REGULAR PRESS BRIEFING BY THE INFORMATION SERVICE

Alessandra Vellucci, Director, United Nations Information Service, chaired the briefing attended by the spokespersons for the World Health Organization, the International Federation of the Red Cross and Red Crescent Societies, the World Food Programme, the World Bank Group, the United Nations Refugee Agency, and the Office for the Coordination of Humanitarian Affairs.

Ebola in the Democratic Republic of the Congo (DRC)

Laura Ngo Fontaine, for the International Federation of the Red Crescent and Red Cross Societies (IFRC), introduced Dr Julie Hall, Director of Global Health at IFRC. Dr Hall said she wished to recognize the strong leadership of the World Health Organization (WHO) and of Médecins Sans Frontières (MSF) in the response to the Ebola crisis, and that together with those organizations IFRC was working in a very coordinated manner on all levels – global, regional and country level - to be able to help and support the communities currently affected by the Ebola outbreak. For IFRC, communities were often the most important when it came to responding to infectious diseases. Engaging the communities right from the beginning, listening to them and having them drive the response was key.

That was what was being seen in the Ebola response in DRC currently. DRC had responded to eight outbreaks in the past, and the DRC Red Cross had been involved in all of those outbreaks and was mobilizing support into the area. IFRC had over 50 volunteers on the ground in the affected areas who were living in the affected communities and they were coming forward to support the information gathering and sharing, as well as helping understand what were the cultural practices, attitudes and knowledge on the ground. IFRC would be taking the lead on safe and dignified burials. The hope was that the need for that would be low, but IFRC was scaling up to make sure the response would be there as part of the overall partner response, also with the community-based surveillance and other forms of community engagement, not just in the affected areas but in neighbouring districts and in the cross-border areas as well.

There were many countries in Africa right now facing famine and malnutrition. Between hunger and death stood diseases, particularly malaria, measles and cholera. Those diseases were only preventable with community/level action. Communities and volunteers working for the Red Cross and Red Crescent were also scaling up, action to make sure that bed nets were distributed to prevent malaria, that vaccination campaigns against measles were a success, and reach those most vulnerable children, and that water, sanitation and other measures were put in place to help prevent cholera.

It was still early days of the Ebola epidemic and much information was still unknown. IFRC and partners were all scaling up to be able to respond to the crisis. It was one of many emergencies happening across Africa and the emphasis on community engagement was essential.

In response to questions, Dr Hall said that with the instability and the movement of thousands of people it was necessary to look at the surrounding areas and cross-border issues, to ensure that people had knowledge about Ebola, that there was community-based surveillance and early warning, and that their basic needs were met. The malnutrition rates among those populations, especially those on the move, were quite high. Children with malnutrition had a nine times higher chance of death of all causes, but particularly from malaria. In the Central African Republic, malaria was already the biggest killer of children. A child with malnutrition who contracted malaria had a two or three times higher risk of dying compared to if they had not been malnourished. It was necessary to look at an integrated package of support at community level, as many of the populations on the move were out of reach of health systems, and often in areas difficult to access. The community-level work to ensure malnutrition screening happened and children and pregnant women were protected from malaria, was absolutely crucial right now.

Dr Hall also said the safety and security of the first responders was critical and there was a lot of training going on, particularly at community level with the volunteers, to ensure that they were aware of the symptoms and wearing the personal protective equipment (PPE) which might be needed under certain circumstances. All first line workers and health facilities needed to be protected from the conflict and the violence, including volunteers and community health workers who were often not taken into account. The protection of health services, health facilities and health commodities, as well as anyone involved in health work, needed to be across the board.

“Health care in danger” was a programme launched by the International Committee of the Red Cross (ICRC), which had many partners. It looked at the many aspects needed to protect health care in danger. IFRC was part of that and very much focused on the community protection that could help support community workers and facilities.

Asked about IFRC’s experience with the DRC Ministry of Health, Dr Hall said they were extremely active and transparent, and that there was much collaboration going on. The DRC Red Cross was formally auxiliary to the Government and part of Government response systems, and it had been a very positive interaction. The DRC Government and Red Cross had responded to all past outbreaks, so there was a high degree of experience there, and understanding between the partners.

Tarik Jasarevic, for the World Health Organization (WHO), added that as of 22 May, the total number of cases in the DRC stood at 43, out of which 38 were suspected cases, two were confirmed and three were considered as probable. There had been four deaths out of the 43 cases, three considered as probable and one confirmed by laboratory tests. Five people were currently in a treatment unit. There were 419 contacts currently being followed and 54 of them were beyond the 21-day period of monitoring.

In response to a question, Mr. Jasarevic said that, as of today, the Government of the DRC had not yet announced a decision for the use of the experimental Ebola vaccine. Work was in progress and MSF had developed a protocol. There were ideas on sending cold chain equipment from Guinea, as the vaccine had to be stored at -80°C, and the logistical plan was being developed. The DRC Government was looking into the epidemiological situation and the method of vaccination. As recommended by the SAGE Committee, the vaccine should be deployed after this sort of assessment and the preferred vaccination method should be ring vaccination, which was vaccinating contacts of people who had been infected, contacts of those contacts and health workers.

Bettina Luescher, for the World Food Programme (WFP), added that the WFP was in charge of logistics for the UN. In DRC the WFP was helping WHO and supporting them in their mission to deal with the Ebola crisis. WFP had deployed a helicopter serving the whole UN community. It was based in Kisangani and had begun rotations into the epicentre in Buta. WFP also had staff in the region and in-country who had much experience with the Ebola response, having worked side-by-side with the WHO on the logistical aspects of the response for the last big outbreak in Western Africa.

Yemen

Asked for an update on the situation regarding cholera in Yemen, Mr. Jasarevic said he would get back to the press with the latest figures. The situation was really difficult, as WHO’s representative from Yemen, Dr Zagaria, had explained to journalists the previous week. There had been thousands of cases reported to WHO within a few weeks. The outbreak, which had started in October-November 2016, had led to a fatality ratio of over 1 per cent. The main problem in Yemen was that the health system was collapsing and health workers had not received salaries for many months. There was no budget to run facilities. WHO had more than 20 cholera treatment centres which had been refurbished when the first outbreak had started in late 2016. Currently, WHO was trying to create hydration corners at health facilities, so people could quickly get ORS (Oral Rehydration Solution) to be treated.

Asked about any plans to deploy cholera vaccines to Yemen, Mr. Jasarevic answered that there had not been such consideration at this stage. There were indeed limited supplies of vaccines. The ones that WHO had had to be administered twice. Another vaccines that had been pre-qualified could be administered only once but there were no plans to administer it yet.

Dr Hall added that the IFRC considered the situation in Yemen quite concerning regarding cholera. ICRC, IFRC and also the National Society in Yemen were working together to look at what more could be done. As WHO had pointed out, the health system in many parts, was not functioning. IFRC was looking at community level support for prevention and early detection of cholera. Malnutrition rates were very high in many parts of Yemen as well, which complicated the situation. IFRC was part of the Global Cholera Task Force, which would be looking at what more could be done to help in supporting Yemen, also in Somalia. Clearly, acute watery diarrhoea and cholera were significant issues in many countries where malnutrition rates were now rising.

Asked if the Global Task Force on Cholera was going to meet during the World Health Assembly, Ms. Chaib said there would be no briefing on cholera during the WHA, but the topic would be raised on two occasions. WHO had a document called “WHO’s response in severe large-scale emergencies”, in which cholera would be mentioned. There would also be a second document dealing with the issue of “Addressing the global shortage of and access to medicines and vaccines” since the shortage of vaccines for cholera was a serious issue.

Burundi

Babar Baloch, for the United Nations Refugee Agency (UNHCR), said that UNHCR was today renewing its concern over the unstable situation in Burundi, which continued to drive people to seek safety in neighbouring countries. Since April 2015, some 410,000 refugees and asylum seekers had been forced to flee their homes. Those numbers were still rising, with an estimated 70,000 refugees having fled so far in 2017.

Arriving refugees continued to cite human rights abuses, fear of persecution and Sexual and Gender-based Violence (SGBV) as reasons for fleeing. With no sign of improvement of the political situation, the total refugee population was expected to grow to over half a million by end of 2017 – making it potentially the third biggest refugee situation in Africa. Currently the United Republic of Tanzania was hosting the majority of Burundian refugees with some 249,000 already accommodated in three overcrowded camps. Rwanda hosted some 84,000 refugees with another 45,000 in Uganda and some 41,000 in the Democratic Republic of the Congo (DRC).

UNHCR had updated its funding needs for the Burundi situation to USD 250 million (from USD 214 million). Resources were badly needed to provide emergency assistance to the new arrivals and proper support to their hosts. UNHCR had so far received only two per cent of the required funds.

Living conditions for refugees in neighbouring countries were extremely difficult. More arrivals were over-stretching the reception capacity in refugee camps, especially in Tanzania, Rwanda and the DRC. Urgent funding was needed to upgrade and construct new settlements to decongest the current ones and provide basic services.

Education of refugee children was also severely affected with school classes unable to accommodate the number of students. In Tanzania, there was a need to construct over 600 new classrooms, as many children attended classes under trees. In DRC, for instance, the transit centres were unable to host incoming refugees, forcing them to live in extremely poor conditions, often without shelter. Underfunding was hampering UNHCR’s efforts to develop a newly identified refugee camp site in Mulongwe in DRC’s South Kivu region.

Overcrowded camps further exposed refugees, especially women and children, to many risks. UNHCR and partners had been pointing to the protection and health risks, and the risk of a new cholera outbreak.

UNHCR renewed its call to donors for continued support to countries hosting Burundian refugees. UNHCR was also repeating its appeal to the neighbouring countries to allow continued access to those fleeing the situation in Burundi and not to return refugees against their will.

In response to questions, Mr. Baloch said that UNHCR had been raising its concerns with the authorities regarding reports coming from the DRC and other hosting countries including Tanzania regarding forced return of refugees. UNHCR was trying to make sure that all those in need of international protection who were seeking safety across the borders were able to get that protection. UNHCR was present at some border points and was trying to increase its monitoring capacity inside Tanzania. An estimated average of 12,700 people were still fleeing month. The peace process was currently stalled and many arriving refugees were citing human rights abuses and other forms of persecution upon arrival in neighbouring countries.

Geneva Events and Announcements

Fadela Chaib, for the World Health Organization (WHO), said today was the second day of the 70th World Health Assembly. The election of the new WHO Director-General, who would start aLaunching five-year term on 1 July, would take place today. There were three candidates: Dr Tedros Adhanom Ghebreyesus of Ethiopia, Dr David Nabarro of the United Kingdom, and Dr Sania Nishtar of Pakistan. The event would start at 2 p.m. and each of the three nominees would make a presentation of 15 minutes, without Q&A, in the Assembly Hall, in the following order: Dr Tedros Adhanom Ghebreyesus, Dr David Nabarro and Dr Sania Nishtar. The WHO would film those presentations and would make the footage and audio files available to the press. The presentations would also be webcast. Chris Black, the WHO audio-visual manager, was the contact regarding the materials.

The voting would start at 3 p.m. with a presentation of the WHO’s legal counsel to the Member States to remind them of the rules of the vote. Each round could last as long as an hour and a half. As soon as the vote was finished, the public and journalists could return to the Assembly Hall to hear the public announcement of the name of the winner. A press release and a bio of the new DG-Elect would be provided. A press conference would be organized shortly thereafter, with details to come.

The candidates themselves would not be present during the vote even if they were part of the delegations of their own countries. Each Member State had the right to vote unless that right was suspended for a specific reason. Ms. Chaib referred the press to document A70/4, which explained the procedure in detail.

In response to questions, Ms. Chaib said that during the presentations of the three candidates, the WHO would be filming and would provide the footage to journalists. During the announcement of the DG-Elect, photographers and cameramen would have access to the room.
A press conference in Room III, and it could be as late as 6 or 7 p.m. It would not be webcast but would be broadcast on Facebook. The possibility had been discussed with the candidates to bring them back on 24 May in the morning, between 9 and 11.30 a.m., for a virtual press conference in Room III (with the possibility of physical presence for the journalists at the Palais).

Ms. Chaib also clarified that it was not known how many rounds of voting there would be. If in the first ballot a candidate obtained a two-thirds majority of members present and voting, s/he would be appointed DG. If not, the candidate having received the least number of votes would be eliminated. If two candidates were tied for the least number of votes, an additional ballot between them would be organized.

Ms. Chaib also said that for now 185 countries were entitled to vote. Countries which had not yet paid their dues could still do so until 2 p.m. today. Five Member States had their voting privileges suspended at the beginning of the WHA and one may have their privileges restored today. Those countries were Somalia, Ukraine, Comores, Guinea-Bissau, and Central African Republic, but Ms. Chaib stressed that it was an evolving situation. Mr. Jasarevic clarified that in total 190 countries had obtained their credentials for the World Health Assembly, out of 194 Member States.

Ms. Chaib added that the acceptance speech by the DG-Elect would take place just after the vote and the public signing of the new DG’s contract would follow. She referred the press to document A-70/5, which gave information about the details of the contract of the DG and their salary.

Each delegation could have a maximum of four delegates present in the room and those delegates could circulate. The Chief Delegate was entitled to vote on behalf of the delegation and could designate another delegate to vote on the delegation’s behalf. Those designated to vote had a special badge with two red stripes.

Asked whether the detailed results would be published, Ms. Chaib said that it would not be the case as it was a complicated, Member-State negotiated process.

Ms. Chaib also said that the Assembly would know the vote before the press and would then re-open for a public announcement, but there was a code of conduct for Member States which stipulated that delegates should not disclose the results before the public announcement.

Anugraha Palan, Communications Lead – Health, Nutrition & Population for the World Bank Group, said that a report on pandemic preparedness would be launched on 25 May at a side-event at the Intercontinental Hotel. The report was titled “From panic and neglect to investing in health security: financing pandemic preparedness at the national level”. The report was being published by an independent group called the Working Group on Financing Preparedness. The group had been established in November 2016 with support from the World Bank and the Wellcome Trust. The idea had been to take forward all the recommendations that had come out post-Ebola, around what types of reforms were needed at the global and national levels to account for pandemic risk and make sure we were equipping ourselves adequately, especially on the national level, to respond to pandemic outbreaks. The idea of the Working Group had been to take the financing aspect of the conversation further. Several creative recommendations would be part of the report.

The Working Group was chaired by Peter Sands, former Head of Standard Chartered Bank, and had 16 other members from academia, industry, international institutions and with country-level expertise. The launch event at the Intercontinental Hotel would take place on 25 May at 7.30 a.m. (it was a breakfast event). An embargoed press release would be sent on 24 May. The speakers would be Peter Sands, Head of the Working Group, Dr Peter Salama, Executive Director of WHO's Health Emergencies Programme, Recep Akdağ, the Minister of Health of Turkey, and Tim Evans, Head of the Health, Nutrition and Population Practice at the World Bank Group. The Director of the Global Health Centre at the Graduate Institute, Ilona Kickbusch, would be moderating the session. Ms. Palan would also share the report under embargo on 24 May. The list of the 16 members of the Working Group was on the first page of the report. Asked about the difference between the presentation at the upcoming event and the one given by Turkey and Tim Evans the previous day, Ms. Palan said it would touch on the financing schemes and priorities for surge financing in outbreaks but would go further in terms of the concrete recommendations, of which there were 12.

Jens Laerke, for the Office for the Coordination of Humanitarian Affairs (OCHA), announced a press conference on 30 May at 12.15 p.m. in Press Room 1 on Nigeria, with the Humanitarian Coordinator and the Deputy Humanitarian Coordinator, who would speak about the situation, in particular in the north of the country, where some 8.5 million people of assistance. Another press conference would take place on 1 June at 2.30 p.m. on the Central African Republic, with the Humanitarian Coordinator, Najat Rochdi, on the massive crisis where hundreds of thousands of people were food insecure and displaced.

Ms. Vellucci announced a press conference on 24 May at 11.45 a.m. in Room III, by the Permanent Mission of Indonesia/Permanent Mission of Norway/EAT Foundation, on the launch of the inaugural Asia Pacific Food Forum in Jakarta. The speakers would be Professor Nila Moeloek, Minister of Health, Indonesia, and Dr. Gunhild Stordalen, President and Founder, EAT Foundation. The press conference would feature remarks by H.E. Datuk Seri S. Subramaniam, Minister of Health, Malaysia, H.E. Mr. Gan Kim Yong, Minister of Health, Singapore (TBC), and H.E. Mr. Hans Brattskar, Ambassador, Permanent Representative of Norway.

Ms. Vellucci also announced a press conference by the United Nations Relief and Works Agency (UNRWA) on 26 May at 2 p.m. in Press Room 1, on the launch of the Annual Report of the UNRWA Health Department. The speaker would be Dr Akihiro Seita, UNRWA Director of Health.

Ms. Vellucci said the Committee on the Rights of the Child (CRC) would complete this morning its review of the report of Qatar, started on 22 May in the afternoon. This afternoon at 3 p.m., the Committee would start its review of the report of Romania, which it would and on 24 May in the morning. Beyond the reports of the United States, Bhutan and Lebanon, reviewed in the past week, the Committee would review during this session the reports of Qatar, Romania, Mongolia, Antigua and Barbuda, and Cameroon.


The Conference on Disarmament (CD), which had opened on 15 May the second part of its 2017 session, running until 30 June, was holding a public plenary this morning starting at 10 a.m. The CD was currently under the presidency of Ambassador Coly Seck of Senegal, until 28 May. In 2017 the presidency would also be ensured respectively by Slovakia, South Africa and Spain.

The webcast for this briefing is available here: http://bit.ly/unog230517