POINT DE PRESSE DU SERVICE DE L'INFORMATION (en anglais)
Ahmad Fawzi, Director a.i. of the United Nations Information Service in Geneva, chaired the briefing attended by spokespersons for the United Nations Children’s Fund, the International Organization for Migration, and the World Health Organization.
UN Secretary-General
Mr. Fawzi said that the United Nations Secretary-General Ban Ki-moon was wrapping up a visit to Oman today. He had met with the Ministers of Defense and the Ministers of Foreign Affairs, discussing the tensions in Syria and in Yemen, as well as the Intra-Syrian talks in Geneva. On the Syria crisis, the Secretary-General had said: “the idea of a so-called winner has lost all meaning. Everyone is losing, and the biggest victims are the innocent civilian populations.” The Secretary-General had noted the start of the talks in Geneva, and had urged all parties to put the people of Syria at the heart of their discussions, above partisan interests.
The Secretary-General had been in Ethiopia the previous weekend and had met with several Heads of State, including the Presidents of Mali, Chad, Rwanda, and South Africa, as well as the second Vice-President of Burundi, with readouts of the meetings being available. He was on his way to London today, where he would attend the Syria Donors Conference on 4 and 5 February, and would head to New York thereafter. Mr. Fawzi also mentioned the Secretary-General’s op-ed in the New York Times today, on the Israeli-Palestinian conflict.
Geneva activities
Mr. Fawzi said that the Conference on Disarmament (CD), which had opened its 2016 session the previous week, would meet this morning in public session. The previous Tuesday, at the first public meeting of its 2016 session, the Conference had adopted its agenda. The 2016 session had begun under the Presidency of Nigeria (until 21 February); the CD would also be successively chaired by Norway, Pakistan, Peru, Poland and the Republic of Korea.
The Committee on the Rights of the Child would issue its concluding observations on Senegal, Iran, Latvia, Oman, France, Ireland, Peru, Haiti, Zimbabwe, Maldives, Benin, Brunei Darussalam, Kenya and Zambia, at a press conference on Thursday, 4 February, in Press Room 1. Speakers at the press conference: Benyam Mezmur (Chair), Gehad Madi, Bernard Gastaud, Hynd Ayoubi Idrissi and Jorge Cardona.
Mr. Fawzi also announced a press conference at the Club Suisse de la Presse, today at 11:30 a.m., with Thomas Jordan, Chairman of the Governing Board of the Swiss National Bank, on “Perspectives on Swiss economy and monetary policy by the Swiss National Bank”.
Syria
Mr. Fawzi said that the Syrian Government’s delegation was expected to arrive at 11 a.m. today at Door 4, but there was no information yet about press stakeouts.
In response to a question, Mr. Fawzi said that information from the Special Envoy’s team about stakeouts would continue to be shared as soon as possible. Close attention would also be paid to the availability of translation from Arabic.
Children and women on the move in Europe
Sarah Crowe, for the United Nations Children’s Fund (UNICEF), briefed the press on the latest data on children and women on the move as part of the refugee and migrant crisis. For the first time since the start of the crisis, the majority of those crossing into Gevgelijia - nearly 60 per cent – were children and women. In early to mid-2015, one in ten of those on the move had been children, compared to more than one in three today. Germany and Sweden had the most thorough data on the numbers of unaccompanied children who had requested asylum: 60,000 in Germany (as of 29 January 2016) and 35,400 in Sweden. More and more children and women were at risk at sea and needed support on land. Protection systems, health systems, welfare systems needed to be strengthened. Child protection systems across Europe were completely overwhelmed. Reports of children who were not fully accounted for in those systems were extremely concerning. Effective guardianship programs for children on the move were needed every step of the way.
In response to questions, Ms. Crowe said that children who were not fully accounted for risked exploitation and abuse. At the end of 2015, UNICEF and UNHCR had put out a joint statement calling for a much more predictable and unified response across all borders, so that those on the move would know what their rights were, and where they could go. Unaccompanied children were mainly adolescents, coming primarily from Syria, Afghanistan and Iraq. In certain countries, they were temporarily delayed and, getting frustrated, they tended to move on, as they did not want to be detained in centers. The processes needed to be faster, keeping the children’s best interests at heart, so that children were informed and asked about their needs and understanding of asylum procedures. Answering another question, Ms. Crowe clarified that UNICEF was waiting for the Greek government for a green light to operate fully in Greece - as of now, UNICEF was only present in Greece through its national committee, focusing on advocacy and awareness-raising.
Gathering accurate data across Europe was a challenge, as only Sweden, Germany, and to a certain extent, Austria, were fully collating data on children and young adolescents on the move. Those who were not accounted for were falling through the cracks because of weak child protection and monitoring systems. Some of them could be staying with family and not registered in the country they had gone to. In response to another question, Ms. Crowe said that UNICEF was trying to help governments, but that ultimately, it was the governments’ responsibility to have better figures and improve their protection systems.
She also said that there was no concrete evidence regarding violence experienced by children and women. The reunification rate for children lost in transit had been 100% so far, so there were no children who were definitively lost. The majority of unaccompanied children were adolescents, 15 to 17 years old. There was a great risk of trafficking, but so far there was only anecdotal evidence. UNICEF was emphasizing a need for much more effective guardianship programs. Children needed to be brought into the countries’ welfare systems, and there needed to be a much stronger plan across Europe of how to deal with these large numbers of children on the move.
Mediterranean migrants
Joel Millman, for the International Organization for Migration (IOM), stated that the total numbers of arrivals in Greece had topped 62,000 for January, which was much higher than in January 2015. Moreover, fatalities of migrants in the Mediterranean in the previous month had topped 360 due to a particular deadly final weekend of the month, when over a hundred men, women and children had died in the waters off Greece, Turkey and Italy.
In what was now the fourth year of the Mediterranean’s migrant emergency, children had been particularly vulnerable in January. IOM estimated that 60 children under the age of 18 had died on the eastern Mediterranean route over the course of the month, bringing to 330 the total number of minors drowning in those waters since the beginning of September. About 95 children had died in October and 82 in December.
IOM estimated that in 2015, 114,000 unaccompanied and accompanied minors had arrived on the eastern Mediterranean route, which was about one in seven of the 847,000 total. In 2016, almost 20,000 unaccompanied and accompanied minors had arrived on that route - about one in three of all migrants and refugees. In Italy in 2015, the numbers were about one in ten. For 2016, IOM was still preparing the breakdown, however, it seemed that especially on the eastern route, Turkey into Greece, the percentage of children had grown enormously.
In response to a question, Mr. Millman said that the numbers provided by IOM reflected mainly those arriving irregularly from either Africa or Turkey on boats. IOM was not aware of boats coming directly from Syria, however, Syrians arriving in the Greek Islands and Turkey were coming from Syria itself, from neighboring countries such as Turkey, and from refugee camps.
Mr. Millman also said that the resettlement of Syrians from Lebanon to Canada had passed 8,000, and mentioned a press note available in Press Room III on IOM helping Iraqi migrants voluntarily return home from Belgium and from the rest of Europe. He added that several Pacific citizens who had drifted for six weeks around Micronesia had been rescued and repatriated the previous day.
Zika virus
Regarding Zika, Christophe Boulierac for the United Nations Children’s Fund (UNICEF) said that UNICEF had to act fast to provide pregnant women with information on how to protect themselves and their babies. It was essential to engage with communities in Brazil on how to avoid mosquito bites and eliminate breeding sites, reminding them of protection measures. It was very important to engage people at the community level. UNICEF was launching an appeal for USD 9 million to limit the spread of the virus and mitigate its impact on newborns and their families in the region.
Mr. Boulierac specified that UNICEF wanted to promote simple measures to keep people safe: using insect repellent, covering as much of the body as possible with long, light-colored clothing, removing places where mosquitoes could breed, and putting screens on windows and doors. Pregnant women who thought they could have been exposed to the virus should seek professional care. More information would be available in an upcoming press release.
For the World Health Organization (WHO), Tarik Jasarevic reiterated that WHO had declared a public health emergency the previous day, regarding the cluster of microcephaly and other neurological disorders in relation to the Zika virus. He then introduced Dr. Antony Costello, Director, Maternal, Child and Adolescent Health, at the WHO, who reinforced the fact that the public health emergency would not have been declared for the Zika virus itself (which was a milder virus than dengue and chikungunya), but because of the apparent association with a surge in the number of cases of microcephaly. Microcephaly was a relatively rare condition – affecting between one in three thousand and one in five thousand. The causes were known to be associated with infections in early pregnancy, exposure to toxins and heavy metals, genetic conditions like Down Syndrome, and occasionally, malnutrition. Since 2015, the Zika virus had spread rapidly and had been detected in 25 countries. At the same time, there had been a surge in cases of microcephaly particularly in northeastern Brazil.
A key challenge was posed by the lack of a commercially available diagnostic test. Furthermore, the existing test only detected the virus when it was active, during a period of about five days. Also, microcephaly was not a simple diagnosis to make. Nearly 4,200 cases had been reported as suspect in Brazil, and were being looked at. The protocol for diagnosing microcephaly started with measuring the head of the baby at least one day after birth, and then certain cut-offs were being used, by comparison with international standards, to see if it was below a certain level. Out of the 4,200 cases, a significant proportion would probably be discarded because the head was small for another reason. Still, the surge was evident. In Brazil, the average over the past five years until now had been 163 cases per year. Today, the increase could be as much as ten-fold. During the 2015 outbreak in Polynesia there had also been reported cases of microcephaly.
Microcephaly could be responsible for a number of problems, from convulsions to learning disabilities. It could be very serious, with some people requiring lifelong care. However, there are occasional reports of people with confirmed microcephaly who have normal development. As Dr. Costello said in response to a journalist’s question, the outlook was not always bleak and it was important to be cautious. Generally, the condition was associated with a whole range of developmental problems, but it was necessary to look at the full spectrum of the children and conduct careful assessments.
Children were being screened very carefully, with multiple measurements, imaging, and looking for signs of any disturbance in terms of development milestones. The reason why it was a global concern was the worry was it could spread back into other areas of the world where the population may not be immune. The mosquitoes that carry Zika virus were present through most of Africa, parts of southern Europe, and many parts of Asia, particularly south Asia.
A global response unit had been set up, bringing together all people across WHO in Headquarters and in the regions, to prepare a formal response using the lessons learned during the Ebola crisis. WHO was calling a group of experts together to standardize the definition of microcephaly and ensure accurate measures in all parts of the world. An estimate of pre-Zika virus rates of microcephaly in low and middle income countries was necessary as well. Much more research was needed on the links between microcephaly and Zika virus, requiring the development of diagnostic tests. It was also necessary to develop good guidelines for women and health workers, in pregnancy, during childbirth and after birth, to give them the best possible advice. The WHO office in Latin America had been extremely active in linking with the Brazil Ministry of Health, and with all ministries, to help develop the laboratory testing, the surveillance systems, and the clinical management of suspected cases. The decision about deploying further people in Latin America and in other regions would be made soon.
In response to another question, Dr. Costello said that he would have to check how many microcephaly cases had been linked to Zika in French Polynesia. Mr. Jasarevic stated that he would come back to the press regarding the appearance of Zika in Thailand, and would share the list of countries that had reported cases.
Putting the health emergency in context, Dr. Costello reaffirmed that even though the Zika virus itself was not life-threatening, the complications of the illness could be potentially devastating for families. The potential for spread not just across Latin America, but into Africa and Asia, which had the highest birth rates in the world, was also a matter of public health concern, constituting an international emergency. Also, the tools for detecting the virus and for carrying out surveillance of this condition needed to be worked on urgently. There were still many unknowns about the virus.
Dr. Costello also clarified that the cut-off value for head circumference, below which a diagnosis of microcephaly would be issued, could change depending on how many false positives one was willing to accept. The definition for a screening test was different from the overall determination of microcephaly, which was also based on monitoring the head growth over the first few months, and a neuro-developmental assessment of babies, as well as imaging of babies’ brains. The goal today was to develop guidelines for standardized measurement and surveillance for all countries.
Regarding the possibility to pick up abnormalities in the brain of the fetus during ultrasounds, Dr. Costello confirmed that it was possible but that there was little access to skilled ultrasonography in many places. Also, any problems would be identified relatively late in the day and beyond the point when pregnancy termination would be allowed in many countries.
Dr. Costello said that WHO had a number of collaborating surveillance centers around the world, and wanted to set up more surveillance sites with partners, to collect as much data as possible, and identify patterns. The most important issue was the improvement of Zika virus diagnostics, to look more accurately at the populations where the virus had spread rapidly.
Vector control was a priority, and WHO focused on advising pregnant women to take all possible measures of protection against mosquito bites. Mass community engagement was needed, with the mobilization of women’s groups and of partners who could do a lot to control the vector: removing stagnant pools of water, getting rid of breeding sites, killing larvae, blocking off windows and doors. Mobilizing communities was a critical public health measure – a lesson learned from the Ebola crisis. Educating health workers and sharing information on risks and diagnostics was also key.
In response to another question, Dr. Costello said of the association between Zika virus and microcephaly that the approach today could be summarized as “guilty until proven innocent”. Twelve cases of microcephaly were known where Zika virus had been detected, but for the moment, circumstantial evidence was the most persuasive. The time it would take to establish a clear link would depend on how quickly diagnostic capabilities could be improved. Dr. Costello also underscored the importance of suitable surveillance systems, and support from WHO in lower income countries to set up sentinel sites. Finally, regarding the prospects for the development of a vaccine, Dr. Costello said that it may be years, not months away, and that diagnostics, which were also key, were generally developed more rapidly than vaccines.