Attacks on multilateral system threaten global peace and security – The Elders

Governance – Multilateral System

Attacks on multilateral system threaten global peace and security
The Elders – 03 Dec 2019
The multilateral system is under unprecedented attack. Isolationist and arbitrary actions by leading powers, including the United States, are threatening to undermine critical efforts to tackle global challenges from nuclear disarmament and non-proliferation to climate change, and the regulation of international trade.

The Elders urge all world leaders to acknowledge that effective multilateralism is in their own national interest, regardless of size or strength. Getting others to cooperate by means of internationally-agreed mechanisms is less costly and more reliable than unilateral force.

Yet since 2017, the US has: withdrawn from the Paris Agreement on Climate Change; pulled out of the Iranian nuclear deal; left the UN Human Rights Council and UNESCO; abandoned the Intermediate-Range Nuclear Forces (INF) Treaty; unilaterally imposed trade barriers; and concurrently blocked the appointment of new judges at the World Trade Organization.

As an immediate step, WTO member states must respond to persistent US intransigence by appointing without further delay the necessary new judges to the Appellate Body by majority voting, to avoid the collapse of the WTO’s entire dispute settlement capability.

Following the formal US notification of its withdrawal from the Paris Agreement, all other signatories must now use the upcoming COP 25 summit in Madrid to urgently step up their climate action and ambition. Countries must cut carbon emissions more drastically and quickly than in previously-submitted pledges, and also adopt rigorous monitoring of compliance with such commitments.

The network of international covenants and institutions agreed and constructed since the end of the Second World War, with the United Nations at its core, is far from perfect. But it has nevertheless decisively supported the pursuit of peace, security and the protection of human rights, as well as economic and social progress across the globe, for over seven decades.

It is a sad irony that the multilateral system’s principal assailant, the US, is the very country that led the design and construction of its institutions in the 1940s and benefited enormously from it in the subsequent decades.

To make matters worse, the response by other influential powers has too often been erratic, uncoordinated and counter-productive. Most have opted to negotiate bilaterally with the US to try to resolve crises, further eroding existing multilateral frameworks.

This is myopic and self-harming. A regression from a rules-based system into power-based strategies will not result in a safer, more predictable or propitious environment for any country.

Without a concerted commitment to defend multilateralism, we will not bequeath a safe world to future generations. They will neither forget nor forgive such a collective failure.

UN asks the world to invest $29 billion in humanity in 2020

UN asks the world to invest $29 billion in humanity in 2020
:: A record 168 million people worldwide will need humanitarian assistance and protection in 2020.
:: Protracted conflicts, extreme weather events and crumbling economies have pushed millions to the brink of survival.
:: Humanitarian organizations today present their plans for how to respond and what it will cost.

(Geneva, 4 December 2019) – The United Nations in collaboration with hundreds of non-governmental humanitarian organizations today present the global overview of their plans to assist 109 million of the most vulnerable people caught up in humanitarian crises worldwide.

The Global Humanitarian Overview (GHO) 2020 is launched simultaneously in five locations – Geneva, Berlin, Brussels, London and Washington DC.

One in every 45 people on the planet are in need of food, shelter, health care, emergency education, protection or other basic assistance. The global humanitarian community stands ready to help and counts on the international community’s continued generosity to help them save more lives and alleviate human suffering in crises spanning 53 countries from Afghanistan to Zambia…

Comparable figures show that the number of people in need globally has increased by some 22 million over the past year. The main drivers of need are protracted and highly violent conflicts, extreme weather events associated with climate change and under-performing economies. The plans set out in the GHO 2020 aim to reach 109 million vulnerable people with aid and protection. The combined requirements are nearly US$29 billion.

“The brutal truth is 2020 will be difficult for millions of people. The good news is that the humanitarian response is getting better and faster in reaching the most vulnerable, including women, children and people with disabilities,” Emergency Relief Coordinator Mark Lowcock said, launching the GHO 2020 in Geneva…

In 2019, more people than forecasted needed humanitarian assistance, mostly because of conflicts and natural disasters. Donors generously provided a record $16 billion for inter-agency appeals between January and November 2019. Aid groups reached 64 per cent of the people targeted to receive aid through Humanitarian Response Plans in 22 of the countries for which data were available.

The GHO 2020 is available online http://unocha.org/GHO2020

Note to Editors
[1] The Global Humanitarian Overview 2020 is based on Humanitarian Response Plans in Afghanistan, Burkina Faso, Burundi, Cameroon, Сentral African Republic, Chad, Democratic Republic of the Congo, Ethiopia, Haiti, Iraq, Libya, Mali, Myanmar, Niger, Nigeria, occupied Palestinian territories, Somalia, South Sudan, Sudan, Syria, Ukraine, Venezuela and Yemen.
[2] Other types of inter-agency plans are included for Bangladesh, DPR Korea and Venezuela/Regional.
[3] The GHO also includes Regional Refugee Response Plans for Burundi, Democratic Republic of the Congo, Nigeria, South Sudan and Syria.

IRC: Failure to end civil war in Yemen could cost $29 billion

Yemen

Failure to end civil war in Yemen could cost $29 billion
IRC Press Release
Sana’a, Yemen, December 2, 2019 — Almost one year since the Stockholm agreement, the war in Yemen continues unabated. New International Rescue Committee research highlights the devastating impact of continued conflict on ordinary Yemenis. The international community must push the warring parties to build on a rare window of opportunity for peace to secure a nationwide ceasefire.

:: At the current rate of decline, it will take 20 years to return Yemen to pre-crisis levels of child hunger.
:: If the war continues for another five years it will cost the international community as much as $29 billion in humanitarian funding – more than the entire annual humanitarian budget globally.
:: The IRC is calling on members of the UN Security Council to use their significant diplomatic influence to build on recent political developments and kick-start UN-led negotiations.
:: The IRC reaches more than 21,000 people each week with healthcare and nutrition services, women’s protection and empowerment programs and education for children.

The IRC released a new report today detailing the devastating consequences a continuation of the war will have for the people of Yemen. “The War Destroyed Our Dreams” shows that at the current rate of decline, it will take 20 years for the country to return to pre-war levels of child malnutrition, which were already amongst the worst in the world. Another five years of fighting will cost the international community as much as $29 billion USD just to sustain the current level of humanitarian aid.

Recent developments in Yemen suggest a rare window of opportunity has opened to push for peace. The recent power sharing agreement between the Internationally Recognized Government (IRG) and the Southern Transitional Council (STC) offers hope for more inclusive peace talks. However, this is far from assured. World leaders must invest in diplomacy and put their full focus on bringing together warring parties for negotiations. A nationwide ceasefire is needed immediately to avoid further catastrophe…

Educational Attainment :: Young people struggling in digital world, finds latest OECD PISA survey

Educational Attainment

PISA [Program for International Student Assessment] 2018 Results
The OECD Programme for International Student Assessment (PISA) examines what students know in reading, mathematics and science, and what they can do with what they know. It provides the most comprehensive and rigorous international assessment of student learning outcomes to date. Results from PISA indicate the quality and equity of learning outcomes attained around the world, and allow educators and policy makers to learn from the policies and practices applied in other countries. This is one of six volumes that present the results of the PISA 2018 survey, the seventh round of the triennial assessment.

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Young people struggling in digital world, finds latest OECD PISA survey
03/12/2019 –
One in four students in OECD countries are unable to complete even the most basic reading tasks, meaning they are likely to struggle to find their way through life in an increasingly volatile, digital world. This is one of the findings of the OECD’s latest PISA global education test, which evaluates the quality, equity and efficiency of school systems.

The OECD’s PISA 2018 tested around 600,000 15-year-old students in 79 countries and economies on reading, science and mathematics. The main focus was on reading, with most students doing the test on computers.

Most countries, particularly in the developed world, have seen little improvement in their performances over the past decade, even though spending on schooling increased by 15% over the same period. In reading, Beijing, Shanghai, Jiangsu and Zhejiang (China), together with Singapore, scored significantly higher than other countries. The top OECD countries were Estonia, Canada, Finland and Ireland…

The share of students with only very basic reading skills highlights the challenge countries, including those in the developed world, face in achieving the United Nations Sustainable Development Goals for 2030 (SDGs), particularly in relation to “ensuring inclusive and equitable quality education and promoting lifelong learning opportunities for all.” (SDG 4). The share of low-performers, both girls and boys, also increased on average between 2018 and 2009, the last time reading was the main focus of PISA…

Around 1 in 10 students across OECD countries, and 1 in 4 in Singapore, perform at the highest levels in reading. However, the gap between socio-economically advantaged and disadvantaged students is stark: the reading level of the richest 10% of students in OECD countries is around three years ahead of the poorest 10%. In France, Germany, Hungary and Israel, the gap is four years.

Yet some countries have shown an impressive improvement over the past few years. Portugal has advanced to the level of most OECD countries, despite being hit hard by the financial crisis. Sweden has improved across all three subjects since 2012, reversing earlier declines. Turkey has also progressed while at the same time doubling the share of 15-year-olds in school.

The latest PISA findings also reveal the extent to which digital technologies are transforming the world outside of school. More students today consider reading a waste of time (+ 5 percentage points) and fewer boys and girls read for pleasure (- 5 percentage points) than their counterparts did in 2009. They also spend about 3 hours outside of school online on weekdays, an increase of an hour since 2012, and 3.5 hours on weekends…

Around one in four students in OECD countries, on average, do not attain the basic level of science (22%) or maths (24%). This means that they cannot, for example, convert a price into a different currency…

Girls significantly outperformed boys in reading on average across OECD countries, by the equivalent of nearly a year of schooling. Across the world, the narrowest gaps were in Argentina, Beijing, Shanghai, Jiangsu and Zhejiang (China), Chile, Colombia, Costa Rica, Mexico, Panama and Peru. Boys overall did slightly better than girls in maths but less well in science…

One in four students in OECD countries are unable to complete even the most basic reading tasks, meaning they are likely to struggle to find their way through life in an increasingly volatile, digital world…

Ensuring access to affordable, timely vaccines in emergencies

Featured Journal Content

Bulletin of the World Health Organization
Volume 97, Number 12, December 2019, 789-856
https://www.who.int/bulletin/volumes/97/12/en/
PERSPECTIVES
Ensuring access to affordable, timely vaccines in emergencies
— Kate Elder, Barbara Saitta, Tanja Ducomble, Miriam Alia, Ryan Close, Suzanne Scheele, Elise Erickson, Rosalind Scourse, Patricia Kahn & Greg Elder
http://dx.doi.org/10.2471/BLT.18.228585
Vaccination is an effective intervention to reduce disease, disability, death and health inequities worldwide. Over the last two decades, vaccines have become more accessible in low-income countries; however, significant gaps remain, particularly in humanitarian emergencies, where populations face increased risks of many diseases. In 2013, the World Health Organization (WHO) published Vaccination in acute humanitarian emergencies: a framework for decision-making, to provide guidance on which vaccines to prioritize during emergencies.1 However, substantial obstacles, especially high prices for new vaccines, hinder implementation of this framework and of critical vaccination activities in emergency settings.

In response to these challenges, global health stakeholders held a series of consultations in 2016 and proposed a WHO-based mechanism, the Humanitarian Mechanism, for the rapid procurement of affordable vaccines during emergencies, to be used by nongovernmental organizations (NGOs), civil society organizations, United Nations (UN) agencies and governments.
Here we present the background of the creation of the mechanism from the perspective of Médecins Sans Frontières (MSF), including a description of our past challenges in accessing affordable pneumococcal conjugate vaccine (PCV; Box 1), a critical vaccine during many emergencies. We then describe how the mechanism has so far facilitated access to more affordable PCV and outline steps that could increase its potential for saving lives…

Next steps
Building on these initial successes, we see three critical elements of the mechanism, which if fully implemented, could greatly enhance its impact.

First, the mechanism needs to be better known among global health actors, including UN agencies and NGOs, who should be encouraged to use it under appropriate circumstances.

Second, while the mechanism’s terms of reference includes use by governments responding to emergencies,8 conditions attached to the PCV pledges discussed here (the only pledges to the mechanism so far) exclude governmental use. Manufacturers should allow governments to access the mechanism during emergencies to procure critical vaccines needed to protect their populations. Many middle-income countries already grapple with high vaccine prices for routine immunization programmes and may find the cost of extending vaccination to influxes of displaced people during emergencies prohibitive. While Gavi adopted a fragility, emergencies and refugees policy in June 2017 to allow more flexible use of Gavi-supported vaccine doses in specific contexts, strict criteria exist for how and where this flexibility can be applied, and it can only cover Gavi-eligible countries.12

Finally, the types of vaccines pledged to the mechanism by manufacturers should be expanded: the only commitments to date are for pneumococcal conjugate vaccines. Current and future manufacturers should commit other vaccines with affordability and accessibility challenges to the mechanism, so they can be procured rapidly at the lowest global price

Conclusion
The mechanism is a significant step forward in delivering life-saving vaccines to populations caught in emergencies and conflict. The mechanism’s mandate is strengthened by multiple organizations recognizing the gap between existing technical guidelines and constraints on their implementation, that is, the lack of rapidly available, affordable vaccines. While the mechanism does not address the broader systemic failures of the vaccine market, it was created to specifically address the failure of the global vaccine market to meet relatively small, urgent vaccine procurement needs efficiently and affordably. Further steps are needed for the mechanism to reach its full potential; however, it already provides a critical platform during humanitarian crises for expanding the number of people who can receive life-saving vaccines.

Emergencies

Emergencies

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

Ebola Outbreak in DRC 70: 03 December 2019
Situation Update
In the week of 25 November to 1 December 2019, 10 new confirmed EVD cases were reported from two health zones in two affected provinces in the Democratic Republic of the Congo. The confirmed cases in this week came from Mabalako (50%, n=5) and Mandima (50%, n=5) Health Zones.
In the past week, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations.
On the night of 27 November 2019, an attack on the Ebola response camp in Biakato Mines resulted in the death of three responders and the injury of seven others. Response personnel in Biakato were relocated to Goma, and the majority of response activities in the area have been suspended. On the same night, a separate attack on the Ebola coordination office in Mangina resulted in one death. Most response personnel in Mangina have also been relocated. As of 2 December 2019, North Kivu Province has declared ‘ville morte’ and many response activities have been suspended across the province.
As seen previously during this outbreak, such disruptions limit contact tracing, surveillance, and vaccination efforts, and they may result in increased transmission…

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WHO Director-General praises bravery of health workers during visit to eastern Democratic Republic of Congo following fatal attacks on Ebola responders
1 December 2019 News release

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Democratic Republic of Congo
As security situation deteriorates, MSF withdraws staff from Biakato
Statement 6 Dec 2019
On 4 December 2019, Medecins Sans Frontières (MSF) took the painful decision to temporarily withdraw our staff from the Biakato region of Ituri province, Democratic Republic of Congo. After months of working extremely closely with the community to address the health needs in the region, MSF is saddened to have made this decision….

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Gavi Board approves new Ebola vaccine programme
New Delhi, 5 December 2019 – A global emergency stockpile of Ebola vaccines will be available to countries for outbreak response and prevention following the approval of a new Ebola vaccine programme by the Board of Gavi, the Vaccine Alliance, which met this week in New Delhi, India.

Gavi will open a new funding window, with estimated investment of US$ 178 million between now and 2025 for the new Ebola vaccine programme. Gavi-supported low- and middle-income countries will be able to access the stockpile free of charge and will receive support for the operational costs of vaccination campaigns. Wealthier countries will be able to access vaccines but will be expected to self-finance.

As well as creating the emergency stockpile, Gavi will also support targeted preventative vaccination outside of an outbreak in high-risk populations, such as health workers, in countries at risk. The target populations and scope of countries will be based on future recommendations by the WHO’s Strategic Advisory Group of Experts on Immunisation (SAGE).

“Today, I think about Ebola victim Dr Ameyo Adadevoh, a true vaccine hero who died stopping the Ebola virus from spreading in Nigeria and we should all be excited by the Alliance decision,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board. “This is a historic milestone in humanity’s fight against this horrific disease. Just five years ago we faced an Ebola outbreak in West Africa with no vaccine and no way to treat the disease. Today, thanks to the heroic efforts of countless patients, health workers, scientists, manufacturers, donors, partners as well as the leadership of African countries, we now have one vaccine approved for use and more on their way, as well as rapid diagnostics and several promising treatments. With these tools at our disposal, the battle against Ebola can be won, and I’m proud of the role Gavi has played in this.”
The W
HO’s SAGE Working Group on Ebola Vaccines and Vaccination has provided guidance that the global emergency stockpile should be maintained at 500,000 licensed doses of vaccines. The price of Ebola vaccines funded by Gavi will be defined as part of a tender process managed by UNICEF, as Gavi’s partner and procurement agency.

There are currently eight candidate Zaire Ebolavirus vaccines at different phases of development. This includes Merck’s vaccine currently being used under compassionate use as part of the response to the ongoing DRC outbreak, which has recently received conditional marketing approval from the European Commission and prequalification from the WHO. More than 250,000 people have received it since the outbreak started in August last year. Moreover, close to a thousand people have received a second candidate vaccine manufactured by Johnson & Johnson as part of a study in North Kivu, DRC.

“The Ebola vaccine has shown extraordinary efficacy in tackling the outbreak in the DRC,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This achievement demonstrates the Alliance at its best. Now that funding has been approved, we will get to work with manufacturers and our Alliance partners to build the stockpile. It will be critical for Gavi to secure enough funding for the 2021-2025 period to maintain this Ebola vaccine programme in order to protect people, health systems and economies that may be threatened by this devastating disease in the future.”

A coordinating mechanism to decide how and when the vaccine stockpile will be deployed will be established with partner organisations.

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 04 December 2019
:: To provide an insight on the status of polio eradication efforts as at September 2019, the WHO Director-General’s report on polio eradication to the upcoming Executive Board (EB) meeting has been published here. Available in six languages, the report summarizes the programmatic, epidemiological and financial challenges to securing a lasting polio-free world.

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan — one WPV1 case and one WPV1 positive environmental sample;
:: Pakistan — 25 WPV1 positive environmental samples;
:: Angola — 16 cVDPV2 cases and four cVDPV2 positive environmental samples.

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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 7 Dec 2019]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 70: 03 December 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 7 Dec 2019]

Angola
:: WHO supports Angola’s Government efforts to end polio outbreak 02 December 2019

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
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
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 7 Dec 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 – No new digest announcements identified
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
:: 06 December 2019 Southern Africa: Humanitarian Key Messages, December 2019

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 30 November 2019

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

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

PDF: The Sentinel_ period ending 30 Nov 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]

ILO – More than 500 billion dollars a year needed to ensure basic levels of social protection worldwide

Social Protection

Press Release
More than 500 billion dollars a year needed to ensure basic levels of social protection worldwide
25 November 2019
GENEVA (ILO News) – More than US$500 billion a year needs to be invested if countries are to meet a basic set of social protection measures – known as a social protection floor – by 2030, says a new ILO report.

According to the report, spending on coverage needs to increase dramatically to achieve universal coverage of a basic set of social protection measures. This would include:
:: Cash transfers to children
:: Maternity benefits for mothers with newborns
:: Disability benefits
:: Old age social pensions

Based on research carried out in 134 countries, the findings show that at current levels social protection covers only 8.5 per cent of children and 15.3 per cent of older persons in low-income countries. By contrast, in upper-middle income countries 35 per cent of children and 90 per cent of older persons are covered…

Many middle- or upper-middle-income countries have the domestic capacity to generate the resources to finance a universal social protection floor, say the report’s authors. However, substantial amounts of overseas development aid will be needed to close the financing gap in the 28 low-income countries covered in the research, to achieve universal coverage by 2030.

According to the report the low-income countries would need to spend 5.6 per cent (US$27 billion per year) of their Gross Domestic Product (GDP) to close the financing gap. The lower middle-income countries would need to earmark 1.9 per cent of GDP (US$ 136 billion per year), whereas the upper-middle income countries would need to spend 1.4 per cent of their GDP (US$ 365 billion per year).

Policy options to create the necessary financing presented in the report include, among others, increasing tax revenue, extending social security coverage and contributions, increasing official development assistance (ODA) with priority given to low-income countries, and eliminating illicit financing flows.

“Promoting the extension of contributory social insurance coverage to workers in the informal economy, in countries where social insurance is still underdeveloped, would create additional revenues of 1.2 per cent of the GDP of these countries,” said Fabio Duran-Valverde, Head of the Public Finance, Actuarial and Statistics Unit.

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ILO Working paper
Measuring financing gaps in social protection for achieving SDG target 1.3: Global estimates and strategies for developing countries
25 November 2019 :: 58 pages
F. Durán Valverde; J. Pacheco-Jiménez; T. Muzaffar; H. Elizondo-Barboza
PDF: https://www.ilo.org/wcmsp5/groups/public/—ed_protect/—soc_sec/documents/publication/wcms_729111.pdf
Social security is a human right but it is not yet a reality. Only 45 per cent of the global population are effectively covered by at least one social protection benefit, while the remaining 55 per cent – as many as 4 billion people – are unprotected. Closing the coverage gap will require additional investments in social protection, which can and should be achieved by increasing the “fiscal space” for social protection.

IOM – World Migration Report 2020

Migration

World Migration Report 2020
IOM
2019 :: 496 pages
ISSN: 1561-5502 E-ISBN: 978-92-9068-789-4
PDF: https://publications.iom.int/system/files/pdf/wmr_2020.pdf
Since 2000, IOM has been producing world migration reports. The World Migration Report 2020, the tenth in the world migration report series, has been produced to contribute to increased understanding of migration throughout the world. This new edition presents key data and information on migration as well as thematic chapters on highly topical migration issues, and is structured to focus on two key contributions for readers: Part I: key information on migration and migrants (including migration-related statistics); and Part II: balanced, evidence-based analysis of complex and emerging migration issues.

This flagship World Migration Report has been produced in line with IOM’s Environment Policy and is available online only. Printed hard copies have not been made in order to reduce paper, printing and transportation impacts.

Highlights from Part I: Data and information on migration and migrants
The number of international migrants globally in 2019: 272 million (3.5% of the world’s population)
• 52 per cent of international migrants were male; 48 per cent were female.
• 74 per cent of all international migrants were of working age (20–64 years).

India continued to be the largest country of origin of international migrants
• India had the largest number of migrants living abroad (17.5 million), followed by Mexico and
China (11.8 million and 10.7 million respectively).
• The top destination country remained the United States (50.7 million international migrants).

The number of migrant workers declined slightly in high income countries while increasing elsewhere
• Between 2013 and 2017, high-income countries experienced a slight drop in migrant workers
(from 112.3 million to 111.2 million). Upper middle-income countries observed the biggest
increase (from 17.5 million to 30.5 million).
• Globally, male migrant workers outnumbered female migrant workers by 28 million in 2017.
There were 96 million male migrant workers (58%) and 68 million female migrant workers (42%).

International remittances increased to USD 689 billion in 2018
• The top 3 remittance recipients were India (USD 78.6 billion), China (USD 67.4 billion) and
Mexico (USD 35.7 billion).
• The United States remained the top remittance-sending country (USD 68.0 billion) followed by
the United Arab Emirates (USD 44.4 billion) and Saudi Arabia (USD 36.1 billion).

The global refugee population was 25.9 million in 2018
• 20.4 million refugees were under the mandate of the United Nations High Commissioner for
Refugees (UNHCR) and 5.5 million were refugees under the mandate of the United Nations
Relief and Works Agency for Palestine Refugees (UNRWA) in the Near East.
• 52 per cent of the global refugee population was under 18 years of age.

The number of internally displaced persons due to violence and conflict reached 41.3 million
• This was the highest number on record since the Internal Displacement Monitoring Centre
began monitoring in 1998.
• The Syrian Arab Republic had the highest number of people displaced (6.1 million) followed by
Colombia (5.8 million) and the Democratic Republic of the Congo (3.1 million).

The number of stateless persons globally in 2018 was 3.9 million
• Bangladesh had the largest number of stateless persons (around 906,000). It was followed by
Côte d’Ivoire (692,000) and Myanmar (620,000).

Migration patterns vary from region to region
• While most international migrants born in Africa, Asia and Europe reside within their regions
of birth, the majority of migrants from Latin America and the Caribbean and Northern America
reside outside their regions of birth. In Oceania, the number of intraregional migrants and those
residing outside the region remained about the same in 2019.
• More than half of all international migrants (141 million) lived in Europe and Northern America.

Migration has been a key determinant of population change in several countries
• Intraregional migration has been an important contributor to population change in some African
countries such as Equatorial Guinea.
• Labour migration has contributed to significant population changes especially in Gulf Cooperation
Council (GCC) States. With the exceptions of Oman and Saudi Arabia, migrants made up the
majority of the populations in GCC countries.

Displacement remained a major feature in some regions
• The Syrian Arab Republic and Turkey were the origin and host of the largest number of
refugees globally, 6.7 million and 3.7 million, respectively. Canada became the largest refugee
resettlement country, resettling more refugees than the United States in 2018.
• The Philippines had the largest number of new disaster displacements in 2018 (3.8 million).
• Around 4 million Venezuelans had left their country by mid-2019. The Bolivarian Republic of
Venezuela was the largest source country of asylum seekers in 2018 (over 340,000).

Migration research and analysis output remained high
• There was a continued increase in the number of migration-related academic publications, with
the largest ever academic output produced during the last two years. There was significant
output from international organizations on a wide range of migration issues.
• Academic output on migration is dominated with perspectives from destination countries,
especially in relation to Europe. A geographic comparison of the primary affiliations of authors
in selected journals shows that most are from institutions in developed countries.

NAS – Regulating Medicines in a Globalized World: The Need for Increased Reliance Among Regulators

Policy/Regulation

Regulating Medicines in a Globalized World: The Need for Increased Reliance Among Regulators
National Academies of Sciences, Engineering, and Medicine; doi.org/10.17226/25594.
Alastair Wood and Patricia Cuff, Editors
November 2019 :: 160 pages
Open Access – PDF: https://www.nap.edu/login.php?record_id=25594&page=https%3A%2F%2Fwww.nap.edu%2Fdownload%2F25594
Description
Globalization is rapidly changing lives and industries around the world. Drug development, authorization, and regulatory supervision have become international endeavors, with most medicines becoming global commodities. Drug companies utilize global supply chains that often include facilities in countries with inconsistent regulations from those of the United States, perform pivotal trials in multiple countries to support registration submissions in various jurisdictions, and subsequently market their medicines throughout most of the world. These companies operate across borders and require individual national regulators to ensure that drugs authorized for use in their countries are safe and effective, and appropriate for their health care system and their population. This process involves significant resources and often duplicative work. It is important to consider how this process can be improved in order to better allocate resources, time, and efforts to improve public health.

Regulating Medicines in a Globalized World: The Need for Increased Reliance Among Regulators considers the role of mutual recognition and other reliance activities among regulators in contributing to enhancing public health. This report identifies opportunities for leveraging reliance activities more broadly in order to potentially impact public health globally. Key topics in this report include the job of medicines regulators in today’s world, what policy makers need to know about today’s regulatory environment, stakeholder views of recognition and reliance, as well as removing impediments and facilitating action for greater recognition and reliance among regulatory authorities.

Joint statement on EPA proposed rule and public availability of data (2019)

Featured Journal Content

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 30 Nov 2019)
Perspective
Joint statement on EPA proposed rule and public availability of data (2019)
H. Holden Thorp, Magdalena Skipper, Veronique Kiermer, May Berenbaum, Deborah Sweet, Richard Horton
| published 26 Nov 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003014
Eighteen months after articulating our concerns [1] regarding the 2018 “Strengthening Transparency in Regulatory Science” rule proposed by the Environmental Protection Agency (EPA) [2], we have become more concerned in response to recent media coverage and a 13 November hearing on the role of science in decision-making at the EPA. These events suggest that the proposed rule is now moving toward implementation; whether it includes amendments sufficient to address the concerns raised by us and many others remains a question.

Our previous statement on the proposed rule, authored and published by the editors-in-chief of five major scientific journals in May 2018, reflected alarm that the proposal’s push for “transparency” would be used as a mechanism for suppressing the use of relevant scientific evidence in policy-making, including public health regulations. After the public comment period for the proposed rule closed, the EPA reported more than 590,000 comments from individuals and scientific, medical, and legal groups, many of which articulated similar concerns [3].

As leaders of peer-reviewed journals, we support open sharing of research data, but we also recognize the validity of scientific studies that, for confidentiality reasons, cannot indiscriminately share absolutely all data. Datasets featuring personal identifiers—including studies evaluating genomes of thousands of people to characterize medically relevant genetic variants—are but one example. Such data may be critical to developing new drugs or diagnostic tools but cannot be shared openly; even anonymized personal data can be subject to re-identification, and it has been a longstanding practice for agencies and journals to acknowledge the value of data privacy adjustments. The principles of careful data management, as they inform medicine, are just as applicable to data regarding environmental influences on public health. Discounting evidence from the decision-making process on the basis that some data is confidential runs counter to the EPA stated mission “to reduce environmental risks…based on the best available scientific information” [4].

We are also concerned about how the agency plans to consider options related to existing regulations. Even if a new standard is not applied retroactively, the standard could apply when a regulation is updated; thus, foundational science from years past—research on air quality and asthma, for example, or water quality and human health—could be deemed by the EPA to be insufficient for informing our most significant public health issues. That would be a catastrophe.

We urge the EPA to continue to adopt an approach that ensures the data used in decision-making are the best available, which will at times require consideration of peer-reviewed scientific data, not all of which may be open to all members of the public. The most relevant science, vetted through peer review, should inform public policy. Anything less will harm decision-making that claims to protect our health.

We hope that in the end, decisions that are made to inform the proposed EPA rule will rise above any form of politics, focusing on what’s best for our communities. We encourage anyone with concerns or opinions about this issue to express their views through relevant legislative channels. Whether submitting public comments to the EPA or communicating with lawmakers in Congress, it is important to emphasize that decision-making that affects us all should be informed by nothing less than the full suite of relevant science vetted through peer review.

References at title link above
1. Berg J, Campbell P, Kiermer V, Raikhel N, Sweet D. Joint statement on EPA proposed rule and public availability of data. Science. 2018; 360: 6388. 10.1126/science.aau0116.
2. U.S. Environmental Protection Agency, News Releases. EPA Administrator Pruitt proposes rule to strengthen science used In EPA regulations. 24 Apr 2018. Available from: www.epa.gov/newsreleases/epa-administrator-pruitt-proposes-rule-strengthen-science-used-epa-regulations.
3. U.S. Environmental Protection Agency, Science Advisor Programs. Strengthening transparency in regulatory science. 30 Apr 2018. Available from: www.epa.gov/osa/strengthening-transparency-regulatory-science.
4. U.S. Environmental Protection Agency. Our mission and what we do. 2018. Available from: www.epa.gov/aboutepa/our-mission-and-what-we-do.

Lancet Editorial – Research integrity: time for global action

Featured Journal Content

The Lancet
Nov 30, 2019 Volume 394 Number 10213 p1965-2038, e38
https://www.thelancet.com/journals/lancet/issue/current
Editorial
Research integrity: time for global action
The Lancet
China has become a formidable global leader in scientific—including medical—research, with the world’s largest publication output, a rapid surge in the number of highly cited researchers, and an increasingly unparalleled quality of scientific publications. However, there is often a shadow hanging over any country’s progress, especially a nation that has advanced with spectacular velocity. China is no exception. And the current concern, escalated to the highest levels of the Chinese Government, is research integrity….

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The unfolding migrant crisis in Latin America
The Lancet
With the political crisis intensifying across Latin America, the difficulties in a region already struggling with massive migration and economic instability are becoming more complex. The number of people migrating across borders within this region has increased by 36% in the past 15 years, reaching 63·7 million in 2015; and of these migrants, 808 000 were defined as refugees, who are the most vulnerable type of migrants and often have insufficient access to appropriate health services. People smuggled by human trafficking and victims of violence are among these migrants.

There are several reasons for migration. Established migrant flows (eg, from Peru to Chile) are driven by labour markets, whereas more recent migration flows (eg, from Venezuela to Colombia) are driven by political and economic instability. Climate change might also become a substantial driver of migration: the UN estimates that of the top 25 nations most at risk for natural disasters, eight are in Latin America and the Caribbean. Inadequate sanitation and shelter, lack of sufficient water and food, and overcrowding in transit centres might increase the risk of migrants acquiring communicable diseases. Without adequate surveillance measures, diseases that were once eradicated from a country can re-emerge. According to the UN, the 634 migrant deaths registered in 2019 in the Americas has already surpassed the number in 2018 (517), and 2019 might be the deadliest year on record for migrants in the region.

The global UN resolution adopted in 2018 urged cooperation among member states in protecting migrants. However, although it is laudable to have migrants’ right to health on the global agenda, Latin American countries are still struggling to improve their national health policies. To protect migrants from the increasing political instability in Latin America, preparedness is crucial. All governments must take their share of responsibility, fully commit, and coordinate efforts with non-governmental organisations and civil society to translate the global agreement on migration into national practices.

Emergencies

Emergencies

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

Ebola Outbreak in DRC 69: 26 November 2019
Situation Update
In the week of 18 to 24 November 2019, seven new confirmed EVD cases were reported from four health zones in two affected provinces in Democratic Republic of the Congo. The majority of the confirmed cases in this week came from Mabalako Health Zone (57%; n=4).

Violence and civil unrest in the week have led to the suspension of Ebola response activities in some areas of Beni, Butembo, and Oicha health zones. On 26 November 2019, some response personnel were temporarily relocated from Beni, though most remain in place to continue responding. The immediate focus will be on maintaining the safety and welfare of response personnel while preserving essential response activities in these places.

The disruptions to the response and lack of access to Ebola-affected communities is threatening to reverse recent progress. As seen previously during this outbreak, such disruptions limit contact tracing, surveillance, and vaccination efforts, and they often result in increased transmission…

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Dead and injured following attacks on Ebola responders in the Democratic Republic of the Congo
Attacks in eastern Democratic Republic of the Congo
28 November 2019 News release
Two attacks in eastern Democratic Republic of the Congo (DRC) have killed 4 workers responding to the Ebola outbreak and injured 5 others.
The attacks occurred overnight on a shared living camp in Biakato Mines and an Ebola response coordination office in Mangina.
We are heartbroken that people have died in the line of duty as they worked to save others,” said Dr Tedros Adhanom Ghebreyesus, World Health Organization Director-General. “The world has lost brave professionals.”
The dead include a member of a vaccination team, two drivers and a police officer. No WHO staff are among those killed, one staff member was injured.
“My heart goes out to the family and friends of the first responders killed in these attacks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We are doing everything possible to bring the injured and front-line workers in the impacted areas to safety. These constant attacks must stop. We will continue to work with the DRC Government, partners and MONUSCO to ensure the security of our staff and other health workers.”…

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New England Journal of Medicine
Online November 27, 2019
DOI: 10.1056/NEJMoa1910993
Original Article
A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics
Sabue Mulangu, M.D., Lori E. Dodd, Ph.D., Richard T. Davey, Jr., M.D., Olivier Tshiani Mbaya, M.D., Michael Proschan, Ph.D., Daniel Mukadi, M.D., Mariano Lusakibanza Manzo, Ph.D., Didier Nzolo, M.D., Antoine Tshomba Oloma, M.D., Augustin Ibanda, B.S., Rosine Ali, M.S., Sinaré Coulibaly, M.D., Adam C. Levine, M.D., Rebecca Grais, Ph.D., Janet Diaz, M.D., H. Clifford Lane, M.D., Jean-Jacques Muyembe-Tamfum, M.D., and the PALM Writing Group for the PALM Consortium Study Team*
Abstract
Background
Although several experimental therapeutics for Ebola virus disease (EVD) have been developed, the safety and efficacy of the most promising therapies need to be assessed in the context of a randomized, controlled trial.
Methods
We conducted a trial of four investigational therapies for EVD in the Democratic Republic of Congo, where an outbreak began in August 2018. Patients of any age who had a positive result for Ebola virus RNA on reverse-transcriptase–polymerase-chain-reaction assay were enrolled. All patients received standard care and were randomly assigned in a 1:1:1:1 ratio to intravenous administration of the triple monoclonal antibody ZMapp (the control group), the antiviral agent remdesivir, the single monoclonal antibody MAb114, or the triple monoclonal antibody REGN-EB3. The REGN-EB3 group was added in a later version of the protocol, so data from these patients were compared with those of patients in the ZMapp group who were enrolled at or after the time the REGN-EB3 group was added (the ZMapp subgroup). The primary end point was death at 28 days.
Results
A total of 681 patients were enrolled from November 20, 2018, to August 9, 2019, at which time the data and safety monitoring board recommended that patients be assigned only to the MAb114 and REGN-EB3 groups for the remainder of the trial; the recommendation was based on the results of an interim analysis that showed superiority of these groups to ZMapp and remdesivir with respect to mortality. At 28 days, death had occurred in 61 of 174 patients (35.1%) in the MAb114 group, as compared with 84 of 169 (49.7%) in the ZMapp group (P=0.007), and in 52 of 155 (33.5%) in the REGN-EB3 group, as compared with 79 of 154 (51.3%) in the ZMapp subgroup (P=0.002). A shorter duration of symptoms before admission and lower baseline values for viral load and for serum creatinine and aminotransferase levels each correlated with improved survival. Four serious adverse events were judged to be potentially related to the trial drugs.
Conclusions
Both MAb114 and REGN-EB3 were superior to ZMapp in reducing mortality from EVD. Scientifically and ethically sound clinical research can be conducted during disease outbreaks and can help inform the outbreak response. (Funded by the National Institute of Allergy and Infectious Diseases and others; PALM ClinicalTrials.gov number, NCT03719586. opens in new tab.)

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Investigational Drugs Reduce Risk of Death from Ebola Virus Disease – NIH
Study Leaders Publish Results from NIH-DRC-WHO Clinical Trial of Four Experimental Therapies.
November 27, 2019
The investigational therapeutics mAb114 and REGN-EB3 offer patients a greater chance of surviving Ebola virus disease (EVD) compared to the investigational treatment ZMapp, according to published results from a clinical trial conducted in the Democratic Republic of the Congo (DRC). The new report also shows that early diagnosis and treatment are associated with an increased likelihood of survival from EVD.
The results appear online this week in the New England Journal of Medicine. An announcement made on August 12, 2019, noted that the study leaders halted the trial early, on August 9, 2019, as recommended by an independent data and safety monitoring board based on its review of preliminary data from 499 study patients. The preliminary analysis found that both mAb114 and REGN-EB3 performed better than ZMapp. The fourth drug, remdesivir, performed similarly to ZMapp. Today’s publication provides a comprehensive analysis of the full dataset from nearly 200 additional patients enrolled in the clinical study.
The clinical trial known as PALM, short for “Pamoja Tulinde Maisha,” a Kiswahili phrase that translates to “together save lives,” was organized by an international research consortium coordinated by the World Health Organization (WHO). It is led and funded by the DRC’s National Institute for Biomedical Research (INRB) and Ministry of Health, and the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health. Professor Jean-Jacques Muyembe-Tamfum, M.D., Ph.D., director-general of the INRB and head of the DRC’s Ebola response, and Richard T. Davey, Jr., M.D., deputy director of NIAID’s Division of Clinical Research, are co-principal investigators for the study.
“Response teams have faced unprecedented challenges in ongoing efforts to save lives and control the outbreak of Ebola in a highly insecure region of the Democratic Republic of the Congo,” said NIAID Director Anthony S. Fauci, M.D. “Although effective treatments alone will not end this outbreak, the PALM study findings identify the first efficacious treatments for Ebola virus disease and therefore mark a significant step forward in improving care for Ebola patients. We thank the study team for their extraordinary efforts to conduct this landmark trial.”
The study enrolled 681 people with Ebola virus disease between November 2018 and August 2019 at four Ebola treatment centers (ETCs) in the cities of Beni, Butembo, Katwa and Mangina. Staff from The Alliance for International Medical Action (ALIMA), International Medical Corps (IMC), Médecins Sans Frontières/Doctors Without Borders (MSF) and the DRC Ministry of Health implemented the trial at the ETCs with support from Congolese staff, the World Health Organization, the Frederick National Laboratory for Cancer Research and The Mitchell Group.
The study was designed to compare mortality among patients who received one of three investigational Ebola drugs with that from a control group of patients who received the investigational monoclonal antibody cocktail ZMapp, developed by Mapp Biopharmaceutical, Inc. The other therapies were mAb114, a single monoclonal antibody product developed for clinical use by NIAID’s Vaccine Research Center and the INRB and licensed to Ridgeback Biotherapeutics and Mapp Biopharmaceutical; REGN-EB3, a monoclonal antibody cocktail developed by Regeneron Pharmaceuticals, Inc.; and remdesivir, an antiviral drug developed by Gilead Sciences, Inc. The Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services, also has provided support for the development of REGN-EB3, ZMapp and mAb114.
The four therapies are administered as intravenous infusions. REGN-EB3 and mAb114 are administered as single infusions and ZMapp and remdesivir are administered as infusions over multiple days. Study participants also received optimized supportive care, including oral and/or intravenous fluids, electrolyte replacement, monitoring of oxygen levels and blood pressure (with supportive measures as needed), blood transfusions, pain management, and antibiotics and antimalarials as indicated….
All four study drugs were generally well tolerated. There were a total of four serious adverse events that were judged to be potentially related to the experimental drugs. Three of these were in two of the patients who received ZMapp. One was in a patient who received remdesivir.
The authors note that despite encouraging findings regarding mAb114 and REGN-EB3, approximately one-third of patients who received these therapeutics died, highlighting the potential to improve upon these results, whether through further optimization of supportive care, combination therapy using agents with complementary mechanisms of action or other strategies.
“Despite unprecedented challenges — including an unstable electrical power grid and evacuations of staff and patients from treatment centers due to violent attacks — the PALM trial demonstrates that scientifically rigorous and ethically sound clinical research can be conducted during disease outbreaks,” said H. Clifford Lane, M.D., NIAID deputy director for Clinical Research and Special Projects. “We thank the patients and the medical staff in the field and at the treatment sites for their participation and exceptional commitment to the trial.”

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 20 November 2019
:: A four-day regional emergency preparedness workshop is currently underway in Lomé, Togo, for senior public health officials to strengthen the capabilities within West African countries to respond to polio outbreaks. Read more about the workshop.
:: “It was good to know that a country like India could eradicate polio. It gives us hope that Pakistan can do it too, and we will soon be polio free.” These are the words of Aziz Memon, a Rotarian who has dedicated his life to fight polio in Pakistan. Read about his journey.

Summary of new viruses this week (AFP cases and ES positives):
:: Pakistan— five WPV1 cases, two cVDPV2 cases and one cVDPV2 positive environmental sample;
:: Democratic Republic of the Congo (DR Congo)- five cVDPV2 cases;
:: Benin – four cVDPV2 cases;
:: Ghana— four cVDPV2 cases and two cVDPV2 positive environmental samples;
:: Philippines – three cVDPV2 cases and five cVDPV2 positive environmental samples;
:: Togo – two cVDPV2 cases.

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More than 3.1 million Iraqi children to be vaccinated against polio
Baghdad, 26 November 2019 – Health authorities in Iraq, in partnership with the World Health Organization (WHO) and UNICEF, have launched a campaign to reach more than 3.1 million children under-5 years of age with lifesaving polio vaccine.

The 5-day campaign aims to target children in 65 districts in the governorates of Baghdad, Babylon, Diwaniya, Diyala, Muthanna, Thi-Qar, Missan and Basra.

“Over the years, WHO, the Ministry of Health and UNICEF have worked hard to improve immunization coverage in the country. Therefore, it is important that we keep building on our work by making sure that children are vaccinated against childhood preventable diseases like polio and we keep Iraq polio free,” said Dr Adham Ismail, WHO Representative for Iraq. “During this second phase of the campaign, we want to reach all the children under 5 regardless of their previous vaccination status with oral polio vaccine leaving no one out no matter where they are,” added Dr Adham…

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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 30 Nov 2019]

Democratic Republic of the Congo
:: Dead and injured following attacks on Ebola responders in the Democratic Republic of the Congo 28 November 2019
:: Ebola Outbreak in DRC 69: 26 November 2019

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

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WHO Grade 2 Emergencies [to 30 Nov 2019]

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

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

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The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 23 November 2019

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

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

PDF: The Sentinel_ period ending 23 Nov 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]

30th Anniversary of the Adoption of the Convention on the Rights of the Child: Statement by SRSG Gamba

Children – CRC 30th Anniversary

30th Anniversary of the Adoption of the Convention on the Rights of the Child: Statement by SRSG Gamba
Wednesday, 20 November 2019
Excellencies, Ladies and gentlemen,
Concern for children’s rights and their protection has brought world leaders together in 1989 to make a historical commitment to children and adopt a common standard around which to rally. The Convention on the Rights of the Child is however much more than a human rights convention for the protection of children and the fulfillment of their rights. It is the recognition that children, including those affected by armed conflict, are holders of human rights and should be considered not only as objects of protection but also as individuals who can be agents of change by exercising their rights.

The Convention says that childhood is separate from adulthood and lasts until 18; it is a protected time, in which children must be allowed to grow, learn, play, develop and flourish with dignity and without discrimination. Conflict was and remains however the greatest threat to that principle and to the realization of children’s rights contained in the Convention. For children trapped in conflict zones the concept of childhood as set forth in the Convention oftentimes stays a distant dream. At the same time, during times of war the vulnerability of children is compounded by the violence and turbulence which accompany conflict and children are more than ever in dire need of specific protection.

The Convention on the Rights of the Child is at the heart of the international legal framework for the protection of children affected by armed conflict and a guiding source of operative principles and standards for the mandate that I represent. A direct link with this protection can be found in its article 38 on the recruitment and use of children in armed conflicts and its article 39 stressing that States Parties shall take all appropriate measures to promote physical and psychological recovery and social reintegration of a child victim of armed conflict. Other rights contained in the Convention are also important for the protection of children affected by armed conflict— such as the right to birth registration and the right to acquire a nationality (Article 7). Even during armed conflict states parties are required to ensure that all children, boys and girls, are effectively protected against all forms of physical, sexual or other forms of violence, abuse or exploitation as it says in Articles 19, 32–38 and to implement the rights which are critical for children’s survival and development, including the right to the highest attainable standard of health (Article 24), the right to benefit from social security (Article 26), the right to an adequate standard of living (Article 27), the right to education (Article 28), and the right to rest and leisure and to engage in play and in recreational and cultural activities (Article 31).

While an appropriate tool for the protection of children affected by armed conflict the Convention is a starting – rather than an ending – point. The standards contained therein have thus been upgraded at international level including through the Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict as well as at regional level through amongst others the African Charter on the Rights and Welfare of the Child. They have been further strengthened through resolutions of the UN Security Council on Children and Armed Conflict as well as through political commitments such as the Paris Principles, the Safe Schools Declaration and the Vancouver Principles.

Ladies and gentlemen,
Standards set only on paper do not change the world for children affected by war. What is needed is their full implementation through the adoption of national laws and policies as well as enforcement initiatives addressing violations of children’s rights in conflict. I am calling on all of you here today to turn good intentions into real change for children. Let me finish with the words of Nelson Mandela: “Our children are our greatest treasure. They are our future. Those who abuse them tear at the fabric of our society and weaken our nation”. This remains true for all of us. Thank you.

Children paying a high price for inequality – OECD Report

Children – Inequality

Children paying a high price for inequality
19/11/2019 – Rising income inequalities in OECD countries over the past two decades have hit vulnerable children hard, making it less likely they will fulfill their economic and social potential later in life, according to a new OECD report.

Changing the Odds for Vulnerable Children: Building Opportunities and Resilience says that the challenges some children face significantly raise the risk that they become disadvantaged in adulthood, putting the brakes on social mobility. Yet early investment in education, health and families yields high returns later in life.

Children who grow up in poor families have less access to quality education and health care. As young people, they are likely to enter the labour market at an earlier age than their peers and take up low-skilled jobs at a time when technological change and globalisation are increasing the returns to education.

Child poverty has increased in almost two-thirds of OECD countries over the past decade, with one in seven children in the OECD growing up in poverty today. The living standards of children from low-income families have also declined in many countries, particularly for those families with the smallest incomes.

The report also reveals homelessness among families has risen significantly in England, Ireland, New Zealand and some US states. For children, homelessness can lead to increased anxiety, loss of contact with family and friends and poor educational outcomes.

“The odds are stacked against vulnerable children and countries need to act now,” said Gabriela Ramos, OECD Chief of Staff and Leader of the OECD’s Inclusive Growth Initiative, launching the report during a conference at the OECD on the issue of vulnerable children, which included an address by Nobel Prize Peace Winner Kailash Satyarthi. “More efforts are needed and quickly to redress the balance to create a level playing field and ensure that the children who are worst off can get the better deal they deserve. Countries should quickly put in place child well-being strategies that prioritise the needs of vulnerable children.”

Children with disabilities, for example, are twice as likely to live in poor households. Maltreatment is also a major issue, with around 4-16% of children experiencing physical abuse, 10% neglect or emotional abuse and over childhood 5-10% of girls and 1-5% of boys experience sexual abuse. Chronic stress in early childhood can also have long-term consequences for cognitive and social and emotional development, as well as children’s health.

The odds can be changed when vulnerable children are given the right support to build resilience, says the report. This includes providing children with opportunities to build positive relationships with adults, providing early intervention for mental health difficulties and supporting parents. Programmes such as mentoring, arts education, youth mental health projects and family resource centres empower children and family to overcome adversity and disadvantage.

Direct investments in low-income children’s health and education generate the highest pay-off, many paying for themselves in the long run through increased tax revenue and lower social transfers.

Countries need to put in place policies to tackle these issues, ranging from empowering vulnerable families and enhancing child protection, to giving every child the opportunity of starting education early and reducing child poverty. Early intervention is key and should be prioritised, as young children under three years old are especially affected by family stress and material deprivation because of the rapid pace of early brain development.

In a separate report released at the conference Building Resilience in Vulnerable Children, the OECD revealed the changing patterns of family life. Across the OECD on average, 4 in 5 children live in couple families, but over the past 10 years, the share of children living with informally cohabiting parents has increased from 10 to 16%. Around 17% of children also live in single parent families. Yet a child in a single parent family is three times more likely to be poor than a child in a couple family.

The partnership status of parents should not affect entitlements to child-related support within tax and benefit systems, says the report. However, less than two thirds of OECD countries allow non-married couples to register their partnerships or grant them the tax and benefit advantages available to married couples.

Tax and benefit systems need to be more responsive to changes in children’s living arrangements. This will require better information systems, as well as simpler and more transparent benefit rules and needs assessment criteria in order to help social policy treat all children equally…

Convention on tourism ethics is major step towards tackling child exploitation, say UN human rights experts

Children – Tourism; Exploitation

Convention on tourism ethics is major step towards tackling child exploitation, say UN human rights experts
GENEVA / NEW YORK (19 November 2019) – UN experts on human rights* have urged all States to sign up to a framework convention on the ethics of tourism, which they hailed as an important step forward in combating the exploitation of children in travel and tourism, and in promoting their rights.
“There is an urgent need to tackle the violence and exploitation experienced by children in the context of travel and tourism,” the experts said.

“No country is immune from this grave problem, which has expanded across the globe and has out-paced efforts to respond at the international and national levels.

“The Framework Convention is an important tool for shining a light on the violence and exploitation suffered by children in the context of travel and tourism, and for spurring action to end it. It aims to ensure that tourism develops in line with human rights law. We urge all States to become party to it.”
The Framework Convention, adopted by the UN World Tourism Organization in September 2019, endorses the principle that tourism activities should respect gender equality and promote human rights, especially the individual rights of children, older persons, people with disabilities, ethnic minorities, indigenous peoples, and members of other vulnerable groups.

It notes that the exploitation of human beings in any form, particularly sexual, especially when applied to children, conflicts with the fundamental aims of tourism.

“The Framework Convention was preceded by a Global Code of Ethics for Tourism, which was very valuable in promoting responsible and ethical tourism and tackling the exploitation of children. However, moving from a voluntary set of guidelines to a binding international instrument sends a strong signal that Member States are ready to accelerate their action and to enhance accountability in this field,” the experts said.

States that ratify the Framework Convention will be required to combat and penalise the exploitation of children, especially sexual exploitation. It adds to the existing body of international law devoted to protecting children and prohibiting child labour, such as the Convention on the Rights of the Child and its Optional Protocol on the sale of children, child prostitution and child pornography.

It will also help deliver the 2030 Agenda for Sustainable Development, which has targets on promoting sustainable tourism and ending violence against children.

“These targets are linked to each other and help reinforce each other,” the experts said. “Safeguarding children from discrimination, exclusion, violence and exploitation is indispensable to ensuring that all forms of tourism are truly responsible and sustainable.

“We look forward to working with the UN World Tourism Organization, States, civil society partners, the business sector and others to promote the swift ratification and effective implementation of the Framework Convention.”

The UN experts also hope that by implementing it, Member States will ensure that workers’ rights will be fully respected in line with international standards, and that businesses in the tourism sector will be held accountable for rights violations including trafficking for labour exploitation in their supply chains.
ENDS

*UN experts:
Ms Najat Maalla, Special Representative of the Secretary-General on Violence against Children; Ms Maud De Boer-Buquicchio, Special Rapporteur on the sale and sexual exploitation of children;
Ms Urmila Bhoola, Special Rapporteur on contemporary forms of slavery, including its causes and consequences;
Ms Catalina Devandas-Aguilar, Special Rapporteur on the rights of persons with disabilities;
Ms Maria Grazia Giammarinaro, Special Rapporteur on trafficking in persons, especially women and children;
Mr Saad Alfarargi,Special Rapporteur on the Right to development;
Mr Dainius Pūras, Special Rapporteur on the right to physical and mental health;
Ms E. Tendayi Achiume, Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance;
Ms Rosa Kornfeld-Matte,Independent expert on the enjoyment of all human rights by older persons;
Ms Victoria Tauli-Corpuz,Special Rapporteur on the rights of indigenous peoples.

DECLARATION OF THE 9th WORLD SCIENCE FORUM :: Science Ethics and Responsibility

DECLARATION OF THE 9th WORLD SCIENCE FORUM
Science Ethics and Responsibility
Text adopted on 23 November 2019, Budapest

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PREAMBLE
With the encouragement and support of the partner organisations of the World Science Forum, the United Nations Educational, Scientific and Cultural Organization (UNESCO), the International Science Council (ISC), the Hungarian Academy of Sciences, the American Association for the Advancement of Science (AAAS), The World Academy of Sciences (TWAS), the InterAcademy Partnership (IAP), and the European Academies’ Science Advisory Council (EASAC), we the participants of the 9th World Science Forum, held from 20-23 November 2019 in Budapest, adopt the present declaration.

World Science Forum (WSF), an outcome of the 1999 World Conference on Science, is a biennial event that since 2003 has been successfully assembling scientists, policymakers, industry leaders, civil society and the media to discuss the role of science in meeting global challenges.

In line with the recommendations of the 1999 World Conference on Science (WCS) on Science and the Use of Scientific Knowledge, and taking into account the 2011 Budapest Declaration on the New Era of Global Science, the 2013 Rio de Janeiro Declaration on Science for Global Sustainable Development, the 2015 Budapest Declaration on The Enabling Power of Science, and the 2017 Jordan Declaration on Science for Peace we reaffirm our commitment to the rigorous and ethical conduct of scientific research and the responsible use of scientific knowledge.

Science, Ethics and Responsibility –20 years after the 1999 World Conference on Science
The Declaration on Science and the Use of Scientific Knowledge endorsed by representatives of 155 governments in Budapest at the 1999 UNESCO World Conference of Science was a pioneering document outlining a clear vision for science and society in the 21st century. It defined an expanded role and responsibility for science in a new era of human history in which science and technology are primary drivers of societal change.

Indeed, in the past 20 years, we have seen a revolution in multiple fields of scientific research coupled with deep and ongoing change in our societies. New scientific discoveries in fields such as information and communication technologies, synthetic biology and gene editing, artificial intelligence, big data and machine learning have further increased the pace at which science and technology impact our environment and society, with the potential to entrench rather than reduce inequalities.

Environmental and social challenges including demography, climate change, pollution and water security have raised new expectations for science.

Globally, investment in research and development has greatly increased, and new state and non-state actors have reshaped the established global order and impacted the production of scientific knowledge and the distribution of science investment and funding.

In our societies transformed by the rise of new communication channels and social media, scientific knowledge is increasingly challenged in public discourse by opinions and beliefs based on distrust, insufficient engagement, poor science literacy, and inefficient communication of science to the public and policymakers. At a time of accelerating global change, it is particularly important that young people in all societies have access to scientific education.

:: We recall the 1999 Declaration on Science and the use of Scientific Knowledge and acknowledge the growing importance of the message of “Science for the 21st Century: A New Commitment” as presented in its recommendations.

:: We must ensure shared responsibility for ethical considerations to be recognised as intrinsic to defining the objectives of scientific inquiry, making funding allocations, and conducting, disseminating and applying research. This should apply in particular to the education and inclusion of young and emerging scientists and innovators.

:: We foster a proactive culture of self-regulation by scientists.

:: We embrace the Principle of Freedom and Responsibility in Science adopted by ISC member organisations, the renewed Recommendation on Science and Scientific Researchers adopted by UNESCO, and the AAAS Statement on Scientific Freedom and Responsibility as reference documents for further consideration.

:: We celebrate 20 years of international science dialogue since the 1999 World Conference on Science and 100 years since the establishment of the International Research Council, the first non-governmental organisation to foster scientific collaboration on a global scale. We affirm our commitment to scientific responsibility for the global public good through attainment of the United Nations Sustainable Development Goals.

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[1] Science for global well-being
The value of science cannot be measured solely by its contribution to economic prosperity. Science is a global public good with the ability to contribute to sustainable development and global well-being.

:: We recognise the responsibilities of scientists to conduct and apply science with integrity, in the interest of humanity, for well-being and with respect to human rights.

:: We call for the reassessment of science and funding policies recognizing the value of science as a tool to push the boundaries of human knowledge, to promote universal well-being, to monitor, analyse and respond to environmental, social and economic challenges, and to address the capacity needs of scientifically lagging countries.

:: We embrace the freedom of scientists to plan and conduct research that may not be specifically responsive to any immediate socio-economic or environmental expectations. Good science must be free to fly when curiosity is the driving factor.

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[2] Strengthen global standards in research integrity
In the world of globalised science there is a growing need for the harmonisation and promotion of research integrity which includes common codes of conduct and their enforcement. This should apply especially for rapidly developing areas of science and research performed by transnational entities.

:: We call for harmonisation and enforcement of standards of conduct of scientific research across borders and across public and private research.

:: We acknowledge that worthy research requires more than intellectual merit and impact; it must be ethical, inclusive, and socially responsible.

:: We call for the establishment of self-regulatory processes by which scientists can report suspected research misconduct and other irresponsible research practices, without fear of reprisal, and the establishment of procedures for responding to such allegations.

:: We support regional and national efforts to promote global standards of research integrity, and in particular we celebrate the emergence from World Science Forum 2017 of the Charter of Ethics of Science and Technology in the Arab Region.

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[3] Fulfilment of academic freedom and the human right to science
While acknowledging that the principle of academic freedom is supported and promoted by science organisations globally, there is little consensus on the conditions that enable its fulfilment. In an evolving era in which science is increasingly dependent on research infrastructure, research funding, and top-down policy agendas, the concept of academic freedom must be revisited.

Academic freedom must operate at every point in the research process. It must encompass the autonomy of researchers and research institutions, access to peer-reviewed scientific knowledge and data without systemic barriers, access to research infrastructure and funding, and the freedom to set bottom-up research agendas in all fields of science, including social sciences, and the freedom to communicate scientific results.

:: We acknowledge that scientific freedom can only be respected by society if it is based on strict ethical principles.

:: We call on the international scientific community to develop new standards for the fulfilment of academic freedom, and to create tools to describe, monitor and measure its integral conditions.
We acknowledge the vital nature of curiosity-driven basic sciences. We welcome the UNESCO’s designation of 2022 as the International Year of Basic Sciences for Development.

:: We reaffirm our support for the rights of refugee and other displaced scientists.

:: We reinforce our commitment to promote the right to science for all—including those underrepresented and underserved by science, such as women and minorities —as an essential precursor to sustainable and prosperous societies and durable peace.

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[4] The responsibility and ethics of communicating science
The pace of scientific discovery has quickened, but barriers to scientific information and the benefits of research remain. The increased complexity and volume of scientific information requires new methods of data validation and research dissemination. While the application of artificial intelligence opens new paths for the management of scientific research and data, it also raises concerns about privacy, control and the use of personal data. Such developments alter the landscape of access to knowledge and present challenges in transitioning to novel publishing models and the application of new communication strategies.

:: We reinforce our commitment to science as a global public good and support open science and new publishing models that grant access to scientific publications.

:: We recognize the importance of scientists engaging with the public about science, including the risks associated with its conduct or application and the acknowledgement of other interpretations of research.

:: We encourage scientists to foster citizen science and to promote the co-creation of actionable knowledge.

:: We recognize the imperatives for evidence-informed decision-making and a stronger science-policy-practice interface and, therefore, the need for scientists to be trained to communicate their work to decision-makers and the general public.

:: We recognize the powerful role of media in communicating scientific information and call for rigorous fact checking and analysis in reporting. We call for a reassessment of science’s relationship with media, particularly in view of conflicting or misleading news and information, and the use of false equivalence.

:: We encourage scientists to produce, apply and communicate science and to raise awareness of both the benefits and ethical considerations.

100 Countries Now Commit to Ending Attacks on Education

Education

100 Countries Now Commit to Ending Attacks on Education
Incidents of the Military Use of Schools Decline in Countries Endorsing the Safe Schools Declaration

(New York, November 20, 2019) The recent endorsements by Morocco, Vietnam, the Marshall Islands, Vanuatu and Ukraine bring the total number of states that have joined the Safe Schools Declaration to 100, the Global Coalition to Protect Education from Attack (GCPEA) said today. Ukraine became the 100th country to endorse the declaration today.

“More than half of all United Nations members have now joined the Safe Schools Declaration, representing a critical mass of countries committed to protecting students, teachers, their schools and universities from attack,” said Diya Nijhowne, GCPEA’s Executive Director. “The remaining governments should also sign on and fully implement the Declaration if the UN Sustainable Development Goals are to be achieved, not only for education but all the goals, as they are inextricably linked to safe education for all.”

The Safe Schools Declaration is an inter-governmental political commitment to protect education in armed conflict led by the governments of Argentina and Norway and launched in May 2015, with GCPEA’s active support. By endorsing the Safe Schools Declaration, governments commit to improve monitoring and reporting of attacks on education and military use of schools, assist victims of attacks, prosecute perpetrators, and promote measures that enable safe education to continue during war. By joining the Declaration, governments also endorse and commit to use the Guidelines for Protecting Schools and Universities from Military Use during Armed Conflict.

Between 2015 and mid-2019, GCPEA identified nearly 10,000 reported incidents of attacks on education harming over 17,800 students, teachers, and education personnel across all levels of education. GCPEA identified a systematic pattern of attacks on education in 37 countries in this period, and collected reports of military use of schools and universities in 32 countries…

In its new fact sheet, Practical Impact of the Safe Schools Declaration, GCPEA presents a growing body of evidence showing how the Safe Schools Declaration is helping to protect education from targeted and indiscriminate attack during armed conflict. It also underscores a significant decline in schools and universities being used as bases and barracks, weapons stores, detention centers, and for other military purposes.

In 2018, GCPEA found at least 80 reported incidents of military use of schools and universities, a drop from 2015, when GCPEA identified at least 160 reported incidents, among the 12 countries that endorsed the Safe Schools Declaration in 2015 and experienced at least one incident of military use of schools…

Four private foundations announce they will provide at least $20 million in a combined grantmaking initiative to strengthen women’s funding organizations around the world

Philanthropy – “Women’s Funding Organizations”

Four private foundations announce they will provide at least $20 million in a combined grantmaking initiative to strengthen women’s funding organizations around the world
November 20, 2019
Four private US foundations announced today that they are providing at least $20 million in a combined effort to strengthen women’s funds—organizations that provide financial and other support to advance the human rights and opportunities of women, girls, and LGBTQI people in countries around the world.

Women’s funds have a long track record of knowing where and how to support organizations working to achieve gender equality in their communities, countries, and regions. Today, they are leading women’s rights movements in some of the most challenging contexts and informing philanthropic donors in supporting those efforts.

The initiative will help women’s funds invest in their own organizations—strengthening infrastructure, leadership, communications, fundraising, learning, and other efforts—to help them maximize their impact and achieve their goals.

Foundation for a Just Society, the Open Society Foundations, Wellspring Philanthropic Fund, and the William and Flora Hewlett Foundation have designed the five-year initiative in consultation with women’s funds.

“We at Prospera International Network of Women’s Funds see this initiative as a great opportunity for ensuring a healthy and vibrant ecosystem for funding women’s rights and gender justice throughout the world. By strengthening the capacity of women’s funds to better operate and respond to a rapidly changing world, these funders will be able to better support feminist movements at the forefront of social change,” said Emilienne de León, executive director of Prospera International Network of Women’s Funds.

New Venture Fund (NVF) has been selected by the four foundations through a competitive process as the initiative’s fiscal sponsor and will provide guidance and administrative support to the initiative. NVF will in turn be supported by Arabella Advisors, a philanthropic consulting firm.

Women’s funds have received significant new resources from the Dutch Ministry of Foreign Affairs, Global Affairs Canada, and several private foundations in recent years. However, the vast majority of these resources are used to make grants to smaller, grassroots organizations working to advance women’s rights and not to support the development of women’s funds. This reflects the limitations of bilateral funding and the commitment of women’s funds to support feminist movements.

This initiative is designed to build women’s funds own organizational capacity—by using the resources to invest in areas such as communications; resource mobilization; leadership; information technology; and monitoring, evaluation, and learning, among others…

In addition to helping women’s funds strengthen their own organizational capacity, the donors aim to make women’s funds more visible to other funders and supporters of women’s and LGBTQI rights. The money will also support efforts to help women’s funds learn from one another and for philanthropic organizations to learn from them as well…

This press release is also available in Spanish, French, and Brazilian Portuguese.