Cuba First Country to Eliminate Mother to Child HIV Transmission

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June 30, 2015 – The Caribbean region has the second highest incidence of HIV after sub-Saharan African but has made steady progress over the past decade in reducing new infections and on Tuesday Cuba achieved a feat that has so far evaded the rest of the world.

The World Health Organization announced that the island nation has become the first country to eliminate mother-to-child transmission of HIV. The most recent figures from WHO show that 240,000 children globally were born with HIV in 2013, down from 400,000 in 2009.

“Eliminating transmission of the virus is one of the greatest public health achievements possible,” WHO Executive-Director Margaret Chan said in a statement. “This is a celebration for Cuba and a celebration for children and families everywhere.”

An estimated 1.4 million women living with HIV become pregnant annually and, unless treated with anti-retrovirals, have a 15-45 percent chance of transmitting the virus during pregnancy, labor or through breastfeeding. If both mother and child receive antiretroviral treatment during these crucial stages then the risk of transmission is lowered to about 1 percent, according to WHO.

The Caribbean nation has also eliminated mother-to-child transmission of syphilis. Some 1 million pregnant women are infected with the disease annually and it results in early miscarriage and stillbirth, newborn death, low-birth-weight and other serious infection in newborns.

The WHO guidelines for validating elimination of mother-to-child transmission of HIV and syphilis notes that as treatment is not 100 percent effective, elimination is defined as a reduction to such a low-level that it no longer constitutes a public health concern. Among the indicators are new HIV infections among infants are less than 50 cases per 100,000 live births or less than 5 percent for women living with HIV who are breastfeeding. These targets must be met for two consecutive years.

In 2013, only two babies in Cuba were born with HIV and only five with syphilis.

- Denis Fitzgerald 
On Twitter @denisfitz

Syria Overtakes Afghanistan as Top Source Country for Refugees

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June 18, 2015 - Before the conflict in Syria started, the country was among the top five refugee hosting states. It is now the number one source country for refugees, having overtaken Afghanistan which had been the number one source country since 1981.

There are now a record 59.5 million people forcibly displaced worldwide, mostly as a result of war and persecution, according to figures released Thursday by the UN Refugee Agency in its annual Global Trends report. In addition to the 3.9 million Syrian refugees in 107 countries, there are another 7.6 million internally displaced Syrians. The vast majority of Syrian refugees are hosted in neighboring countries Jordan, Turkey, Lebanon and Iraq.

The number of Afghan refugees stands at 2.6 million, making them the second largest refugee group. The majority of Afghan refugees are hosted in Pakistan and Iran.

The next highest group of refugees are Somalis with 1.1 million, mostly residing in Kenya and Ethiopia.

Sudan and South Sudan are the third and fourth largest countries of origin for refugees with the latter experiencing a massive outflow of people fleeing war and hunger in the past twelve months – some 616,200 South Sudanese are now refugees compared with 114,400 last year. Ethiopia and Kenya were the top destination countries for South Sudanese.

Armed conflicts in the Central African Republic and Ukraine saw the number of refugees from these countries grow with Cameroon hosting the majority of CAR’s 412,000 refugees while more than 270,000 Ukrainians applied for asylum or refugee status in Russia. There are also more than 800,000 displaced inside Ukraine.

Developing countries continue to bear the primary burden of hosting refugees while the Americas hosts the lowest number and Europe – excluding Russian and Turkey, which is now the world’s biggest host country – the next lowest.

UNHCR said in its report that at least 3,500 people died crossing the Mediterranean last year seeking shelter in Europe.

More than half of the world’s refugees are children, the agency said.

The full report is here.

- Denis Fitzgerald
On Twitter @denisfitz

Image: Wikimedia

Impunity Fueling Sexual Abuse and Exploitation by UN Peacekeepers

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June 11, 2015 – When UN peacekeepers commit acts of sexual abuse and exploitation, they do so knowing that their crimes have every chance of never being punished.

Under the current system, when a country contributes troops to a peacekeeping mission, it enters into an understanding with the United Nations that it will pursue cases of misconduct by its troops and report back to the UN, but in reality the UN has no way to enforce this and, at present, no way to sanction troop contributing countries (TCCs) who fail to act on cases of misconduct.

As it stands, the UN merely has administrative jurisdiction over its military contingents. Under the Status of Forces Agreement, which the UN negotiates with the the host state, each TCC retains exclusive jurisdiction to prosecute and otherwise discipline its military personnel. This immunity cannot be waived by the Secretary-General since jurisdiction is exclusive to the TCC (the immunity can be waived in the case of UN employees).

Most militaries have a poor record of holding their personnel accountable for violations. In the majority of cases, perpetrators are sent home – sometimes to a state where there is no legislation for sexual crimes or where such crimes are not taken seriously – and no further action is taken.

Similarly, when women give birth to babies fathered by UN peacekeepers, the United Nations policy is to assist the mother in making a claim for financial support but that claim is then forwarded to the troop contributing country for consideration. NGOs have called for the UN to establish a Trust Fund for victims and children who are born to peacekeepers, but no action has been taken on this.

While it’s unlikely that troop contributing countries will cede jurisdiction for their troops, the UN could enforce sanctions on troop contributing countries who fail to act on cases of misconduct such as barring them from future UN missions and garnishing pay of peacekeepers who father children while on duty. What is lacking right now is the will to push through such measures but if the UN is to live up to its promise, the Secretariat, member states and troop contributing countries must all do a lot more to eliminate sexual abuse and exploitation from UN peacekeeping.

- Denis Fitzgerald
On Twitter @denisfitz

South Sudan’s Expulsion of UN Official Brings Controversial Integrated Approach Into Focus

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June 2, 2015 – Since the early 2000s, the United Nations has favored an integrated approach for some of its most difficult missions with the ostensibly neutral Humanitarian Coordinator also double hatted as the explicitly political Resident Coordinator, and triple hatted as the deputy special representative of the secretary-general.

The reasons behind an integrated approach were well-intentioned: to streamline UN efforts and ensure that the objectives of all UN forces and agencies are channeled towards an over-arching common goal (Weir:2006). But aid agencies have raised concerns on the basis of neutrality and impartiality, saying that the line between the UN’s military objectives and its humanitarian objectives is increasingly blurred by an integrated approach, and that it leads to the shrinking of humanitarian space (see Stimson Center report here). In Somalia and Afghanistan, NGO’s have withdrawn from, or refused to enter into, UN coordination mechanisms because of the support of these missions for the Afghan and Somali governments respectively.

UNMISS in South Sudan is one of the more recent integrated UN missions. On Monday, the government in Juba expelled Toby Lanzer, reportedly for comments he made criticizing the government’s failure. Lanzer is an experienced United Nations official who was chief-of-staff of one of the first UN integrated missions, in Timor-Leste in 2006. In South Sudan, he wears four hats: deputy special-representative of the secretary-general; UN resident coordinator; humanitarian coordinator; and resident representative of UNDP.

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Diagram from UN OCHA showing civil-military coordination in South Sudan: source UN OCHA

His is, or rather was, an impossible task – Lanzer was due to be replaced at the end of the month. The original UNMISS mandate in 2011 called for UNMISS to protect civilians and support the South Sudan government in consolidating peace and building state institutions, but the language on supporting the government has been stripped from subsequent resolutions – the most recent mandate renewal was passed by the Security Council last week.

UNMISS has essentially shifted into neutral mode following reports of mass graves, extra-judicial killings, sexual violence, attacks on peacekeepers and massive displacement of civilian populations – tens of thousands of whom are sheltering in UN bases – and the world’s newest country is currently at risk of famine.

But peacekeeping missions are hardly neutral and require the support of the host government to achieve peacebuilding and institution building mandates and need freedom of movement to fulfill a protection of civilians mandate.

UNMISS is a $1 billion mission, financed by mandatory assessments on UN member states, while the UN’s humanitarian appeal for South Sudan is for $658 million, though only $70 million has been received as it relies on voluntary contributions.

There are no easy answers to the South Sudan crisis but it puts the utility of integrated missions once again under the microscope and the wisdom of having one person responsible for coordinating humanitarian activities while also responsible for political activities and institution building and will likely lead to further calls for the UN to re-examine the integrated approach.

- Denis Fitzgerald
On Twitter @denisfitz

Tough Task Awaits New UN OCHA Chief Stephen O’Brien

Ban Ki-moon greets new UN emergency relief coordinator Stephen O'Brien

Ban Ki-moon greets new UN emergency relief coordinator Stephen O’Brien

May 31, 2015 – The new head of the UN Office for the Coordination of Humanitarian Affairs, Stephen O’Brien, who takes over from Valerie Amos on Monday as the world’s top aid official, will have to immediately tackle a funding crisis, work more with local actors, and strengthen OCHA’s role in conflict and complex situations, such as in Syria and Somalia, says Shannon Scribner of Oxfam’s humanitarian policy team.

OCHA has received less than 25 percent of the almost $20 billion it appealed for at the start of the year to assist 114 million people affected by disaster and conflict, and new crises continue to emerge such as the earthquake in Nepal and the deteriorating situation in Yemen as well as a growing crisis in Burundi.

Stephen O’Brien is stepping into a situation where the UN system is overwhelmed. So that would be the first business, how is he going to address this overwhelmed system where the UN is responding to four L3 emergencies in Central African Republic, Iraq, South Sudan and Syria and they don’t have enough funding to do that,” said Scribner in an interview with UN Tribune. “Oxfam would make two recommendations. The first would be recommending mandatory assessments for UN member states for humanitarian assistance. This would be similar to what they do in UN peacekeeping where they have assessed contributions.”

Scribner added that this is something that O’Brien could work on with the new high-level panel on humanitarian financing that was appointed by Ban Ki-moon last week. The UN currently relies on voluntary contributions for relief funding.

“The other thing that Oxfam is going to start emphasizing and Stephen O’Brien should be looking at this, as well as International NGOs like Oxfam, is we need to do more direct funding to local actors,” she said.

“The assistance we give is often too little and it’s often too late but we have local actors, such as local NGO’s and civil-society and, where appropriate, governments. From 2007-2013, only 2.4 percent of annual humanitarian assistance went directly to local actors and that just doesn’t make sense,” Scribner said. “They’re the first responders on the ground and they’re often the ones who are put in harm’s way. If you look at the number of aid workers that have been killed, the majority are local aid workers so we need to do a better job as a humanitarian community – international NGOs, UN OCHA and donors – to give more direct assistance to local actors.”

As an example of how neglect of local NGOs affects an emergency response, she said that meetings of the humanitarian cluster groups in Haiti during the 2010 earthquake were held in French or English even though most of the first responders spoke Creole “so that wasn’t helpful.”

Scribner added that local actors are not really considered true partners in the humanitarian response but rather as sub-contractors to implement programs that have already been designed. She said they need to be seen “as true partners where they are designing the interventions with us and they’re implementing the interventions.”

Finally, she said that the UN has do a better job in complex and conflict situations and need to appoint envoys who know the region or country and even better, know the local language, and where the UN has already has a mandate, it must ensure that protecting civilians is part of that mandate and its neutrality is unquestioned.

As an example, Scribner cited the UN’s support for the Africa Union mission in Somalia where the emphasis is on protecting government institutions.

“If they have a political mandate, then they’re going to be seen as political and they’re going to be seen as allying with one side. Their mandate should really be about giving assistance to people in need and making sure NGO’s have access, and protecting aid workers,” she said. “We have seen an increase in the number of aid workers that have been attacked and killed. In 2001 there was about 90 violent attacks on aid workers and in 2013, there was 460 such incidents and 80 percent of fatalities since 2001 have been local aid workers. If the UN can really show such leadership in those areas it will really help on the ground – they do play a very tricky and difficult role in these complex crises.”

Scribner said that the liaison role OCHA plays is key for humanitarian efforts in conflict situations but that it hasn’t always been up to the task and this will need to be on O’Brien’s list of pressing priorities. “NGO’s like Oxfam rely on OCHA to play the main liaison role in conflict settings and that’s really important for the independence and neutrality of NGO’s. I think Syria’s an example where we needed UN OCHA to really step up and play that role and they just don’t have the presence on the ground and the International NGOs are left to to kind of fill that role in terms of access and that liaison role. That is something he will have to grapple with, especially in these complex emergencies that are continuing to grow.”

- Denis Fitzgerald

On Twitter @denisfitz

Syrian Government Attacks on Medical Facilities Reach Record High in April

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May 28, 2015 – A medical facility was attacked almost every other day by Syrian government forces during April and the majority of attacks involved the use of barrel bombs, Ban Ki-moon reported to the Security Council on Thursday.

In his monthly report to the Council, Ban wrote that there were 14 attacks on medical facilities throughout the country in April. Five of the attacks occurred in Idlib, four in Aleppo, two in Damascus and one each in the Deir ez -Zor, Hama and Hasakeh Governorates. In addition, ambulances and medical personnel continue to be targeted. Seven medial workers were killed in April, five by shelling and two who were shot. Government forces were responsible for all attacks, the UN chief stated.

“The number of attacks on medical facilities in April was the highest monthly total on record in my monthly reports since the adoption of Security Council Resolution 2139,” Ban wrote. “Attacks on such facilities have a multiplier effect, not only killing and injuring, but also leaving many people unable to get the treatment that they need.”

Meanwhile, the number of people in besieged areas stands at 422,000 including 163,500 besieged by government forces in eastern Ghouta. No assistance reached eastern Ghouta in April but in early May, the World Health Organization was able to deliver, through the Syrian Arab Red Crescent (SARC), diabetes treatment for 200 people as well as two dialysis machines, according to the report.

WHO had requested permission to send 2,000 renal failure medicines but permission was granted for only 250. The SARC convoy delivering the aid was hit by mortar fire resulting in the death of one volunteer and injuries to three others.

More than 225,000 people are besieged by ISIL Deir ez-Zor city. No aid has reached them since March when the Food and Agriculture Organization delivered 140 sheep.

The UN defines a besieged area as “an area surrounded by armed actors with the sustained effect that humanitarian assistance cannot regularly enter, and civilians, the sick and wounded cannot regularly exit.”

The government is also confiscating medical supplies, Ban said in the monthly report to the Council.

“Despite obtaining approval from the local authorities, all injectable medicines, surgical supplies and medical kits were removed from a United Nations inter-agency convoy to Ar-Rastan in Homs by the security forces. Consequently, people were deprived of 10,459 treatments,” he said in the report.”

A measles vaccination campaign by UNICEF and WHO in April targeting 2.5 million children reached 1.6 million children, Ban wrote. ISIL did not permit the campaign in Raqqa and large parts of Deir ez -Zor with the exception of allowing 1,000 children to be vaccinated in Raqqa. Fighting prevented the campaign reaching other areas including in Aleppo, Homs and rural Damascus.

Nine humanitarian aid workers have been killed in Syria since the start of the year, according to the report, bringing to 76 the number killed since March 2011.

The full report is below.

- Denis Fitzgerald
On Twitter @denisfitz

Photo: ICRC

Ban Ki-moon Monthly Report on Syria resolutions

Foreign Terrorist Fighters Come from More than 100 UN Member States

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May 26, 2015 – More than half of the UN’s 193 member states are generating fighters for Al Qaeda and the Islamic State with some 25,000 recruits joining the terrorist groups from countries as diverse as Trinidad and Tajikistan, according to a new report from a United Nations expert group.

The report, from the Security Council team monitoring sanctions on individuals associated with Al Qaeda, says that six UN member states have generated more than 1,000 foreign fighters each while another 42 have generated more than 100 such fighters each.

“Open-source analysis by the team indicates an increase of 71 per cent in reported foreign terrorist fighters worldwide between the middle of 2014 and March 2015, in part owing to more comprehensive internal reporting by Member States and greater open-source data,” the authors state. “There has also been a sharp increase (from 70 to 733 per cent) in fighters from a number of European and Asian Member States.”

The destination countries for the majority of foreign fighters are Syria, Iraq and Afghanistan, with smaller numbers present in Yemen, Libya, Pakistan, the Sahel countries, Somalia and the Philippines, according to the report while origin countries for large number of foreign fighters include Russia, Tunisia, Morocco and France. Smaller numbers are coming from countries that have no previous association with terrorism including Finland, the Maldives and Trinidad.

There is no standard profile for those that leave their home country to join terrorists groups, according to the report, other than they tend to be males between the ages of 15 and 35, though some are older veterans who fought in Chechnya and Afghanistan and returned home.

For some countries such as France, those joining terrorist groups often have a record of petty crime while in Britain, there are clusters of recruitment associated with certain towns and schools. In other cases, criminal networks, such as ethnic Chechens in Austria, are associated with recruitment.

Libya has become a major training ground for foreign fighters, the report says.

The Security Council is set to discuss the findings on Friday.

The full report is below.

- Denis Fitzgerald
On Twitter @denisfitz

UNSC Expert Panel on Al Qaeda Sanctions

NPT Conference Sparks Calls for New Treaty Banning Nuclear Weapons

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May 22, 2015 – The merits of a new treaty banning nuclear weapons have been debated over the past month in UN conference rooms during the five-year review of the Nuclear Non-Proliferation Treaty, which ends today in New York.

Among the reasons cited by advocates of a ban are the reluctance of nuclear armed states to meet their disarmament commitments and that nuclear weapons are the only weapons of mass destruction not banned by treaty, with chemical and biological weapons covered under separate conventions.

But the biggest reason cited is new information on the humanitarian consequences of nuclear weapons. “We’re learning more every day as new documents become declassified and made available,” said Thomas Nash, director of the advocacy group Article 36. In some cases he said the research shows that “sheer luck has prevented the detonation of nuclear warheads.”

The growing information about the catastrophic consequences of nuclear weapons prompted an international conference in Oslo in 2013 on that very issue and concluded:

It is unlikely that any state or international body could address the immediate humanitarian emergency caused by a nuclear weapon detonation in an adequate manner and provide sufficient assistance to those affected… While political circumstances have changed, the destructive potential of nuclear weapons remains.

A follow-up conference in Vienna lead to what has become known as the Humanitarian Pledge, which calls for “effective measures to fill the legal gap for the prohibition and elimination of nuclear weapons and we pledge to cooperate with all stakeholders to achieve this goal.”

“What’s happening now is that because of this deeper frustration at the lack of progress and the intransigence of countries with nuclear weapons, I think states are saying we’re not going to wait for you, we’re going to move forward on negotiations for a treaty to prohibit nuclear weapons even without the nuclear armed states,” Article 36′s Nash said.

So far, 99 countries* have signed on to the pledge, which, as Nash acknowledges, does not outright call for an international treaty banning nuclear weapons but for “effective measures to fill the legal gap” prohibiting these weapons. He said the greatest pushback against the calls for a treaty for the prohibition and elimination of nuclear weapons have come from the UK who have said that it would be “like a referendum on the NPT and that it would basically undermine the NPT.”

“It only undermines the NPT if you see the NPT as something that legitimizes your position on nuclear weapons and the problem is that that is precisely what countries inside the NPT with nuclear weapons see the NPT as,” Nash said. While the NPT prohibits non-nuclear weapons states from acquiring such weapons it also calls for the recognized nuclear powers to disarm – which is not happening.

“They think it’s a great treaty that allows them to keep their nuclear weapons. It gives them special status,” he said, adding that France, the US and the UK are engaged in revisionism arguing that the NPT is not about disarmament, it’s about non-proliferation – even though disarmament is one of the three pillars of the NPT along with non-proliferation and the peaceful use of nuclear energy.

While it’s not clear if all of the 99 countries* that have so far signed the Austrian Pledge are in favor of a treaty to ban nuclear weapons or some other steps to fill the “legal gap,” what is clear is that the countries absent from the pledge are the nuclear armed states as well as NATO members and other countries that are in a security alliance with nuclear states.

Alyn Ware, a longtime disarmament campaigner and member of the World Future Council, said the calls for a treaty among like-minded countries for the prohibition and elimination of nuclear weapons are understandable as the nuclear weapons states are not yet prepared to abolish nuclear weapons. Under this scenario, non-nuclear countries would negotiate a treaty without waiting for the nuclear armed states and those countries in nuclear-weapons alliances to join.

“Such a treaty could be concluded quite quickly” he said. “However, a problem is that it would only apply to those countries that join. It would not impact on the policies of the nuclear-armed states and their allies. Another problem with the proposal is that there does not appear to be even a majority of the non-nuclear countries in support. When the proposal was discussed in the United Nations Open Ended Working Group on Taking Forward Multilateral Nuclear Disarmament Negotiations, a number of non-aligned countries indicated that they would not support a treaty like this that placed new obligations on them, but no additional obligations on the nuclear armed states.”

“Another type of ban treaty, one that might have more impact, would be one banning the use of nuclear weapons as a measure leading towards nuclear disarmament. You could probably capture more of the allied countries, maybe even some of the nuclear weapons states, in such a treaty” he said. “India has already put forward a proposal to the United Nations General Assembly on negotiating a convention to prohibit the use of nuclear weapons. It is a much shorter, and more realizable, step from this position to a ban on use, than it is to jump immediately to a ban on possession.”

Ware pointed out that the global ban on chemical weapons started first with a ban on use, followed by negotiations to achieve the Chemical Weapons Convention banning possession.

But campaigners for an outright ban say it is the only credible option, particularly as the draft final document of the NPT review conference, which has yet to be agreed on, reflects the views of the nuclear weapons states and their allies.

While an earlier draft noted the the growing interest in the humanitarian consequences of nuclear weapons, the final draft now refers to a growing interest “among non-nuclear weapons states” in those consequences and raises doubts on other humanitarian concerns.

“It suggests that only non-nuclear-armed states and civil society learned anything about the humanitarian impact of nuclear weapons over the last three years and argues that it is only the perception of some states that there could be no adequate response to a nuclear weapon detonation,” Ray Acheson of Reaching Critical Will wrote on Friday about the final draft. “States truly committed to disarmament must say ‘enough is enough’ to the nuclear-armed states. As of writing, 99 states* have endorsed the Humanitarian Pledge to fill the legal gap for the prohibition and elimination of nuclear weapons. The pledge should be the basis for negotiations of a nuclear weapon ban treaty.”

- Denis Fitzgerald
On Twitter @denisfitz

*The Pledge has now been signed by 107 countries

Burundi’s Peacekeeping Experience Could Prove Deadly if Army Splits

Burundi chief of armed forces Gen. Prime Niyongabo visiting AMISON troops earlier this year. Photo: AMISOM

Burundi chief of armed forces Gen. Prime Niyongabo visiting AMISON troops earlier this year. Photo: AMISOM

May 14, 2015 – A former force commander with the African Union Mission in Somalia is fighting to prevent troops under his control from abandoning their posts and taking sides with Burundian coup leader Maj. Gen. Godefroid Niyombare.

The chief of staff for Burundi’s armed forces, Gen. Prime Niyongabo, told the BBC on Thursday that the number of soldiers backing the coup had fallen and those that had joined have been given a chance to rejoin the regular army.

Niyongabo was force commander of AMISOM from 2009 – 2010. The UN-backed mission comprises some 21,000 troops with more than 5,000 of those from Burundi.

Burundi also contributes more than 1,200 troops to UN peacekeeping missions with the bulk of its contingent serving with MINUSCA in the Central African Republic.

Burundi was one of 25 African countries selected by the US state department to take part in its ACOTA program which trained more than 250,000 troops for participation in peacekeeping operations.

UN DPKO data on Burundi's troop contributions link

UN DPKO data on Burundi’s troop contributions link


There have been no reports of any former peacekeepers among those siding with coup leader Niyombare but it would not be the first time that former UN troops were involved in a coup.

Former battalion commanders with the UN peacekeeping force in Lebanon were all central to the military’s involvement in three successive coups in Fiji in 1987, 2000 and 2006.

Peter Pham of the Atlantic Council says that as a result of its involvement in UN peacekeeping, Burundian troops are far better armed and trained than at any time in the country’s history, and have gained real battle experience. He is warning that if the military splits a conflict could be far worse than any of the country’s previous conflicts.

Meanwhile, on Thursday the UN Security Council condemned the “unrest” in Burundi and those who seek to seize power through “unlawful means.” The council’s statement did not use the word coup.

- Denis Fitzgerald
On Twitter @denisfitz

 

UN Investigators Find Numerous Flaws With WHO’s Ebola Response

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May 11, 2015 – The World Health Organization is ill prepared to respond to international health emergencies and poorly managed the initial response to last year’s Ebola outbreak in West Africa, an independent team of investigators appointed by the UN has concluded.

The esteemed panel of investigators, in an interim report, said the WHO did not seek support early enough from other United Nations agencies that have experience in emergency response, did not engage with local communities early enough on changing behaviors that spread the disease, and its authoritative status was undermined by a combination of the above as well as fluffed communications including belatedly declaring Ebola a Public Health Emergency of International Concern.

“At present, WHO does not have the operational capacity or culture to deliver a full emergency public health response,” the investigators concluded. Among their recommendations are establishing a new agency for emergency health response or reforming WHO.

The latter is preferable, the investigators said, because “establishing a new agency would take time to put in place and substantial new resources would be required to establish its basic administrative systems, and operational response capacity.”

“A new agency would, in any case, have to rely on and coordinate with WHO for public health and technical resources, creating an unnecessary interface,” the report says. “A WHO that is capable of adequately responding to public health emergencies requires deep and substantial organizational change.”

Although WHO leads the health response cluster during humanitarian emergencies, the investigators write that “it is unclear…how a public health emergency fits into the wider humanitarian system and at what point an outbreak becomes a humanitarian emergency that requires a broader United Nations-wide response.”

They add that “one of the difficulties is that the risk assessment of public health emergencies and so-called humanitarian emergencies differs, because of uncertainty in assessing the likelihood of disease spread.”

Among other recommendations are that WHO should have used medical anthropologists for developing communications strategies for changing traditional burial and funeral practices that contributed to the spread of Ebola and that UN member states should increase their contributions to WHO so that it can effectively respond to public health emergencies.

“Now is the historic political moment for world leaders to give WHO new relevance and empower it to lead in global health,” the report concludes. “In response, the (WHO) Secretariat needs to take serious steps to earn this leadership role in relation to outbreaks and emergency response and to regain the trust of the international community.”

Full report is below.

Denis Fitzgerald
On Twitter @denisfitz

 

Ebola Interim Report on WHO Response