setting priorities and rationing resources in this context means making tragic choices, but these tragic choices can be ethically justified. This is why we have ethics. This policy brief answers a number of questions about the ethics of setting priorities for the allocation of resources during times of scarcity. Such decisions may include access to hospitals, ventilators, vaccines and medicines. It is essential that policies and practices are ethically justified in such contexts. The document provides a high-level ethical framework that can be used to guide decision-making, and complements WHO’s technical guidance.

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Emergencies

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

Ebola Outbreak in DRC 90: 28 April 2020
[Excerpts]
Situation Update WHO Health Emergencies Programme Page 2
From 20 to 26 April 2020, there have been no new confirmed cases of Ebola virus disease (EVD) reported in the Democratic Republic of the Congo. Since the resurgence of the outbreak on 10 April 2020, six confirmed cases have been reported, all from the Kasanga Health Area in Beni Health Zone.

…Conclusion
The resurgence of EVD in Beni Health Zone highlights the importance of heightened vigilance for this disease in the face of significant challenges around community engagement, access to affected areas, ongoing insecurity, and limited response capacity due to other local and global emergencies. New cases are expected among contacts of recent cases. It is essential to detect, isolate, test and treat new suspected cases as early as possible in order to improve outcome of cases and break the chain of transmission. Strong coordination and communication among partners, the Ministry of Health, local authorities and the communities are essential to address these challenges. In addition, stronger advocacy for survivors is essential, such as mitigating rumours and stigmatization of EVD survivors.

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Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 28 April 2020
:: The Twenty-fourth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the Director General on 26 March 2020 with committee members only attending via teleconference, supported by the WHO Secretariat. Read the statement from the meeting.

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan: one WPV1 case and one WPV1 positive environmental sample
:: Pakistan: six WPV1 positive environmental samples, two cVDPV2 cases and two cVDPV2 positive environmental samples
:: Cote d’Ivoire: one cVDPV2 case and six cVDPV2 positive environmental sample

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WHO Grade 3 Emergencies [to 2 May 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 90: 28 April 2020
[See Ebola above for detail]

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 May 2020]
Angola – No new digest announcements identified
Afghanistan – 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
Iran – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi – 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 2 May 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: COVID-19 Update No. 08 – 2 May 2020
:: Syrian Arab Republic: Whole of Syria COVID-19 Response Update No.01 (As of 29 April 2020)

Yemen
:: 30 April 2020 Yemen: Flash Floods Flash Update No. 3 (As of 30 April 2020)
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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
:: 29 April 2020 Zimbabwe Situation Report, 29 Apr 2020

:: 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 25 April 2020 :: Number 313

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 25 Apr 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 a

COVID-19: Global Commitments/Equity/Access

Global leaders unite to ensure everyone everywhere can access new vaccines, tests and treatments for COVID-19
Unprecedented gathering of heads of government, institutions and industry cements commitment to accelerate development and delivery for all populations
24 April 2020 News release
GENEVA – Heads of state and global health leaders today made an unprecedented commitment to work together [see below] to accelerate the development and production of new vaccines, tests and treatments for COVID-19 and assure equitable access worldwide.

…leaders came together at a virtual event, co-hosted by the World Health Organization, the President of France, the President of the European Commission, and the Bill & Melinda Gates Foundation. The event was joined by the UN Secretary General, the AU Commission Chairperson, the G20 President, heads of state of France, South Africa, Germany, Vietnam, Costa Rica, Italy, Rwanda, Norway, Spain, Malaysia and the UK (represented by the First Secretary of State).

Health leaders from the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI-the Vaccine Alliance, the Global Fund, UNITAID, the Wellcome Trust, the International Red Cross and Red Crescent Movement (IFRC), the International Federation of Pharmaceutical Manufacturers (IFPMA), the Developing Countries Vaccine Manufacturers’ Network (DCVMN), and the International Generic and Biosimilar Medicines Association (IGBA) committed to come together, guided by a common vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, to launch this groundbreaking collaboration. They are joined by two Special Envoys: Ngozi Okonjo-Iweala, Gavi Board Chair and Sir Andrew Witty, former CEO of GlaxoSmithKline…

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Commitment and call to action: Global collaboration to accelerate new COVID-19 health technologies
A Global Collaboration to Accelerate the Development, Production and Equitable Access to New COVID-19 diagnostics, therapeutics and vaccines
24 April 2020
Statement
Our Vision and Mission
Grounded in a vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, we, an initial group of global health actors (BMGF, CEPI, Gavi, Global Fund, UNITAID, Wellcome Trust, WHO) and private sector partners and other stakeholders, are launching a landmark, global and time-limited collaboration to accelerate the development, production and equitable global access to new COVID-19 essential health technologies.

We know that as long as anyone is at risk from this virus, the entire world is at risk – every single person on the planet needs to be protected from this disease.

We agree that alongside evidence-based public health measures, innovative COVID-19 diagnostics, therapeutics and vaccines are needed – in record time and at record scale and access – to save millions of lives and countless trillions of dollars, and to return the world to a sense of ‘normalcy’.

We recognize the significant amount of critical work, investment and initiatives already ongoing around the world to expedite the development and deployment of innovative COVID-19 related products and interventions.

We appreciate that while development and deployment of innovative products is essential, it will not be enough. We must simultaneously and urgently accelerate the strengthening of sustainable health systems and capacities to enable delivery of the new COVID-19 tools to those who need them and to mitigate the knock-on impact on other diseases.

We remember lessons from the past, which have shown that even when effective tools are available to the world, too often some are protected, while others are not. This inequity is unacceptable – all tools to address COVID-19 must be available to all. In the fight against COVID-19, no one should be left behind.

We understand we cannot do this alone, and that we need to work together in unprecedented and inclusive partnership with all stakeholders – political leaders, public and private sector partners, civil society, academia, and all other stakeholders across society – jointly leveraging our comparative strengths and respective voices to drive towards collective solutions, an accelerated path, and access for all. We are stronger, faster and more effective working together.

Our Mission is not only accelerated development and availability of new COVID-19 tools – it is to accelerate equitable global access to safe, quality, effective, and affordable COVID-19 diagnostics, therapeutics and vaccines, and thus to ensure that in the fight against COVID-19, no one is left behind.

Our Commitment
[1] We commit to the shared aim of equitable global access to innovative tools for COVID-19 for all.
[2] We commit to an unprecedented level of partnership – proactively engaging stakeholders, aligning and coordinating efforts, building on existing collaborations, collectively devising solutions, and grounding our partnership in transparency, and science.
[3] We commit to create a strong unified voice to maximize impact, recognizing this is not about singular decision-making authority, but rather collective problem-solving, interconnectedness and inclusivity, where all stakeholders can connect and benefit from the expertise, knowledge and activities of this shared action-oriented platform.
[4] We commit to build on past experiences towards achieving this objective, including ensuring that every activity we undertake is executed through the lens of equitable global access, and that the voices of the communities most affected are heard.
[5] We commit to be accountable to the world, to communities, and to one another. We are coming together in the spirit of solidarity, and in the service of humanity, to achieve our mission and vision.

Our Call
We ask the global community and political leaders to support this landmark collaboration, and for donors to provide the necessary resources to accelerate achievement of the objectives of this global collaboration, capitalizing on the opportunity provided by the rolling pledging campaign that will start on 4 May 2020.

Over 13 million children did not receive any vaccines at all even before COVID-19 disrupted global immunization – UNICEF
NEW YORK, 25 April 2020 – As the world waits desperately for a vaccine, the COVID-19 pandemic is continuing to surge across the globe. Millions of children are in danger of missing life-saving vaccines against measles, diphtheria and polio due to disruptions in immunization services. At last count, most countries had suspended mass polio campaigns and 25 countries had postponed mass measles campaigns, as per recommended guidance.

Even before the COVID-19 pandemic, measles, polio and other vaccines were out of reach for 20 million children below the age of one every year. Over 13 million children below the age of one globally did not receive any vaccines at all in 2018, many of whom live in countries with weak health systems. Given the current disruptions, this could create pathways to disastrous outbreaks in 2020 and well beyond.

“The stakes have never been higher. As COVID-19 continues to spread globally, our life-saving work to provide children with vaccines is critical,” said Robin Nandy, UNICEF Principal Adviser and Chief of Immunization. “With disruptions in immunization services due to the COVID-19 pandemic, the fates of millions of young lives hang in the balance.”

An estimated 182 million children missed out on the first dose of the measles vaccine between 2010 and 2018, or 20.3 million children a year on average, according to a UNICEF analysis. This is because the global coverage of the first dose of measles stands only at 86 per cent, well below the 95 per cent needed to prevent measles outbreaks.

Widening pockets of unvaccinated children led to alarming measles outbreaks in 2019, including in high-income countries like the US, UK and France.

Among low-income countries, the gaps in measles coverage before COVID-19 were already alarming. Between 2010 and 2018, Ethiopia had the highest number of children under one year of age who missed out on the first dose of measles, at nearly 10.9 million. It was followed by the Democratic Republic of the Congo (6.2 million), Afghanistan (3.8 million), Chad, Madagascar and Uganda with about 2.7 million each.

Beyond measles, the immunization gaps were already quite dire, according to new regional profiles developed by UNICEF. In Africa, more children have missed out on vaccines over the past years due to rising number of births and a stagnation in immunization services. For example, in West and Central Africa, coverage has stagnated at 70 per cent for DTP3 – which is the lowest among all regions – at 70 per cent for polio, and at 71 per cent for measles. This has led to repeated outbreaks of measles and polio in countries such as the Democratic Republic of the Congo. Meanwhile, in South Asia, an estimated 3.2 million children did not receive any vaccines in 2018. In Eastern and Southern Africa, the number of unvaccinated children has remained almost the same for the last decade, at around 2 million. All regions are now also battling COVID-19 outbreaks.

UNICEF is sending critical vaccine supplies to immunize children, where possible, in areas with outbreaks and to replenish their routine supplies.In the Democratic Republic of the Congo, for example, UNICEF is supporting the Government with vaccine supplies and protective equipment to continue immunization activities in North Kivu province, where over 3,000 cases of measles were reported since January 1. And in Uganda, UNICEF procured 3,842,000 doses of bivalent oral polio vaccine (bOPV) to immunize 900,000 children below the age of one year. Children receive three doses of the polio vaccine before they celebrate their first birthday.

As the world races to develop and test a new COVID-19 vaccine, UNICEF and partners in the Measles & Rubella Initiative and Gavi, the Vaccine Alliance are calling on governments and donors to:
:: Sustain immunization services while keeping health workers and communities safe;
:: Start planning to ramp up vaccinations for every missed child when the pandemic ends;
: Fully replenish Gavi, as the alliance supports immunization programmes in the future;
:: Ensure that when the COVID-19 vaccine is available, it reaches those most in need.

“Children missing out now on vaccines must not go their whole lives without protection from disease,” said Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance “The legacy of COVID-19 must not include the global resurgence of other killers like measles and polio.”