Yemen hanging on by a thread

More than five years of conflict have left Yemenis “hanging on by a thread, their economy in tatters” and their institutions “facing near-collapse”, the chief of the UN told a virtual pledging conference, calling for a demonstration of solidarity with some of the world’s poorest and most vulnerable. 

“Four people out of every five [Yemenis] — 24 million people in all — need lifesaving aid in what remains the world’s largest humanitarian crisis”, said UN Secretary-General António Guterres. “Two million Yemeni children are suffering from acute malnutrition, which could stunt their growth and affect them throughout their lives”. 

Moreover, since the start of the year, some 80,000 more people were forced from their homes, bringing the total displaced to almost four million. Cholera continues to threaten lives with 110,000 people contracting it so far this year; and recent floods have raised the risk of malaria and dengue fever.  And then there’s COVID 19.

On Tuesday, international donors promised $1.35 billion in humanitarian aid to Yemen, U.N. aid chief Mark Lowcock told a pledging conference to help the war-torn country.

Fighting intensified across Yemen in 2015 between a Saudi-led coalition backing the internationally-recognized Government, and the Houthi armed movement.

[UN News / Reuters]

Trump announces end of US relationship with World Health Organization

President Donald Trump announced on Friday that the United States will terminate its relationship with the World Health Organization (WHO).

“Because they have failed to make the requested and greatly needed reforms, we will be today terminating our relationship with the World Health Organization and redirecting those funds to other worldwide and deserving, urgent global public health needs,” Trump said.

The President had previously announced a temporary halt of funding to the WHO and sent a letter to the agency earlier in May saying that the US would permanently pull funding if the WHO did not “commit to major substantive improvements in the next 30 days.”

Health experts and world leaders have expressed concern over defunding the organization amid a pandemic. In April, more than 1,000 organizations and individuals including charities, medical experts and health care companies from around the world signed a letter urging the Trump administration to reverse course and maintain funding.

Trump’s decision to permanently terminate the US relationship with the WHO follows a years-long pattern of skepticism of world organizations, with the President claiming in nearly every circumstance that the US was being taken advantage of.

The President has also questioned US funding to the United Nations and the Northern Atlantic Treaty Organization, withdrawn from the Paris climate accords and repeatedly criticized the World Trade Organization.

[CNN]

For the world’s poor, the nutritional crisis of covid-19 will be even worse than the disease

Even though they may not have yet been directly ravaged by the virus, the world’s poorest people may yet suffer some of the pandemic’s greatest losses—in the form of growing hunger.

“There’s a huge covid impact which is economic, and that is drowning out the disease itself,” Mark Lowcock, the U.N. under-secretary-general for humanitarian affairs and emergency relief coordinator, said an interview last week.

The global economy is now expected to shrink this year by at least 3 percent, delivering a direct hit to the primary goods exports, remittances and tourism on which many poor countries subsist.

According to Lowcock, for the first time in 30 years, the percentage of the world’s population in extreme poverty—those living on less than $1.90 a day—will increase.

At the beginning of 2020, the United Nations reckoned that 130 million people would be at risk of starvation. “Now we think there will be 265 million,” Lowcock said. “We could have mass hunger and multiple famines.”

[Washington Post]

Travel restrictions hamper COVID-19 response

The COVID-19 pandemic has sparked an unprecedented shutdown of borders and airlines, with 90% of commercial passenger flights grounded, all of which is severely restricting the movement of essential medical personnel and supplies that are vital to save lives.

At least 90% of the world’s population, or 7·1 billion people, live in countries with restrictions on people arriving from other countries who are neither citizens nor residents, according to a Pew Research Center analysis.

The World Health Organization (WHO) gives the example of Africa where the delivery of equipment and personnel is vital for the COVID-19 response. “There are 47 countries not allowing any airlines to land and we need to support them with equipment, especially as we cannot send any experts to give technical support, for example, with contact tracing or analysis”, Michel Yao, head of WHO’s emergency operations in Africa, told The Lancet. “There is a big shortage of ventilators and also intensive care unit capacity. There are only about 3000 doctors who have intensive care unit expertise in all of Africa.”

“What people don’t realize is that passenger planes also carry a large bulk of the world’s cargo, and [so the major reduction in regular commercial flights] poses a huge problem for us”, Amer Daoudi, head of logistics for World Food Programme (WFP), told The Lancet. As a result of the restrictions, the WFP has an ambitious network of air bridges that will act like a humanitarian airline for fighting COVID-19 around the world, with WHO as the lead partner for sourcing medical supplies and personnel.

“WFP is committed to getting vital medical supplies to front lines and shielding medical workers as they save lives”, said David Beasley, WFP’s executive director. “Our air bridges need to be fully funded to do this and we stand ready to transport frontline health and humanitarian workers as well as medical cargo.”

Médecins Sans Frontières (MSF) received exemption from the EU’s ban on exports of personal protective equipment (PPE), said Brice de le Vingne, head of MSF’s COVID-19 task force. MSF needs PPE for its own personnel who work around the world as well as for training on infection prevention and control measures it provides, for example, in Iraq.

Issues of deployment and repatriation of experts have also hit the Pan American Health Organization (PAHO), the WHO regional office for the Americas. “A recent example of this occurred when we deployed an expert to Guayaquil [Ecuador], which we were only able to do by hiring a charter flight from Colombia”, Jarbas Barbosa, assistant director of PAHO, told The Lancet. Restrictions on commercial flights had also caused widespread disruption to deliveries of medical supplies, he said. “Shipments, including PPE, lab supplies, etc, have to wait for space on cargo planes and as demand for these planes increases, there have been challenges.”

[The Lancet]

China steps up to the plate with $2B in funding

China will provide 2 billion U.S. dollars over two years to help with COVID-19 response and with economic and social development in affected countries, especially developing countries.

So announced  Chinese President Xi Jinping via video link on Monday at the opening of the 73rd session of the World Health Assembly.

Xi added that when a vaccine for the disease is available, it “will be made a global public good.” A number of Chinese companies are at the forefront of development and testing for a Covid-19 vaccine.

Xi also emphasized how China would work in particular to support Africa in virus prevention and control efforts.

Major implications for the world’s most vulnerable if America cuts funding to WHO

The head of emergencies at the World Health Organization, Michael Ryan, warned Wednesday that any end to sizable U.S. funding for the U.N. health agency will have a “major implication for delivering essential health services to the most vulnerable people in the world.”

“Replacing those lifesaving funds for front-line health services to some of the most difficult places in the world: we’ll obviously have to work with other partners to ensure that those funds can still flow,” Ryan said. “We trust that other donors will, if necessary, step in to fill that gap.”

WHO Director-General Tedros Adhanom Ghebreyesus said: “We have of course received the letter [from President Donald Trump] and we are looking into it.”

Trump has criticized the WHO for its early response to the outbreak and what he considers its excessive praise of China, where the outbreak began, at a time when his administration’s response in the U.S. has come under scrutiny.

Trump has already ordered a pause in U.S. funding, which totaled nearly $900 million to the WHO’s budget for 2018-19, according to information on the agency’s website. That represented one-fifth of its total $4.4 billion budget for those years.

[AP]

On President Trump’s letter to the World Health Organization

NPR spoke to global health experts in the U.S., Canada and Switzerland regarding some of the assertions in President Trump’s letter to the WHO:

An excerpt from Trump’s letter reads: “The International Health Regulations require countries to report the risk of a health emergency within 24 hours. But China did not inform the World Health Organization of Wuhan’s several cases of pneumonia, of unknown origin, until December 31, 2019, even though it likely had knowledge of these cases days or weeks earlier. Even now, China continues to … refusing to share accurate and timely data, viral samples and isolates, and by withholding vital information about the virus and its origins.“

Lawrence Gostin, a global health professor at Georgetown University Law Center, agrees China was not transparent early on in the outbreak. “China was anywhere from two to even up to six weeks’ late in reporting to the World Health Organization,” noting there’s evidence that Chinese health authorities knew the coronavirus was circulating in December.

Second, while China quickly shared the genome sequence for the coronavirus, “it has not been as forthcoming with sharing biological samples which are needed for epidemiology and also for vaccines and treatments,” Gostin adds.

But Gostin said blaming the WHO for China’s reporting delays and sample hoarding is misdirected. Of these charges by Trump, he said: “They’re valid critiques of China but not the World Health Organization.”

Trump’s letter also states: “The World Health Organization consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier, including reports from the Lancet medical journal. The World Health Organization failed to independently investigate credible reports that conflicted directly with the Chinese government’s official accounts, even those that came from sources within Wuhan itself.“

The Lancet, a respected medical journal, said of this statement: “This statement is factually incorrect.” The journal said it published its first papers on the novel coronavirus on Jan. 24. In two papers published that day, researchers from China and Hong Kong described the first 41 patients in Wuhan and provided scientific evidence for human-to-human transmission.

On Jan. 24, Trump tweeted: “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

Yet in his letter to the WHO dated May 18, Trump writes: “The only way forward for the World Health Organization is if it can actually demonstrate independence from China. My Administration has already started discussions with you on how to reform the organization. But action is needed quickly.“

This demand comes with no specifics, global health observers said. “What exactly does the Trump administration want WHO to do?” asks Kelley Lee, a global health professor at Simon Fraser University. It’s not clear what “action” the U.S. is asking for, or how WHO could demonstrate “independence from China,” because no solutions are outlined in the letter.

“For the United States to blame the World Health Organization for its own months and months and months of inaction seems factually untrue and designed to divide the world at a moment when global solidarity is needed most,” said Benjamin Mason Meier, associate professor of global health policy at the University of North Carolina at Chapel Hill. “It undercuts the World Health Organization‘s efforts to provide a collective response to this common threat [of the COVID-19 pandemic].”

[Read full NPR article]

Lancet urges “replace Trump and bolster the CDC”

Americans should oust President Trump from the White House and elect a leader who will support – rather than undermine – public health experts who are battling the COVID-19 pandemic, British medical journal The Lancet says in a newly published editorial.

The unsigned editorial sharply criticizes the Trump administration, saying it has marginalized the Centers for Disease Control and Prevention to a degree that is dangerous for both the U.S. and the world. “Americans must put a president in the White House come January, 2021, who will understand that public health should not be guided by partisan politics,” the medical journal says.

“The Administration is obsessed with magic bullets — vaccines, new medicines, or a hope that the virus will simply disappear,” the journal states. “But only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency.”

Seeking to lay a pile of critical failings at Trump’s feet, the editorial says a federal agency that was once “the gold standard for global disease detection and control” has devolved into an “ineffective and nominal adviser” on the U.S. response to a disease that poses a public health threat of historic proportions.

The Trump administration has “chipped away at the CDC’s capacity to combat infectious diseases” in a number of ways, The Lancet says, citing the reduction of CDC staff in China and the withdrawal of the last American CDC expert from the Chinese CDC campus last July – moves that left an “intelligence vacuum” when the novel coronavirus was detected in Hubei province in late 2019.

The Lancet is a weekly journal that has become one of the world’s leading medical periodicals since its founding in 1823.

[NPR]

Angelina Jolie Mother’s Day Tribute to refugee moms

On Mother’s Day 2020, Angelina Jolie recognized women with children who are refugees, acknowledging their marked strength and sacrifices.

Her essay, published by the New York Times on Saturday, spoke to the challenges faced by refugee mothers caring for families without economic resources or physical security.

“This Mother’s Day, I think of refugee mothers I have met, living in poverty and displacement,” wrote the actor, filmmaker and activist, who became a Special Envoy to the United Nations’ Refugee Agency (UNHCR) in 2012. “Every one began her journey of motherhood with a promise to do all she could to protect her child. To lay down her life if necessary. And if she is defeated and silenced, few things are more tragic.”

Continuing, Jolie shared lessons she has learned about motherhood from interactions with women living as refugees. “I’ve come to believe that a mother is the strongest person on earth,” she said, referencing the elevated incidence of gender-based violence against women in areas of conflict. As human rights organizations like UNHCR have noted, many women refugees have experienced abuse, with some seeking asylum specifically to escape it. According to a report from the Migration Policy Institute, it is not uncommon for women and girls pursuing refugee status to encounter continued threats to their physical safety along the way.

Jolie paid reverence to women refugees and others who have survived gender-based violence, calling particular attention to the prioritization of their children’s safety. “Women who are abused aren’t ‘weak women,’ they are often mothers. They are often trying to manage danger with no way out. They will stand between their child and harm. They will face isolation and criticism.

“But their only thought will be: ‘Hurt me, not my child. Insult and ignore me, not my child. Take away my food, but not my child’s,'” she wrote, adding, “to the mothers everywhere who feel helpless — yet who still give every last bit of energy, every last bite of food and the only blanket to their children — I honor you.”

[Newsweek]