Impressive African health gains at risk from changing trends: WHO report

Life expectancy across Africa has improved significantly, says a new United Nations World Health Organization (WHO) report released on Thursday, but national health systems must be improved to ensure that services get to the people who need them most.

The study, launched during the 68th session of the WHO Regional Committee in Dakar, provides a snapshot of the state of health in the African region.

Emerging data shows a continued improvement, with the continent seeing the biggest jump in healthy life expectancy – time spent in full health – anywhere in the world: from 50.9 years in 2012, to 53.8 years in 2015.

Deaths resulting from the ten biggest health risks in Africa – such as lower respiratory infections, HIV and diarrhoeal diseases – dropped by half between 2000 and 2015, partly as a result of specialized health programmes.

Speaking at the launch of the report, Dr. Matshidiso Moeti, WHO’s Regional Director for Africa in Dakar, expressed his pride that Africans are now living longer and healthier lives: “Nearly three years of extra health is a gift that makes us all proud. Of course, we hope that these gains will continue, and the region will reach global standards.”

At the same time, the report warns that this achievement can only be sustained and expanded if health services are significantly improved, and states that the performance of health systems in the region – measured by access to services, quality of care, community demand for services and resilience to outbreaks – is low.

Chronic diseases like heart disease and cancer need to be tackled, with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease. And two critical age groups – adolescents and the elderly – are being under-served, with surveys indicating a complete lack of elder care in a third of African countries.

“Health services must keep up with the evolving health trends in the region,” said Dr Moeti. “In the past we focused on specific diseases as these were causing a disproportionately high number of deaths. We have been highly successful at stopping these threats, and people’s health is now being challenged by a broad range of conditions. We need to develop a new and more holistic approach to health.”

This approach involves increasing spending on health, but also targeting funds in more effective ways. The report suggests that health systems that perform well invest up to 40 per cent of their budgets on their workforce, and a third on infrastructure.

Whilst it is not a scorecard, the report makes specific recommendations for each of the 47 countries of the region, and identifies areas where nations are demonstrating good practice. Examples include Algeria, with its good coverage of available health service; Kenya, which has a good range of available essential services; and Mauritius, where there is good access to services.

By improving performance, the countries named in the study have a better chance of meeting their commitment to achieve health-related targets set by the Sustainable Development Goals (SDGs).

UN food relief agency airlifts aid to DR Congo province hit by Ebola outbreak

Emergency food aid is being delivered to people affected by the Ebola virus in the eastern part of the Democratic Republic of the Congo (DRC), the World Food Programme (WFP) reported on Thursday.

The UN agency is airlifting high energy biscuits from its warehouse in Dubai to Goma, capital of North Kivu province, where an Ebola outbreak was declared on 1 August.

So far, 111 cases have been recorded, 83 of which have been confirmed, while more than 4,000 people have been vaccinated.

“This tenth Ebola outbreak is unfolding in an area of active armed conflict and displacement. It poses a risk of a regional health emergency involving three countries – DRC, Rwanda and Uganda,” said Claude Jibidar, WFP Country Director, in a press release.

“With its food assistance, logistics and air support already firmly in place, WFP is committed to do even more, to save lives and to prevent the epidemic from spreading.”

WFP and its partner, Caritas, are providing food to patients and caregivers in hospitals in the town of Mangina as well as in Beni, located in the epicentre of the outbreak.

High energy biscuits are often used in emergency situations as they are easy to transport and do not require cooking, the agency explained.

Food is also being distributed to villages in the area, with around 4,000 people receiving a month’s supply of cereal, beans, oil and salt. WFP wants to reach those who have been in contact with affected people and their families in efforts to limit population movements and prevent the virus from being spread further.

Prior to the outbreak, WFP was already assisting hundreds of thousands of people in North Kivu province who were displaced by fighting, with 12,000 in Beni territory receiving monthly food rations since July.

WFP also has been providing logistical support to the DRC’s Ministry of Health and its sister UN agency, the World Health Organization (WHO). This same approach was taken during the Ebola outbreak in DRC’s Equateur province in May, which was recently halted

The agency has deployed three mobile warehouses to Beni, while seven of its trucks carry medicine, food, cars, motorbikes, thermometers, refrigerators, and other supplies to treatment centres.

Meanwhile, WFP aviation specialists are helping with air traffic management in and out of the town, while WFP-run humanitarian flights transport aid workers as well as medical and protection equipment, and other cargo, between Goma and Beni each day.

The Ebola outbreak in North Kivu province is the 10th in the DRC in 40 years.

Ebola virus was first identified in 1976. WHO said although its origin is not known, fruit bats potentially may be a host.

UN envoy says he ‘is ready to go to Idlib’ to help ensure civilian safety amid rising fears of government offensive

A massive military escalation by the Government of Syria to retake Idlib risks a “worst case scenario”, United Nations negotiator Staffan de Mistura said on Thursday.

A massive military escalation by the Government of Syria to retake Idlib risks a “worst case scenario”, top UN negotiator Staffan de Mistura said on Thursday.

Speaking to journalists in Geneva, the UN Special Envoy for Syria offered to personally escort residents of Idlib to safety ahead of any attack on the last main opposition-held area in the country, echoing an offer to do the same in Aleppo in 2016.

The envoy’s comments reiterate an earlier appeal by UN Secretary-General António Guterres, who cautioned against a full-scale military operation and expressed deep concern over the growing risk of a “humanitarian catastrophe” in the war-torn province, which borders Turkey and is home to nearly three million people.

“There is…no other Idlib, where can they go?” Mr. de Mistura said. “Where can anyone go? So, for every time there was a crisis and there was a conclusion to that one crisis, there was a place where many could opt to go. There is no other Idlib.”

The fate of Idlib is important because it’s mainly civilian population has been displaced or evacuated from other conflict zones in the country amid territorial gains by Government forces in the more than seven-year war.

So I’m once again prepared, personally and physically, to get involved myself, with the Government cooperation this time, because that is an area where they are in charge outside Idlib – Staffan de Mistura

It is also the last zone in Syria that is covered by an internationally-agreed ceasefire deal, Mr. de Mistura explained, a reference to a de-escalation pact between Russia, Turkey and Iran, known as the ‘Astana guarantors’ after the Kazakh capital where the deal was struck.

“Why such a hurry and not provide more time, to allow more discussions, especially among the Astana guarantors?” he said. “They are the ones … who announced and provided the guarantees originally for this last but hugely inhabited de-escalation area.”

In the past six months alone, a reported 500,000 people have arrived in Idlib after fleeing Government offensives in Dera’a, eastern Ghouta and other opposition-held areas.

The north-western province is also the base for “an extremely high concentration of foreign fighters”, Mr. de Mistura said, noting that this amounted to approximately 10,000 Al Nusra or Al Qaeda members, who have been recognized as terrorists by the UN.

The extremists are understood to have the capability of weaponizing chlorine – as is the Government of Syria – Mr. de Mistura said, highlighting the risks of a “worst case scenario” occurring in the event of a military attack.

Although “no-one questions” the Syrian Government’s right to fight UN-identified terrorists, nor its right to recover “all of its territorial integrity”, there was “no justification” to using heavy weapons in densely populated areas, he added.

Reiterating the UN Secretary General’s statement on Wednesday, he noted that the systematic use of indiscriminate weapons in populated areas may amount to war crimes.

It would be a “tragic irony” at the end of the war inside Syria with a “most horrific tragedy” involving large numbers of civilians, Mr. de Mistura insisted, ahead of his offer to escort people away from Idlib.

His offer to do the same in Aleppo in 2016 had been rejected by Al Nusra, he reminded journalists, saying that this had led to thousands of people dying.

“So I’m once again prepared, personally and physically, to get involved myself, with the Government cooperation this time, because that is an area where they are in charge outside Idlib,” he said. To ensure such a temporary corridor(s) would be feasible and guaranteed for the people, so that they can then could return to their own places untouched once this is over.”

Responding to questions, the UN official said he had no “specific information” that an attack on Idlib was imminent. “But I do have eyes and information regarding preparations and build-ups and messages and declarations,” he said. “And the fact that while we are talking, two of the main guarantors – in this case Turkey and the Russian Federation – are trying and we hope will succeed, in avoiding the worst-case scenario.”

UN-led efforts to secure a peaceful solution to the conflict are set to continue with meetings planned in Geneva on 10 and 11 September with representatives from Russia, Turkey and Iran, Mr de Mistura said.

Those discussions are due to be followed on 14 September by encounters on constitutional matters with senior delegations from seven other Member States: Egypt, France, Germany, Jordan, Saudi Arabia, the United Kingdom and the United States.

As conflicts become more complex, ‘mediation is no longer an option; it is a necessity’, UN chief tells Security Council

Speaking alongside the UN chief were the Archbishop of Canterbury, Justin Welby, a member of his High-Level Advisory Board on Mediation, and Mossarat Qadeem, the co-founder of PAIMAN Alumni Trust, a civil society group working to prevent violent extremism in Pakistan.

As speakers at the day-long debate warned that the maintenance of international peace and security faces multiple challenges, Mr. Guterres noted that many internal conflicts feature a deadly mix of fragmented armed groups and political interests, funded by criminal activities, and that peace agreements are becoming more elusive and short-lived.

Archbishop Justin expressed concern that the international rules-based order is struggling, with national interests too often allowed, “even in this chamber”, to overcome the wisdom of those who have lived through war.

For this reason, the Secretary-General has made diplomacy for peace one of his key priorities, with a focus on prevention and investment in mediation, peacebuilding and sustainable development.

As an example of his commitment, he pointed to the creation of the High-Level Advisory Board on Mediation in September 2017, which aims to allow the UN to work more effectively with regional organizations, non-governmental groups and others involved in mediation around the world.

Mr. Guterres pointed to the work of Board member and former Nigerian President Olusegun Obasanjo – who travelled to Liberia on behalf of the Secretary-General to support the peaceful transfer of power after the 2017 elections – as an example of how the Board can be deployed in the cause of conflict prevention.

He added that the UN is already has a wide range of mediation resources at its disposal, including special envoys and representatives pursuing consultations, good offices and formal talks.

An example is the UN Standby Team of Senior Mediation Advisers, a group with expertise on a wide range of issues connected to peace negotiations. The group, part of the UN Mediation Unit, is providing crucial advice in areas of conflict, from the Central African Republic to Yemen and South Sudan.

Archbishop Justin described the Unit as a vital component of the UN’s cross-agency and cross-departmental reconciliation strategy, which is helping to build shared understanding between the UN and its partners.

Mr. Guterres told the Council that the UN recognizes the important role played by an “enormous range” of actors, from national bodies to civil society group, women’s organisations, religious leaders and young activists.

In South Sudan, where a peace deal has recently been agreed, the UN envoy there is supporting local efforts to address communal conflicts and, as Archbishop Justin explained, church leaders are playing an increasingly important role in moving the South Sudanese peace process beyond its current roadblocks.

The Secretary-General and Ms. Qadeem both emphasised the importance of investing in women’s meaningful participation and leadership in peace processes. Mr. Guterres cited the emergence of regional networks of women mediators, such as the Nordic Women’s Mediators’ Network and the African Union’s FemWise group.

Ms. Qadeem highlighted ways in which women have been excluded from mediation, with many sceptical of their ability to talk to violent extremist groups like the Tamil Tigers or the Taliban. In fact, women have played mediation roles in both cases.

For example, several years ago a group of mothers of missing soldiers in Sri Lanka successfully mediated a ceasefire, which was followed by peace talks. And Ms. Qadeem shared her own experience of speaking with the Taliban in Pakistan.

“I found the courage not only to speak with them to release my staff members they had captured, but I took the chance to seek support for the implementation of health and education projects. This is mediation.”

The UN chief told the Council that a changed conflict landscape calls for bold, creative thinking in international mediation: using social media effectively as a tool to bring communities together, speaking with one voice, and supporting the mediation efforts of regional and sub-regional organisations. “Innovative thinking on mediation”, he said, “is no longer an option; it is a necessity.”

Syria: UN chief warns Idlib offensive may set off ‘humanitarian catastrophe’

According to a statement issued by his Spokesperson, Mr. Guterres said that “any use of chemical weapons is totally unacceptable,” adding that he “urgently appeals to the Government of Syria and all parties to exercise restraint and to prioritize the protection of civilians.”

“He calls on the Astana guarantors to step up efforts to find a peaceful solution to the situation in Idlib, the last remaining de-escalation zone,” the spokesperson stressed, referring to Russia, Turkey and Iran, which have since last year worked together on the establishment of de-escalation zones in Syria’s war-ravaged areas.

The Secretary-General, in today’s statement, further called on all parties “to take all necessary measures to safeguard civilian lives, allow freedom of movement, and protect civilian infrastructure, including medical and educational facilities, in accordance with international humanitarian law and human rights law.”

The statement came one day after John Ging, Director of Operations with the UN Office for Coordination of Humanitarian Affairs (OCHA), told the Security Council that intense aerial bombardment and shelling in Idlib and three other governorates in north-west Syria have left death, damage and destruction in their wake, and placed an even greater strain on aid workers and communities hosting displaced people.

According to news reports, the three million people – roughly half of whom are native residents and the other half persons displaced within the country – of Idlib, the last big rebel enclave, are bracing for Syrian Government forces to begin a phased offensive.