The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
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Week ending 8 June 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 8 Jun 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]

Humanitarian Response

U.S. Charities Launch Global Emergency Response Coalition to Expedite Action During Humanitarian Crisis
June 5, 2019
Coalition appoints new Managing Director to lead efforts

Washington, DC – June 5, 2019 – Eight of the leading U.S.-based international relief organizations have renewed their commitment to the Global Emergency Response Coalition. Originally created in April 2017 to broaden awareness and take urgent action when disasters occur, the Coalition is made up of field-based, well respected and vetted organizations that are combining their capabilities and technical capacities in a joint effort. The Coalition will harness the fundraising power of the United States to save lives by inspiring donors and quickly getting them involved at the onset of disasters.

“Too often children and families around the world in dire need of help go unnoticed due to lack of public awareness,” said the CEOs of the Global Emergency Response Coalition member NGOs. “We have come together to use our collective energies, increase the U.S. public’s attention to global disaster, and leverage the massive influence and generosity that Americans can bring toward creating global action.”

The Coalition, composed of CARE, International Medical Corps, International Rescue Committee, Mercy Corps, Oxfam America, Plan International USA, Save the Children and World Vision, originally came together with a goal of bringing attention to and increasing funding for the East Africa Hunger Crisis, expediting and amplifying lifesaving aid to reach the 20 million people who were at risk of starvation at the time. Up until that point, despite the large number of people in need, the crisis had received little attention.

Today, the need for urgent aid continues to expand. An increase in natural disasters, conflict-related refugees, and food insecurity worldwide are all contributing to a humanitarian system that is dangerously underfunded. UN OCHA estimates that one out of every 70 people around the world is in need of humanitarian assistance. And the need surrounding disasters is lasting longer – now an average of nine years.

The Coalition recently appointed Gwen Young as its Managing Director to lead this expanded effort. Young has more than 25 years of experience in international relief and development, including most recently as the Director of the Global Women’s Leadership Initiative at the Wilson Center. She previously served at Africare, the Bill & Melinda Gates Foundation, and Médecins Sans Frontières. She began her new role March 1st.

“The worsening nature and duration of humanitarian crisis is sadly the new normal,” said Young. “It requires that we, as key humanitarian actors, combine our efforts to ensure that people and communities get the lifesaving assistance they need.”

Visit the Global Emergency Response Coalition website for more information and to donate.

CEOs of the Global Emergency Response Coalition:
Michelle Nunn, CARE
Nancy Aossey, International Medical Corps
David Miliband, International Rescue Committee
Neal Keny-Guyer, Mercy Corps
Abby Maxman, Oxfam America
Tessie San Martin, Plan International USA
Carolyn Miles, Save the Children
Edgar Sandoval, World Vision

About the Global Emergency Response Coalition:
The Global Emergency Response Coalition is a lifesaving humanitarian alliance made up of eight leading U.S.-based international aid organizations. When disaster strikes, the Coalition mobilizes to help children and families in urgent need. By working together, we can increase awareness and funds to deliver emergency relief quickly and efficiently to save lives and help rebuild communities

Humanitarian Response

Cameroon tops list of most neglected crises
Norwegian Refugee Council Published 04. Jun 2019
Cameroon tops the Norwegian Refugee Council’s annual list of the world’s most neglected displacement crises launched today.

…The annual list of neglected displacement crises is based on three criteria: lack of funding, lack of media attention and political neglect. Cameroon scored high on all three, followed closely by DR Congo and Central African Republic, two other crises where a lack of public attention has contributed to a lack of funding for humanitarian relief.

“Humanitarian assistance should be given based on needs, and needs alone. However, every day millions of displaced people are neglected because they have been struck by the wrong crisis and the dollars have dried up,” Egeland said.

The majority of the countries on the list are found on the African continent. The Norwegian Refugee Council is calling for increased attention to the crises on the list to prevent the suffering of millions of vulnerable people.

“This depressing list must serve as a wake-up call for all of us. Only by drawing attention to these crises, learning about them and placing them high on the international agenda, can we achieve much needed change,” Egeland said.

This year’s neglected crises list. These are the world’s ten most neglected displacement crises in 2018:
Cameroon
DR Congo
Central African Republic
Burundi
Ukraine
Venezuela
Mali
Libya
Ethiopia
Palestine

Displacement crises resulting in more than 200,000 people displaced have been analysed – 36 crises in total.

Press Freedom – Global Assessment

Freedom and the Media: A Downward Spiral
Freedom House, June 2019
By Sarah Repucci, Senior Director for Research and Analysis
Key Findings
:: Freedom of the media has been deteriorating around the world over the past decade.

:: In some of the most influential democracies in the world, populist leaders have overseen concerted attempts to throttle the independence of the media sector.

:: While the threats to global media freedom are real and concerning in their own right, their impact on the state of democracy is what makes them truly dangerous.

:: Experience has shown, however, that press freedom can rebound from even lengthy stints of repression when given the opportunity. The basic desire for democratic liberties, including access to honest and fact-based journalism, can never be extinguished.

Overview
The fundamental right to seek and disseminate information through an independent press is under attack, and part of the assault has come from an unexpected source. Elected leaders in many democracies, who should be press freedom’s staunchest defenders, have made explicit attempts to silence critical media voices and strengthen outlets that serve up favorable coverage. The trend is linked to a global decline in democracy itself: The erosion of press freedom is both a symptom of and a contributor to the breakdown of other democratic institutions and principles, a fact that makes it especially alarming.

According to Freedom House’s Freedom in the World data, media freedom has been deteriorating around the world over the past decade, with new forms of repression taking hold in open societies and authoritarian states alike. The trend is most acute in Europe, previously a bastion of well-established freedoms, and in Eurasia and the Middle East, where many of the world’s worst dictatorships are concentrated. If democratic powers cease to support media independence at home and impose no consequences for its restriction abroad, the free press corps could be in danger of virtual extinction.
Experience has shown, however, that press freedom can rebound from even lengthy stints of repression when given the opportunity. The basic desire for democratic liberties, including access to honest and fact-based journalism, can never be extinguished, and it is never too late to renew the demand that these rights be granted in full.

Attacks on press freedom in democracies
In some of the most influential democracies in the world, large segments of the population are no longer receiving unbiased news and information. This is not because journalists are being thrown in jail, as might occur in authoritarian settings. Instead, the media have fallen prey to more nuanced efforts to throttle their independence. Common methods include government-backed ownership changes, regulatory and financial pressure, and public denunciations of honest journalists. Governments have also offered proactive support to friendly outlets through measures such as lucrative state contracts, favorable regulatory decisions, and preferential access to state information. The goal is to make the press serve those in power rather than the public.

The problem has arisen in tandem with right-wing populism, which has undermined basic freedoms in many democratic countries. Populist leaders present themselves as the defenders of an aggrieved majority against liberal elites and ethnic minorities whose loyalties they question, and argue that the interests of the nation—as they define it—should override democratic principles like press freedom, transparency, and open debate.

Among Free countries in Freedom House’s Freedom in the World report, 19 percent (16 countries) have endured a reduction in their press freedom scores over the past five years. This is consistent with a key finding of Freedom in the World—that democracies in general are undergoing a decline in political rights and civil liberties. It has become painfully apparent that a free press can never be taken for granted, even when democratic rule has been in place for decades…

…Recommendations
The following recommendations for policymakers in democratic nations will help ensure the sustainability of independent media worldwide:

:: Ensure that their actions do not excuse or inspire violations of press freedom. Democratic nations have a particularly important role to play in maintaining media freedom. Words matter, and when US officials verbally attack the press or fail to swiftly and vigorously condemn acts of repression such as Khashoggi’s murder, it sends a signal to undemocratic leaders around the world that assaults on the press and crimes against journalists are permissible.

:: Take strong and immediate action against any violations of media freedom globally through press statements, phone calls, meetings, letters, and the imposition of targeted sanctions on perpetrators. This includes speaking out against violence against journalists and authorities’ failure to identify and prosecute attackers, restrictions on media access, blocking of websites, and censorship on particular topics.

:: Stand up publicly for the value of a free press, and support civic education that will inform the next generation. Press freedom is one of the most fundamental pillars of American democracy, and constitutional protections in the United States are stronger than in any other country in the world. Citizens could easily forget this amid media mudslinging and incendiary commentary. Political leaders and teachers should reiterate the extent to which we all benefit from professional journalists who hold those in power to account.

:: Ensure that foreign policy and assistance prioritizes support for democratic principles, including media freedom, as the foundation of national security and economic prosperity. The goal of foreign assistance is to bring recipient countries to the point that they no longer need it. In that sense, it is shortsighted for donor governments to invest funding overseas without shoring up press freedom. National security and economic prosperity are strongest in nations where democratic rights are protected, and a free press is a key watchdog of democracy. Foreign aid specifically focused on bolstering independent media by providing technical training and emergency assistance is especially needed given the threats journalists currently face. Countries that have experienced recent expansions in press freedom, such as Angola, Ethiopia, Malaysia, and Ecuador, are particularly vulnerable to backsliding and require special focus.

:: Support social media as an alternative outlet for free expression in repressive environments. Innovative alternatives to state-controlled media regularly spring up on social media, including recently in Venezuela, Armenia, and Sudan. Related technology can be used to circumvent censorship and keep reporters anonymous where needed. Donor agencies should provide funding for technology that increases journalistic freedom.

Governance – Global Regulation/Risk Management in Fintech

The Next Steps for International Cooperation in Fintech
Opening Remarks by Christine Lagarde, Managing Director, IMF
G20 High Level Seminar “Our Future in the Digital Age”
Fukuoka, Japan. June 8, 2019
As Prepared for Delivery
Distinguished guests, ladies and gentlemen — good afternoon! Minasan, konnichiwa!

I would like to thank Japan’s Financial Services Agency for the opportunity to participate in this session focused on the important topic of our future in the digital age.

Opportunities and Risks in Financial Innovation
It is appropriate that we are launching our discussion in Fukuoka. Why? Because Fukuoka is Japan’s start-up city. In each of the last three years more companies have been started in Fukuoka than nearly anywhere else in Japan.

And here in Japan — and in Asia more broadly — is where both the peril and promise of fintech have revealed themselves.

It is in Asia where innovations in digital payments and verification systems first became mainstream.
But it is also in Asia where we first saw the darker side of fintech, with concerns for consumer protection and privacy concerns bubbling to the surface years ago.

Asia, like the rest of the world, is facing a defining moment: How to manage the risks of fintech without suffocating innovation; how to keep up with rapid fintech innovation, while making sure consumers and investors feel secure in their investments.

Technology always has, and always will, spur innovation in finance. The question is whether these innovations will benefit all, or only a select few. If handled correctly, fintech can cut the cost of utilizing financial tools and enable millions to fulfill their aspirations of building a better life.

That is why I believe it is our shared responsibility to create a safe, sound, sustainable and inclusive financial system, protected from criminal abuse.

The Bali Fintech Agenda
How can the IMF help with such an enormous task? Last year, at the request of our membership, the IMF and the World Bank developed the Bali Fintech Agenda. This agenda identifies twelve priorities that countries and other international organizations should focus on in the fintech space.

We then surveyed our members about these elements and 96 countries participated.

Our findings will be released in a new joint IMF-World Bank paper coming later this month and this afternoon I would like to share with you a few highlights. A sneak peak, if you will.

First, countries overwhelmingly see fintech as transformative for financial inclusion. They recognize that inclusion plays a key role in promoting growth, opening access for poor and rural communities through lower costs, and facilitating women’s participation in the formal economy.

Indeed, as IMF research shows, fintech has helped to close the inclusion gender gap in some countries, but not everywhere.

Gaps in access to technology are one explanation, but even when access is equal, there appears to be lower usage by women. For example, in Egypt, Ethiopia, and India, men are 20 percentage points more likely than women to have their own phone; in Bangladesh, men are 22 percentage points more likely than women to have a mobile money account.

Women also tend to use digital services less than men, at least in some countries, possibly due to social norms, or issues related to affordability and financial literacy. That is why we believe increasing financial literacy can play a key role in generating higher gender participation in every economy.

Second, countries are asking for greater international cooperation in fintech:
· Nearly 80% mentioned cybersecurity as their most important priority;
· Around 60% listed anti-money laundering legal and regulatory frameworks;
· Another 40% cited payment systems including across borders.

I should note that these issues are already being discussed in the various international forums in which IMF staff participates, but countries want to see swifter progress.

For example, crypto-assets have been in use for several years, but even among the countries of the G20, there is no consensus on their regulatory treatment.

The same is true about another issue discussed in our review — market concentration.

A significant disruption to the financial landscape is likely to come from the big tech firms, who will use their enormous customer bases and deep pockets to offer financial products based on big data and artificial intelligence.

These developments hold out the promise of accelerating inclusion and modernizing financial markets, but raise, in addition to privacy issues, competition and market concentration concerns, both of which could lead to vulnerabilities in the financial system.

China’s technology industry is a prime example of this trade-off between benefits and challenges. Over the last five years, technology growth in China has been extremely successful and allowed millions of new entrants to benefit from access to financial products and the creation of high-quality jobs. But it has also led to two firms controlling more than 90% of the mobile payments market.

This presents a unique systemic challenge to financial stability and efficiency, and one I hope we can touch on during the G20, and address in a cooperative and consistent fashion

Conclusion
So, let me conclude. Everyone here, and many around the world, recognize that it is critical to continue the international dialogue on fintech. It is not as easy as it seems.

Integrating different national approaches to crypto-assets, non-bank fintech intermediaries, and the governance of data is crucial if we are to harness fintech’s potential to promote greater financial inclusion and development. Yet at the same time, we have to find a way to preserve financial stability and integrity, protect consumers, and increase financial literacy.

Here, we can draw inspiration from the famous Japanese proverb: Walk across the stone bridge only after you have tested its strength.

We will cross the bridge, together, into the fintech future. But we will only do so once we are confident that bridge is safe and secure.

Events like the one organized today are a critical part of this process. I congratulate our hosts and the Government of Japan for taking on this important initiative. The IMF is proud to be your partner.
Thank you very much. Domo Arigato!

Featured Journal Content

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 8 Jun 2019)
Editorial
Science tikkun: A framework embracing the right of access to innovation and translational medicine on a global scale
Peter J. Hotez
| published 06 Jun 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007117

We’re entering an era when global health is being redefined because of the great progress in vaccination and mass drug administration programs on the one hand, yet on the other hand, there is a changing landscape of social determinants, including urbanization, human migrations, rising antiscience, and a paradigm shift in poverty and poverty-related neglected diseases, known as blue marble health. Science tikkun offers a framework for ensuring that the world’s poor continue to receive access to innovation and technologies in this new world order.

In the almost 2 decades since the start of the Millennium Development Goals (MDGs), later transitioning to the Global Goals for Sustainable Development, we have seen dramatic public health gains in terms of the global reductions in the world’s poverty-related neglected diseases. Two of the most dramatic improvements have been in terms of deaths from childhood-preventable vaccines and disability from the neglected tropical diseases (NTDs). Regarding the former, the Global Burden of Disease (GBD) Study reports a 40–75% reduction in deaths of children under the age of five between the years 2000 and 2015 [1], mostly due to expanded vaccine coverage and introduction of the rotavirus and pneumococcal vaccines—activities led by Gavi, the Vaccine Alliance [2]. For NTDs, we have seen almost (but not quite) as dramatic decreases in the disability-adjusted life years (DALYs) from the seven major diseases targeted by “rapid impact” packages of donated medicines that have now reached more than 1 billion people [3, 4].

Although these gains are impressive, there is still a lot of global health work to be done. Indeed, many of our gains in vaccines and NTDs are under threat from a new group of social determinants and forces that could undermine or even reverse progress made since 2000. For example, because of antivaccine activities and lobbying groups that gained ascendancy more or less contemporaneously with the MDGs, we are seeing thousands of measles cases and deaths return to Europe, and now many counties in the American West have large numbers of unvaccinated children vulnerable to measles and other childhood infections [2, 5]. Children are literally dying as a consequence of an antiscience movement. In Latin America, the political instability and collapse of health systems in Venezuela has also promoted the reemergence of measles cases and deaths there and in neighboring Brazil and Colombia [6].

For NTDs, the gains achieved through integrated mass drug administration are also being undermined by Venezuela’s economic collapse [7], as well as conflict and wars in the Middle East, central Asia, and sub-Saharan Africa [8]. NTDs are also reemerging and rising as a consequence of urbanization [9], population shifts and human migrations [10], climate change [11], and other human-associated activities linked with the modern Anthropocene era [12].

The consequences of two sets of opposing forces—reductions in global disease burdens due to expanded use of vaccines and essential medicines for NTDs versus antiscience movements and Anthropocene forces—have produced an interesting quilt or patchwork of poverty-related neglected diseases. Today, some of the highest rates of these conditions likely occur among the world’s estimated 300–400 million indigenous or aboriginal populations [13]. However, on a larger scale, analyses of data from both the GBD and the World Health Organization (WHO) reveal that most of the world’s neglected diseases and NTDs are actually found among the poor living in the wealthiest economies, especially the group of 20 nations (G20) together with Nigeria, which has an economy greater than the bottom tier of G20 countries [14, 15]. The term “blue marble health” has been used to describe how the “poorest of the rich” are now uniquely vulnerable to disease [16]. NTDs are also paradoxically widespread among the poor in technologically sophisticated countries such as China, India, Iran, and Pakistan, each of these nations with capabilities to produce nuclear weapons [17]. Therefore, the world has profoundly changed in a way that suggests rapid progress in disease control, although vulnerable and impoverished populations living amid great wealth and technical sophistication have been left behind. Such populations remain under constant threat from war, urbanization, population migrations, and climate change.

There is an urgent need to repair the gaps left from these modern 21st century forces. According to some religious scholars, the ancient Jewish framework of repairing the parts of the world still left undone after the creation arose some 500 years earlier during the 16th century (Fig 1) [18]. In his Lurianic Kabbalah, the mystic Rabbi Isaac Luria wrote about reconnecting or repairing the world and cosmos through good works and great deeds [18].

In 2017, I first wrote on the concept of “science tikkun” as a means of “repair and redemption through science” [18]. My original definition focused mostly on science diplomacy and international scientific cooperation, citing the examples of joint United States–Soviet cooperation to develop and deploy vaccines for smallpox and polio for purposes of disease eradication [18–20]. Science tikkun also embraces programs of public engagement by scientists, especially US scientists interacting with the US press, military, and educational sectors [18].

The new world order of science and technology gaps engendered from the opposing forces of successes due to global vaccine and NTD programs versus opposing social determinants of shifting poverty and blue marble health, urbanization, war and conflict, and antiscience movements affords us an opportunity to expand our science tikkun definitions. Here, I redefine it as initiatives led by scientists to address the innovation gaps in global health and neglected diseases allowing illness and disease not only among the world’s vulnerable populations but especially among the huge numbers of poor living amid wealth and prosperity. A fundamental tenet of science tikkun is that vulnerable populations have a fundamental right to access innovation [21]. In this context, science tikkun can take on several different dimensions (Box 1 and Fig 2):

First, basic research on the poverty-related neglected diseases would greatly benefit by expanding its footprint into some of the latest developments in the biochemical, physical, and engineering sciences, including gene editing, functional and comparative OMICs, single-cell combinatorial indexing RNA sequencing, and systems biology and immunology, just to name a few approaches [21]. In some cases, resource-poor nations that have invested heavily in nuclear technologies, including India, Iran, and Pakistan, for example, could see important benefits by redirecting their scientific and technical prowess into basic science for the neglected diseases.

Second, science tikkun embraces translational medicine to develop new drugs, vaccines, diagnostics, and vector control approaches for NTDs and other poverty-related neglected diseases. Such tools are sometimes known as “antipoverty” technologies because of the poverty-promoting disabilities resulting from these diseases [22–25]. Today, the development of antipoverty technologies is being led by academic institutions and nonprofit product development partnerships, but increasingly, there are links with product manufacturers in a group of nations sometimes known as innovative developing countries [26] and some of the multinational pharmaceutical companies. In the future, the new Bill & Melinda Gates Medical Research Institute (Gates MRI) may also play an important role in antipoverty translational medicine.

Lastly, science tikkun can address the social determinants that adversely affect access to innovation for the poor, but two areas in particular that stand out are science diplomacy and combating the rise of antiscience. With regard to the former, the original description of science tikkun designated diplomacy as a central tenet, citing the successes of smallpox and polio eradication that were highlighted earlier [18–20]. However, because the rise of antivaccine and other antiscience movements now threatens the introduction of new technologies in areas where they might be the most needed [2, 25], the current and next generation of scientists embarking on innovation for the poor and vulnerable will be required to address this new threat through public engagement and other mechanisms.

Closing the access to innovation and translational medicine gaps for some of the world’s most disenfranchised peoples—aboriginal populations and the poor living amid wealth—remains one of the great science and technology challenges in this relatively new century. Science tikkun offers a potential and overarching framework for these activities.

Featured Journal Content

The Lancet
Jun 08, 2019 Volume 393Number 10188p2275-2358
https://www.thelancet.com/journals/lancet/issue/current
Editorial
Planetary health in the Anthropocene
The Lancet
In May, 29 of 34 members of the Anthropocene Working Group voted to recognise the Anthropocene as the geological epoch entered in the 20th century, characterised by human activity rapidly shaping our planet. Human impact extends beyond geological labelling, affecting all forms of life. Human progress includes multiple successes but has also led to immense pressure on the planetary systems on which we depend, affecting human health through an unfolding climate emergency, human-made air pollution, and broken unsustainable food systems.

Our 2015 Rockefeller Foundation–Lancet Commission on planetary health recommended an urgent expansion of the interdisciplinary scope of research and capacity. Departments of planetary health and academic initiatives and alliances are now taking shape in universities around the world, notably in Sydney and other Australian universities, Oxford and Edinburgh, the UK, the USA, China, and Hong Kong.

Last week, the London School of Hygiene & Tropical Medicine joined this list, celebrating the launch of a new Centre on Climate Change and Planetary Health, directed by Professor Alan Dangour. Alongside their academic output, the School has a practical plan to lead by example, with a working group to develop recommendations for the School to achieve carbon neutrality, a reduction in air travel, and a reduction of waste, while increasing student voices and influence—actions that could be adopted by academic institutions and businesses alike.

We applaud the convergence of disciplines and global academic leadership that is bringing this new community to life, but there is more to do. There remain gaps in securing political will to address the multiple human-caused challenges that threaten all life on Earth. This is visible in relation to global progress in achieving Sustainable Development Goals (SDGs); such as SDG 2—zero hunger, and SDG 3—good health and wellbeing. That we still read news headlines of 60 million children suffering hunger in Africa illustrates such disconnect. Governments now need to be held to account to take political action that supports the evidence emerging around planetary health. The new wave of academia could set its next sights on that goal.

Featured Journal Content

Humanitarian Exchange Magazine
Number 75, May 2019
https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/
Special Feature: Making humanitarian action work for women and girls
by HPN May 2019
The theme of this edition of Humanitarian Exchange, co-edited with Women Deliver, is making humanitarian action work for women and girls. Despite gains, including commitments made at the World Humanitarian Summit, there is still much to be done to address the gendered impacts of humanitarian crises and improve gender-sensitive humanitarian action.

In the lead article, Jacqueline Paul advocates for feminist humanitarian action based on evidence that improvements in women’s socio-economic status can reduce excess mortality among women after shocks. Jean Kemitare, Juliet Were and Jennate Eoomkham look at the role of local women’s rights organisations in preventing and responding to violence against women and girls, and Marcy Hersh and Diana Abou Abbas highlight opportunities for more concrete action on sexual and reproductive health in emergencies.

Citing experience from Vanuatu, Jane Newnham explains how women will choose to use contraceptives even during a humanitarian response, when services and counselling are delivered in an appropriate and responsive way. Drawing on experience in Bangladesh, Tamara Fetters and colleagues challenge the belief that abortion is a non-essential service, or too complicated for humanitarian actors to provide. Darcy Ataman, Shannon Johnson, Justin Cikuru and Jaime Cundy reflect on an innovative programme using music therapy to help survivors of trauma.

Emilie Rees Smith, Emma Symonds and Lauryn Oates highlight lessons from the STAGE education programme in Afghanistan, and Degan Ali and Deqa Saleh outline how African Development Solutions is helping women and girls take on leadership and decision-making roles in Somalia. Fiona Samuels and Taveeshi Gupta explore patterns of suicide among young people in Vietnam, with a particular focus on girls, and Subhashni Raj, Brigitte Laboukly and Shantony Moli illustrate the importance of a gendered approach to community-based disaster risk reduction in the South-West Pacific. Nicola Jones, Workneh Yadete and Kate Pincock draw on research in Ethiopia to explore the gender- and age-specific vulnerabilities of adolescents. The edition ends with an article by Julie Rialet-Cislaghi on how humanitarian responses can better address child marriage.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 5 June 2019
:: This week the world’s largest conference on gender equality and the health, rights, and wellbeing of girls and women is happening in Vancouver, Canada. Women are truly delivering a polio-free world. The GPEI proudly recognizes women’s valuable contributions in the fight against polio. For more information on women on the frontlines, please see http://polioeradication.org/gender-and-polio/women-on-the-frontlines-of-polio-eradication/

:: In Papua New Guinea, a GPEI Outbreak Response Assessment reviewed the impact of current outbreak response and concluded that overall strong response had been implemented.  Commending national and subnational public health authorities and health workers on their efforts, the Assessment team underscored the need on now filling any residual subnational surveillance and immunity gaps.  See ‘Papua New Guinea’ section below for more.

:: On 4 June, The Lancet published the results of the first in-human, Phase 1 clinical trial for nOPV2 – a key first step toward determining the potential for a novel type-2 oral polio vaccine that would provide the same level of protection against type-2 poliovirus as OPV without the same risk of reverting into cVDPV2 in under-immunized populations. These initial results are promising, and suggest the vaccine is safe and immunogenic in adults; further clinical trial results will be important to evaluate nOPV as a potential tool to sustain a world free from all types of polioviruses.

:: The GPEI Semi-Annual Status Report covering the reporting period July-December 2018 is available online, reporting against the major objectives of the Polio Endgame Plan 2013-2018.  The GPEI will continue to publish its Semi-Annual Status Reports, to track progress against the newly-launched Polio Endgame Strategy 2019-2023.

Summary of new viruses this week:
:: Pakistan – two new WPV1 cases and 16 WPV1-positive environmental samples
:: Afghanistan – one new wild poliovirus type 1 (WPV1) case;
:: Niger – one cVDPV2 case;
:: Nigeria – one cVDPV2-positive environmental sample.

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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 8 Jun 2019]

Democratic Republic of the Congo
:: 44: Situation report on the Ebola outbreak in North Kivu 4 June 2019
:: Disease Outbreak News (DONs) Ebola virus disease – Democratic Republic of the Congo
6 June 2019
[See Ebola DRC above for detail]

Bangladesh – Rohingya crisis – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Myanmar – 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 8 Jun 2019]

Afghanistan – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
MERS-CoV – No new digest announcements identified
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 8 Jun 2019]

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – 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.
CYCLONE IDAI and Kenneth
:: 03 Jun 2019
Madagascar: ”Climate change compounds humanitarian needs” – UN Deputy Humanitarian Chief

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The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 1 June 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 1 Jun 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]

Human Rights – DPRK

People in North Korea trapped in vicious cycle of deprivation, corruption and repression – UN human rights report
GENEVA (28 May 2019) – People in the Democratic People’s Republic of Korea (DPRK) are trapped in a vicious cycle, in which the failure of the State to provide for life’s basic necessities forces them to turn to rudimentary markets where they face a host of human rights violations in an uncertain legal environment, according to a new UN human rights report.

The report, published by the UN Human Rights Office on Tuesday, highlights how the public distribution system in the DPRK has been broken for over two decades and how, as people seek to eke out a living in a legally precarious parallel economy, they are exposed to arbitrary arrest, detention, and extortion.

Based on 214 first-hand accounts of escapees gathered by UN Human Rights staff in South Korea in 2017 and 2018, the report describes how the most fundamental rights of ordinary people in the DPRK are widely violated because of economic mismanagement and endemic corruption.

“The rights to food, health, shelter, work, freedom of movement and liberty are universal and inalienable, but in North Korea they depend primarily on the ability of individuals to bribe State officials,” said UN High Commissioner for Human Rights, Michelle Bachelet.

Since the economic collapse of the 1990s, people have been unable to survive through a State-led model of centralized economic planning and distribution, which includes State-assigned jobs and the dispensation of food, clothes and other rations. As a result, working in the informal sector has become an essential means of survival – or else, as one interviewee put it: “If you just follow instructions coming from the State, you starve to death.”

However, when people try to engage in rudimentary market activity, they face arrest and detention, including for travelling within the country, for which a permit is required.

This situation invariably leads to a series of further serious human rights violations, due to absence of rule of law and due process guarantees. People often experience inhumane and degrading treatment in detention, and are sometimes subjected to torture during interrogation and disciplinary procedures.

The whole system is based on the informal but pervasive practice of bribing State officials who are in a position to enable people to side-step State requirements and regulations in order to work in the private sector and avoid arrest.

The constant threat of arrest and prosecution provides State officials with a powerful means to extort money and other favours from people desperate to avoid detention in inhumane conditions, the report says. In addition, the living conditions and treatment of detainees can also depend on the payment of bribes.

As another escapee said to UN human rights officials: “I felt it unfair that one could bribe one’s way out of [detention], when another suffers much more as a result of being unable to bribe. Bribery is effective in North Korea. One cannot lead a life in North Korea if he or she does not bribe his or her way.”

The report also details how women seeking ways to make ends meet are particularly vulnerable to further abuse at the hands of third parties, including brokers and traffickers.

The UN Human Rights Chief called for far-reaching changes: “Our report is a stark illustration of how important it is that the Government tackles the country’s profound human rights problems. Only then can the endemic system of corruption which pervades all aspects of life be effectively dismantled,” she said….
[Full text at title link above]

Development – “Decade of Family Farming”

Launch of the UN’s Decade of Family Farming to unleash family farmers’ full potential
JOINT PRESS RELEASE FAO/IFAD [International Fund for Agricultural Development]
29 May 2019, Rome – The Food and Agriculture Organization (FAO) and the International Fund for Agricultural Development (IFAD) today launched the United Nations’ Decade of Family Farming and a Global Action Plan to boost support for family farmers, particularly those in developing countries.

The two UN agencies lead the implementation of the Decade of Family Farming declared by the United Nations at the end of 2017.

Family farms represent over 90 per cent of all farms globally, and produce 80 percent of the world’s food in value terms. They are key drivers of sustainable development, including ending hunger and all forms of malnutrition.

The Decade of Family Farming aims to create a conducive environment that strengthens their position, and maximizes their contributions to global food security and nutrition, and a healthy, resilient and sustainable future.

The Global Action Plan provides detailed guidance for the international community on collective and coherent actions that can be taken during 2019-2028…

…The Global Action Plan of the Decade of Family Farming is a guide to develop policies, programs and regulations to support family farmers, putting forward collective and coherent actions that can be taken during the next ten years.

It details specific activities to address interconnected challenges, and target a range of actors – governments, United Nations agencies, international financial institutions, regional bodies, farmers and producer organizations, academic and research institutes, civil society organizations and the private sector, including small and medium enterprises.

Actions include:
:: Developing and implementing an enabling policy environment (including comprehensive and coherent policies, investments and institutional frameworks) that support family farming at local, national and international levels;
:: Supporting rural youth and women by enabling them to access productive assets, natural resources, information, education, markets, and participate in policy making processes;
:: Strengthening family farmers’ organizations and their capacities to generate knowledge and link locally specific (traditional) knowledge with new solutions;
:: Improving family farmers’ livelihoods and enhancing their resilience to multiple hazards though access to basic social and economic services, as well as facilitating and promoting production diversification to reduce risks and increase economic returns;
:: Promoting sustainability of family farming for climate-resilient food systems, and their access, responsible management and use of land, water and other natural resources.

Facts and figures on family farming:
:: More than 80 percent of all farms globally are below two hectares.
:: Family farms occupy around 70–80 percent of farmland and produce more than 80 percent of the world’s food in value terms.
:: Women perform nearly 50 percent of farm labor but hold only 15 percent of farmland.
:: 90 percent of fishers are small-scale operators, which account for half of the capture fisheries production in developing countries.
:: Up to 500 million pastoralists rely on livestock rearing to make a living.
:: Mountain farming is largely family farming.
:: Family farmers include forest communities. Around 40 percent of the extreme rural poor live in forest and savannah areas.
:: Traditional indigenous territories encompass up to 22 percent of the world’s land surface and coincide with areas that hold 80 percent of the planet’s biodiversity.

Cyber – Armed Conflict

The potential human cost of cyber operations
29-05-2019 | ICRC Report
This report provides an account of the discussions that took place during a meeting of experts organised by the ICRC in November 2018 on the potential human cost of cyber operations.

Cyber attacks and their consequences are on top of the agenda around the world. Apart from causing substantial economic loss, cyber operations can cause physical damage and affect the delivery of essential services to civilians. Cyber attacks against electrical grids and the health-care sector have underscored the vulnerability of these services.

The use of cyber operations during armed conflicts is also a reality. While only a few States so far have publicly acknowledged that they use them, an increasing number of States are developing military cyber capabilities.

To move towards a realistic assessment of the potential human cost of cyber warfare, the ICRC convened a meeting of scientific and cyber security experts from all over the world. They analysed some of the most sophisticated known cyber operations, regardless of whether they occurred during conflict or in peacetime, focusing on the risk that cyber operations may result in death, injury or physical damage, affect the delivery of essential services to the population, or affect core internet services.

The rich discussions provided a nuanced picture of the risks that cyber warfare can entail for the civilian population. The ICRC looks forward to the feedback to this report to continue to follow the evolution of cyber operations, in particular during armed conflicts.

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The potential human cost of cyber operations
ICRC EXPERT MEETING
14–16 NOVEMBER 2018 – GENEVA :: 80 pages
PDF: https://www.icrc.org/en/download/file/96008/the-potential-human-cost-of-cyber-operations.pdf
Report prepared and edited by Laurent Gisel, senior legal adviser, and Lukasz Olejnik, scientific adviser on cyber, ICRC

Executive Summary [except]
…Avenues that could be explored to reduce the potential human cost of cyber operations
Cyber security measures
Beyond the restraints imposed by IHL upon those carrying out cyber operation, it is critical to enhance the cyber security posture and resilience of the actors potentially affected. While cyber security and defence are constantly improving, older systems with outdated or even non-existing cyber security are particularly vulnerable to cyber attacks and will remain a concern in the years to come. Both the public and private sectors have a role to play through industry standards and legal regulation.

In the health-care sector, for instance, the regulatory environment should be adapted to the increased risk, such as through standardization requirements, with a view to ensuring resilience in the event of a cyber attack. Cyber security needs to be taken into account in the design and development of medical devices and updated throughout their lifetime, no matter how long they last. Similarly, for industrial control systems, industry standards, whether imposed or self-imposed, are critical. This includes reporting incidents and sharing information between trusted partners.

In terms of IHL, parties to armed conflicts must take all feasible precautions to protect civilians and civilian objects under their control against the effects of attack. This is one of the few IHL obligations that States must already implement in peacetime.

Disclosing vulnerabilities
The preferred option for enhancing the safety of cyber space should be disclosing vulnerabilities to the appropriate software developer so that the vulnerabilities can be fixed. Some States have therefore put in place equity processes to balance competing interests and risks and decide whether to disclose the vulnerabilities they identify.

Measures to prevent proliferation
Those who develop cyber weapons should consider creating obstacles in order to make repurposing difficult and expensive. While it is hardly possible from a technical standpoint to guarantee that malware cannot be repurposed, methods like encrypting its payload and including obstacles in different components of the code, for example, could raise the bar in terms of the expertise required to reengineer malicious tools. While there is currently no express obligation under IHL to create obstacles to the repurposing of cyber tools, this could prevent at least some actors from doing so and therefore reduce the risk of subsequent misuse that their proliferation entails. The unique way in which cyber tools proliferate also raises the question of whether existing law is adequate or sufficient to address this phenomenon.

Marking of certain civilian infrastructure
Another avenue, which builds on existing international law, could be to create a “digital watermark” to identify certain actors or infrastructure in cyber space that must be protected (such as objects that enjoy specific protection under IHL). The aim would be to help their identification and prevent them from being targeted during armed conflicts. The potentially positive effects in terms of protection against unintended harm by law-abiding actors would however need to be balanced against the risk of disclosing information on critical infrastructure to potential adversaries, including criminals. The prospects of positive effects might depend in part on attribution becoming easier.

Improving attribution and accountability
Finally, enhanced attribution capacities would help ensure that actors who violate international law in cyber space can be held accountable, which is a means to strengthen compliance with the law and more generally encourage responsible behaviour in cyber space.

Way forward
The use of cyber operations in armed conflict is likely to continue and might remain shrouded in secrecy. Analysing its consequences is a complex and long-term endeavour that requires
multidisciplinary expertise and interaction with a wide variety of stakeholders.

Building upon the conclusions reached at the expert meeting, the ICRC would like to pursue the dialogue with governments, experts and the IT sector. It looks forward to the feedback to this report to continue to follow the evolution of cyber operations, in particular during armed conflicts, and their potential human cost, explore avenues that could reduce them, and work towards a consensus on the interpretation of existing IHL rules, and potentially the development of complementary rules that
afford effective protection to civilians.

Global Governance – Technology

World Economic Forum Inaugurates Global Councils to Restore Trust in Technology
:: Six councils formed to design how emerging technology can be governed for the benefit of society
:: Top decision-makers and experts from the public and private sectors, civil society and academia participate in inaugural Global Fourth Industrial Revolution Council meeting in San Francisco
:: Leaders of Chinese Academy of Medical Sciences, Dana-Farber, European Commission, Microsoft, Qualcomm, Uber, World Bank among chairs
:: Major global summit on technology governance announced, to take place in April 2020

San Francisco, USA, 29 May 2019 – To help policy-makers and businesses strike the right balance between enabling emerging technologies and proactively mitigating the social risks that can result, the World Economic Forum launched six Global Fourth Industrial Revolution Councils today.

Covering the most pressing technology areas of artificial intelligence, autonomous mobility, blockchain, drones, internet of things and precision medicine, global councils bring together more than 200 leaders from the public and private sectors, civil society and academia from around the world.

Council members will work together to develop policy guidance and address “governance gaps” or the absence of well-defined rules for emerging technology. They met for the first time today at Forum’s Centre for the Fourth Industrial Revolution in San Francisco.

“Companies and governments are not moving fast enough to anticipate social expectations in the Fourth Industrial Revolution,” said Richard Samans, Managing Director and Head of Policy and Institutional Impact, World Economic Forum. “We believe that that this bottom-up, societally-focused approach can help to build and maintain public trust in the technologies while strengthening the evidence base on which policy decisions are made by governments and companies. This is the first place where this kind of high-level, strategic dialogue on the governance of these technologies will take place across stakeholders and regions on an ongoing basis.”

Global Fourth Industrial Revolution Councils will:
:: Enable cross-country exchange of policy and regulatory experience, including through case studies;
:: Identify and take action to address gaps in public policy or corporate governance through multistakeholder cooperation;
:: Shape a common understanding of “best” or “good” policy practice as a means of enabling better policy coordination within and among countries;
:: Provide strategic guidance to the Centre for the Fourth Industrial Revolution Network regarding the governance projects and pilots it undertakes.

Councils are organized by the World Economic Forum Centre for the Fourth Industrial Revolution Network. Headquartered in San Francisco, the Network expanded internationally last year to the People’s Republic of China, India and Japan. Affiliate centres in Colombia and the United Arab Emirates opened in early 2019. Five of the G7 countries and more than 100 organizations are officially partnered with the Network to create policy frameworks, pilot them and scale up around the world.

Global Technology Governance Summit
Input from council members will inform the agenda of the Global Technology Governance Summit in April 2020. This event will be the world’s premiere leader-level, multistakeholder meeting dedicated to shaping the governance of emerging technologies. It will bring together government ministers, chief executive officers, civil society leaders, start-ups and international organizations. It will be catalyst a for driving new approaches and collaborative efforts across stakeholders that are human-centred.

Global Artificial Intelligence Council
Co-chairs
Lee Kai-Fu, Chairman and Chief Executive Officer, Sinovation Ventures
Bradford Smith, President, Microsoft Corp

Global Autonomous and Urban Mobility Council
Co-chairs
Brian Gu Hong-Di, Vice-Chairman and President, Xpeng Motors
Keiichi Ishii, Minister of Land, Infrastructure, Transport and Tourism of Japan
Dara Khosrowshahi, Chief Executive Officer, Uber Technologies

Global Blockchain Council
Co-chairs
Elizabeth Rossiello, Chief Executive Officer, Founder, BitPesa
Denis Robitaille, Vice President, Information and Technology Solutions, World Bank

Global Drones and Aerial Mobility Council
Chair
Violeta Bulc, Commissioner for Transport, European Commission

Global Internet of Things Council
Co-chairs
Cristiano Amon, President, Qualcomm Incorporated
Mariya Gabriel, Commissioner for Digital Economy and Society, European Commission
Adrian Lovett, President and Chief Executive Officer, World Wide Web Foundation

Global Precision Medicine Council
Co-chairs
Laurie Glimcher, President and Chief Executive Officer, Dana-Farber Cancer Institute
Peer Schatz, Chief Executive Officer, QIAGEN
Wang Chen, President, Chinese Academy of Medical Sciences

Governance/UN Agencies: Parental Leave

Joint Statement: One UN for family leave and childcare
Posted on June 1, 2019
We, the Heads of UNICEF, UN WOMEN, UNDP and UNFPA, representing over 37,000 UN staff members under the United Nations Common System, are committed to strong gender-responsive, family-friendly policies for all United Nations staff. We are committed to achieving, inter-alia, paid parental leave for all parents regardless of gender, including parents who adopt, foster, or have children through surrogacy or assisted reproductive technology; flexible working arrangements for parents; designated private rooms and appropriate breaks for nursing and pumping; and child-care support for parents with young children.

We encourage the 89th session of the International Civil Service Commission to endorse these policies for the well-being of all UN staff and their families because:

It is the right thing to do:
Family-friendly policies support staff to balance their work and family responsibilities so one need not be chosen over the other. They help reduce the stress and conflict that can arise among families struggling to manage competing work obligations with family demands. They enable bonding between parents and their children, providing a foundation for individual success, family cohesion, and stronger, more sustainable societies.

It is the equitable thing to do:
The United Nations is committed to gender parity for its staff, at all levels, everywhere, as well as to gender equality as a global goal and prerequisite for sustainable development. Companies such as Google, Accenture, and Aetna have reported a significant decrease in employment attrition rates among female employees when effective family-friendly policies are in place. Evidence show that when such policies support greater paternal involvement in child rearing, this is beneficial to children’s social, emotional and cognitive growth, and decreases gender-stereotyping. Additionally, studies show that “the motherhood penalty” – discrimination against mothers in the form of lower likelihood of hiring or promotion, lower salaries, and lower perceived competence and commitment – diminishes in terms of career trajectory in organizations where both parents receive equitable leave.

It is the smart thing to do:
Family-friendly policies are irrefutably linked to better workforce productivity and the ability to attract, motivate, and retain employees. Additionally, by unifying child care and parental leave provisions across United Nations agencies, we not only can streamline human resource systems, inter-agency coordination and career mobility opportunities, but also set good practice standards that support a United Nations-wide enabling environment for high employee morale, job satisfaction and productivity.

It is the healthy thing to do:
Parents in Bangladesh have reported greater productivity and lower absenteeism because of nursing programmes in the workplace, as children were sick less often and parents took less time off as a result. Studies show better development outcomes as well as learning and cognitive improvements for children whose fathers take paternity leave.

We recognize the important consultative efforts of members of formal and informal staff groups from our United Nations agencies who are in support of this statement, including UN Globe who released their Guiding Principles and Proposals on an Inclusive Parental Leave Policy, and advocated for these changes in 2015, UN Feminist Network, UNDP Parents Association, staff associations of all UN agencies through Coordinating Committee for International Staff Unions and Associations, UNICEF Gender Push group, and UNICEF #EarlyMomentsMatter campaign.

It is further supported by UN Women’s Goodwill Ambassador Anne Hathaway who addressed the ICSC on this subject, noting that strong, gender-neutral parental leave policies and child care services for staff are critical to the UN’s role as a standard setter and promoter of equality.

We also rely on the strategic guidance and support from our respective governing bodies in pursuing these goals.

We commit to reviewing our policies to ensure they reflect best practice and consistency across our agencies, including in the following areas and with a focus on exploring options for:
:: Increasing the duration of parental leave (up to 24 weeks) to ensure that all parents have equal rights and adequate time to bond with a child;
:: Official designated nursing and pumping rooms and regular breaks;
:: Child-care support for parents with young children, and
:: Equal treatment and respect for all methods of becoming a parent.

Since its founding, the United Nations has advocated for social and economic empowerment, gender equality, and children’s positive development all over the world. As the global champion for human rights, equity and dignity, we consider it our duty to support the women and men who work every day to make these aspirations a reality. We jointly commit to ‘walk the talk’ for our staff, setting the standards of inclusivity, diversity, and flexibility, that we would want to see in a truly gender equal world, ready to accomplish the aims of the 2030 Agenda for Sustainable Development.

SIGNED BY:
Achim Steiner, UNDP
Natalia Kanem, UNFPA
Henrietta H. Fore, UNICEF
Phumzile Mlambo-Ngcuka, UN Women

Project Anqa Final report
International Council on Monuments and Sites (ICOMOS)
Written on 24 May 2019.
ICOMOS is releasing its final report on Project Anqa which seeks to preserve endangered cultural heritage sites in Syria through their digitalization using state of the art technology, build capacity in the region, promote the transfer of knowledge and create permanent architectural inventory units.

The project resulted in the creation of a web platform which includes virtual tours of 7 endangered heritage sites along with comprehensive data on the sites.

Project Anqa which means “phoenix” in Arabic is a joint initiative of ICOMOS, the non-profit organization CyArk, the Carleton University Immersive Media Studio and Yale University’s Institute for the Preservation of Cultural Heritage (IPCH).
The project began in 2015 in response to the catastrophic loss of cultural heritage in the Middle East and is funded by the Arcadia Fund, a UK grant-making fund whose mission is to protect endangered culture and nature.

The project started in Syria, in partnership with the Directorate General of Antiquities and Museums (DGAM), and has documented seven sites located in Damascus that illustrate the architectural variety of historic buildings in the ancient city.

CONCLUSION:
Although Project Anqa’s partners faced challenges to overcome, the project still successfully reached its goal of creating an online web platform with 3D scans and comprehensive data in open access on built heritage at risk in Syria. Teams from different countries effectively worked together, and the training allowed to build capacity in the region. With the exposure the project has received, it will hopefully serve as an example to inspire future similar projects that seek to preserve endangered cultural heritage.

Heritage Stewardship

The continued and lasting legacy of Peru
May 28, 2019 – Gordon and Betty Moore Foundation Press Release
As Peru approaches its independence bicentennial in 2021, it does so on a wave of economic prosperity that has transformed the nation. The poverty rate has fallen dramatically, from 52.2 percent in 2005 to 26.1 percent in 2013 — but at the same time, threats to protected areas have risen sharply.

Today, illegal resource extraction and poorly planned infrastructure projects endanger the wild areas that make Peru one of the world’s “megadiverse” countries – 17 nations which comprise 70 percent of the planet’s total biodiversity. Peru ranks first in the world for its diversity of butterflies and fish, second for its species of birds, fourth for its amphibians and fifth for its mammals. Between human-induced pressures and a changing climate, the vast wild places of Peru face unprecedented risks. To ensure that these national natural treasures are protected for the next 200 years and beyond, long-term funding and management are critical.

This starts with making sure that Peru’s National Parks — from the spectacular rainforests of Manu to the glaciers and milky blue lagoons of Huascarán — have the institutional resources and management capacity in place to ensure sustainability. Patrimonio Natural del Perú, or “National Parks: Peru’s Natural Legacy,” is a government-led “Project Finance for Permanence” initiative, kickstarted in 2014 at the World Parks Congress, that aims to establish a system of financial sustainability for Peru’s National Parks, starting with the country’s verdant heart, the Peruvian Amazon. On the ground, this will translate into more and better supported staff, better equipment and improved protection protocols.
Now, after years of work and collaboration, the Amazon portion of Patrimonio del Peru is “closed.” This means that the funding goal of $140 million needed to expand and manage 41.6 million acres in the Peruvian Amazon has been met, along with other closing conditions designed to secure the success of this initiative.

“I believe that the protection of our natural resources is vital for the needs we will have in the future,” says Pedro Gamboa Moquillaza, who leads Peru’s National Park Service. “If we don’t work together, the only thing that we are destined to have soon is a nation poor in natural resources.” Institutional partners leading the collaboration include the Peruvian National Park Service, Ministry of Environment, President of Peru, Peruvian Environmental Law Society and World Wildlife Fund who have joined with funders — the Government of Peru, the Peruvian Trust Fund for National Parks and Protected Areas (PROFONANPE), World Wildlife Fund, Amazon Andes Fund, the Global Environment Facility and Moore — to deliver on the promise of Peru’s Legacy…

Featured Journal Content

The Lancet Child & Adolescent Health
Jun 2019 Volume 3Number 6p365-436, e4
https://www.thelancet.com/journals/lanchi/issue/current
Editorial
Partnership between health and education in early childhood
The Lancet Child & Adolescent Health
While primary school enrolment rate in developing regions reached 91% at the end of the Millennium Development Goal era, 60% of children and adolescents worldwide (617 million) are not achieving basic proficiency in reading and mathematics expected of their school year. One reason for this disappointing outcome is that many young children are not developmentally on track at the time they enter primary school because of scarce investment in preschool education, according to UNICEF in their latest report, A World Ready to Learn.

UNICEF’s analysis found that “attending an early childhood education programme is one of the strongest predictors for supporting a child’s readiness for school, regardless of household or national income level”. Evidence shows that positive stimulation in early childhood affects brain development and the neurobiological pathways that underlie functional development. Quality preschool education supports a child’s cognitive, physical, social, and emotional development, providing a safe and nurturing environment for young children to learn and interact with their peers. It can also ameliorate some of the vulnerability stemming from early adversity such as poverty, and offer a powerful opportunity to break intergenerational cycles of inequity in future health, academic, and economic outcomes.

Despite the well recognised importance of investment in these formative years, only half of the world’s preschool-aged children are enrolled in pre-primary education (from age 3 years up to the start of primary education, often age 6 years). In low-income countries, only two in ten have this privilege, and barriers are even higher for marginalised groups (eg, indigenous populations, rural communities, and children with disabilities). Given the current situation, UNICEF warns that a “business as usual” approach will not reach the target of universal, quality pre-primary education in Sustainable Development Goal (SDG) 4.2.

This target is achievable, but only if there is a substantial increase in investment alongside strong political commitment. Globally, 38% of countries, most of which are low and lower-middle income, invest less than 2% of their education budgets in pre-primary education—a huge gap from the 10% recommended internationally. Distribution of these scarce resources highly favours the wealthy within these countries. The shortfall in funding is also apparent at the donor level, with less than 1% of international aid for education being allocated to the preschool years. Even among upper-middle-income and high-income countries, nearly a third will need to accelerate their progress to be on track for 2030.

Early childhood education needs to be prioritised and recognised as a core strategy for strengthening a country’s education system and population health. To accelerate progress towards multiple SDGs, the synergy between the health and education sectors—alongside nutrition, child protection, and social protection—should be leveraged. Such intersectoral collaboration is crucial to ensure that every child receives the nurturing care that will allow them to reach their full developmental potential. Building on the foundations of quality antenatal care, child health professionals, community workers, and early-years practitioners can support responsive parenting, conduct regular health and developmental milestone checks, and deliver nutritional and other interventions as necessary. Preschools provide an important setting for deworming, vaccination, early identification of developmental disorders, and other health screening and interventions; distributing nutritious meals; and establishing lifelong healthy habits such as handwashing and personal hygiene.

Equity and quality must be at the heart of such a multisectoral response. The most disadvantaged children must be considered at the start—not as an afterthought. UNICEF recommends that resource-constrained countries should start with providing one year of universal free pre-primary education, before expanding to include additional years. Quality should be upheld with clear standards, indicators, and expenditure tracking. Capacity building through training more qualified teachers is needed to progressively reach the recommended ratio of no more than 20 children per teacher.

Education and health are integral to human capital development. Given their synergy, the two sectors should forge deeper partnerships to accelerate progress towards the ambitious, but not unreachable, SDGs. The period between the first 1000 days of life and the start of primary school is an important window of opportunity for nurturing care that should not be overlooked. Sustainable investment in the preschool years is the foundation of future population health, prosperity, and social equality—and must be prioritised.

Featured Journal Content

Bulletin of the World Health Organization
Volume 97, Number 6, June 2019, 377-440
https://www.who.int/bulletin/volumes/97/6/en/

EDITORIALS
Health systems research in fragile settings
— Alastair Ager, Shadi Saleh, Haja Wurie & Sophie Witter
http://dx.doi.org/10.2471/BLT.19.233965
Population health indicators have improved in recent decades. Deaths in children younger than five years have declined from over 16 million in 1970 to around 5 million in 20161 and life expectancy at birth has increased from 58 to over 70 years in the same period.2

However, a major constraint to such progress, and in some contexts a potential source of reversal, is fragility. Of the 10 countries with the highest rates of infant mortality, seven are classified as fragile states. Of the 20 countries with the weakest progress on reducing maternal mortality from 1990 to 2015, 14 were fragile.3 However, fragility is increasingly recognized as a phenomenon that is not limited to countries that meet the profile of fragile and conflict-affected states.4 Of those countries that currently meet the Organisation for Economic Cooperation and Development criteria of experiencing significant fragility, comprising political, societal, economic, environmental and security dimensions of instability, almost half are middle-income countries.5

A better understanding of the implications of health-care provision in contexts of fragility is necessary. We have, therefore, established a research unit on health in situations of fragility at Queen Margaret University, Edinburgh, Scotland. This unit is supported by the National Institute for Health Research and builds on the experiences of several institutions in post-conflict health reconstruction strategy, recovery from the Ebola virus disease outbreak in West Africa and response to political instability in the Eastern Mediterranean Region. In our analysis of how the concept of fragility is used in the global health literature, we found that fragility is most often used to describe the circumstances of states or their public health systems; however, it also increasingly addresses the relationship with communities. Where the state’s agenda and communities’ needs are poorly aligned, the strained or ruptured relationship between the two has direct implications for health.

Understanding the weaknesses of health systems and how systems strengthening strategies may address these weaknesses must remain a core component of any approach to secure improvements in population health. However, in contexts of fragility, a key focus is needed on threats to the interface between public health provision and community processes. This exercise inevitably requires a systems for health approach6 that sees community, civil society, private sector actors and the state as key agents within a complex system adjusting to the prevailing drivers of fragility.

Earlier work on health systems resilience in contexts of fragility7,8 repeatedly pointed to the importance of this interface with communities. We are now exploring this further in three countries: El Salvador, Lebanon and Sierra Leone. In each setting, our focus is on the prevention and treatment of noncommunicable diseases and mental health and psychosocial support. Providing a response to these health needs requires an effective connection over time between diverse service providers, patients, carers and communities.

Scoping reviews in each of these fragile settings have identified recurrent challenges at this interface. When fragile settings experience acute shocks, there is a risk that the surge of local provision supported by international agencies will not strengthen health systems in the long-term. Lack of knowledge of available services, uncertain or restricted access, financial barriers or perceptions of health-care settings not constituting a safe place are also repeatedly identified across fragile settings at the community-service interface.9

Participatory group model building10 is a promising method for exploring the connections between the various actors of the systems for health in these fragile settings, and for identifying potential strategies to make these actors’ engagement more effective. Policy-level and health systems interventions are clearly relevant, but it is at the interface of public health provision and community processes that major barriers persist.

Mapping of social connection and trust11 can also clarify key processes supporting or inhibiting engagement within and between communities and health services in contexts of fragility.
We plan to develop a series of studies of strategic interventions designed to secure high-quality and accessible service provision in contexts of fragility. Therefore, we encourage other researchers to engage in this framing of strategic health interventions in such settings. The core goal must be achieving forms of service design and community engagement that prove durable and effective in circumstances of fragility. To the extent that these strategies are effective in building trust and social connection between (and within) the state and local communities, they may also prove of value in addressing the drivers of fragility itself.12

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Research
Comparison of essential medicines lists in 137 countries
— Nav Persaud, Maggie Jiang, Roha Shaikh, Anjli Bali, Efosa Oronsaye, Hannah Woods, Gregory Drozdzal, Yathavan Rajakulasingam, Darshanand Maraj, Sapna Wadhawan, Norman Umali, Ri Wang, Marcy McCall, Jeffrey K Aronson, Annette Plüddemann, Lorenzo Moja, Nicola Magrini & Carl Heneghan
http://dx.doi.org/10.2471/BLT.18.222448
Abstract
Objective
To compare the medicines included in national essential medicines lists with the World Health Organization’s (WHO’s) Model list of essential medicines, and assess the extent to which countries’ characteristics, such as WHO region, size and health care expenditure, account for the differences.
Methods
We searched the WHO’s Essential Medicines and Health Products Information Portal for national essential medicines lists. We compared each national list of essential medicines with both the 2017 WHO model list and other national lists. We used linear regression to determine whether differences were dependent on WHO Region, population size, life expectancy, infant mortality, gross domestic product and health-care expenditure.
Findings
We identified 137 national lists of essential medicines that collectively included 2068 unique medicines. Each national list contained between 44 and 983 medicines (median 310: interquartile range, IQR: 269 to 422). The number of differences between each country’s essential medicines list and WHO’s model list ranged from 93 to 815 (median: 296; IQR: 265 to 381). Linear regression showed that only WHO region and health-care expenditure were significantly associated with the number of differences
Conclusion
The substantial differences between national lists of essential medicines are only partly explained by differences in country characteristics and thus may not be related to different priority needs. This information helps to identify opportunities to improve essential medicines lists

World Health Assembly Update, 27 May 2019
27 May 2019 WHO News release
Member States have agreed a five-year global action plan to promote the health of refugees and migrants. The plan focuses on achieving universal health coverage – and the highest attainable standard of health – for refugees and migrants and for host populations.

The plan includes short and long-term steps to mainstream refugee and migrant health care; enhance partnerships; strengthen health monitoring and information systems and counter misperceptions about migrant and refugee health.

Member States are requesting that the Director-General report back on progress at the 74th World Health Assembly. Reports to the 74th and 76th World Health Assemblies will also include information provided by Member States on a voluntary basis, and UN agencies as appropriate.

Globally, the number of international migrants has grown. During the period 2000–2017, the total number of international migrants rose from 173 million to 258 million, an increase of 49%. The number of forcibly displaced people, 68.5 million, is also the highest ever, and includes 25.4 million refugees. Ten million stateless people lack a nationality and access to basic rights such as education, health care, employment and freedom of movement.