Statement by Henrietta H. Fore, UNICEF Executive Director at the high-level side event on the ACT-Accelerator at the 75th session of UN General Assembly | ReliefWeb.
[News and Press Release] [Source: UNICEF] [Posted: 30 Sep 2020] [Originally Published: 30 Sep 2020] [Origin: View original]
"UNICEF is proud to be part of this historic initiative.
“Three decades ago, we led the universal child immunization initiative.
“Today, with our partners — and thanks to dedicated frontline workers and volunteers worldwide — we deliver nearly 2.5 billion doses of vaccines every year.
“We’ve built an incredible track record of scaling new vaccines for children.
“And most importantly — to your question — we understand the vital importance of preparing countries and communities for vaccines, on both the supply and demand sides.
“Delivery and acceptance go hand-in-hand.
“On the supply side, securing more than two billion doses of vaccine by 2021 will require every ounce of UNICEF’s strengths and expertise in market-shaping and strategic procurement.
“We’re working with WHO and local partners to help prepare governments to receive and deliver a COVID-19 vaccine.
“Even before the pandemic, with our friends at GAVI, we invested nearly $500 million in the last few years to strengthen cold chain infrastructure. Investments that will make it easier to deliver the COVID vaccine where it’s needed.
“But we also know that there are still gaps. So our Country Offices are now working with governments on an urgent basis to close these gaps on the ground.
“On the demand side, we must build confidence and trust in vaccines and in the health systems delivering them.
“The pandemic has brought to light the lingering challenges of mistrust, misinformation and rumours around vaccines — their safety and effectiveness.
“Our teams on the ground are reporting that baseless rumours about the COVID-19 vaccine are eroding trust in other vaccination programmes. In fact, some communities have rejected polio campaigns outright for fear of being subjected to COVID-19 vaccine trials.
“UNICEF has now activated our social mobilization networks for polio to build demand and enhance acceptance. And we’re working with our partners and communities to use social media and other tools to stamp-out rumours and misinformation.
“This work will also be vital as we deploy additional tools like therapeutics and diagnostics, and continue our work to re-build stronger health systems in the aftermath of COVID-19.
“But our success depends on all of us.
“To governments — help us prepare for the rollout of a vaccine in your countries, and keep other campaigns up-and running.
“To donors — help us give this work the funding it deserves, especially in countries that are suffering economically from the pandemic. They need our help.
“And to our partners — let’s keep up the good work and match the historic promise of this exciting initiative with an equally historic effort.”
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Pakistan: Lapses in the anti-polio drive | Editorial | Daily Times.
[SEPTEMBER 30, 2020]
Just whose fault is it that as many as 142,962 children were missed during the recent anti-polio drive in Khyber Pakhtunkhwa (KP) alone? And who should be held responsible for the near 50,000 parents that simply refused the vaccinations for one reason or another? It is, at the end of the day, the duty of the government to run the country effectively and make sure that lives and properties of all the citizens are safe at all times. Then why is it that Pakistan must always be one of the few countries, sometimes the only country, to continue to struggle against the polio virus while all others have been successful? Clearly the government has failed in its primary mission to educate people properly about the necessity of polio drops for their children and just what is at stake if baseless rumours dominate their thinking.
Observes speak of loopholes in the official campaign, lack of proper training, false rumours about the vaccine including one that children grow up to be impotent because of it, etc, as some of the main problems. There is also the popular assertion that said vaccine has nothing to do with polio but rather it is a tool of the enemies of our religion to harm the many Muslims of the country. That the government has been helpless to counter such nonsensical claims and also been unable to win the crucial war against polio speaks volumes about the ineffectiveness of its approach.
And the timing could not have been worse. Anti-polio operations had to be suspended for months due to the coronavirus pandemic but once they resumed there was the feeling that the fight against this deadly disease might finally be over soon. Sadly the truth that is emerging is rather different. The government will have to get its act together for the sake of the children and the country’s future. It also cannot go about with the stained reputation of having failed against polio, something that the entire world has overcome. The government must now move beyond its successes in controlling the spread of the coronavirus and do something about polio, which has a vaccine and every country in the world has used it successfully.
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Sudan: Humanitarian Key Messages (September 2020) | ReliefWeb.
[News and Press Release] [Source: OCHA] [Posted: 30 Sep 2020] [Originally Published: 30 Sep 2020]
IMPACT OF THE ECONOMIC CRISIS ON HUMANITARIAN NEEDS AND OPERATIONS.
The dire economic situation in Sudan, marked by soaring inflation, is compounding chronic underdevelopment and poverty, recurrent climate shocks, disease outbreaks, violence and conflict to generate rising humanitarian needs.
The average price of the local food basket increased by nearly 200 per cent compared to 2019, and the cost of health services increased by 90 per cent in 2020.
The deteriorating economic situation has hampered humanitarian operations, negatively impacting people’s access to essential services when they need it the most.
The dire economic situation in Sudan, marked by soaring inflation, is compounding chronic under-development and poverty, recurrent climate shocks, disease outbreaks, violence and conflict to generate rising humanitarian needs.
Inflation reached nearly 170 per cent in August, according to the Central Bureau of Statistics of Sudan, and the spike in prices and shortages of basic commodities, including fuel, food, medicine and hygiene products, is negatively affecting the most vulnerable, marginalized and impoverished people in the country.
The Sudanese Pound continues to depreciate rapidly, further eroding families’ purchasing power and ability to provide for themselves. In a country where 90 per cent of the families already spend around most of their incomes—some 65 per cent— on food, these additional shocks lead to increased hunger and less access to education, health and other essential services that families deprioritize as they try to cope with the economic hardship.
The average price of the local food basket increased by nearly 200 per cent compared to 2019, according to the World Food Programme (WFP). The inflation is pushing up prices of basic food, like sorghum, which is now 240 per cent higher than one year ago and more than 680 per cent higher than the five-year average. The stable food prices are expected to remain high at least until the production of the current season arrives at the markets in November 2020, further extending the current critical lean season that brought one of the highest levels of food insecurity reported in Sudan in the last decade.
Over 9.6 million people are severely food insecure at the peak of the lean season (June to September), according to the latest Integrated Food Security Phase Classification (IPC) report.
The deteriorating economic situation has hampered humanitarian operations, negatively impacting people’s access to essential services when they need it the most. UN agencies and humanitarian partners are facing important challenges to procure supplies, as the prices increase on a weekly basis. Contracts are being delayed, as the vendors’ offer often change before the process is finalized. Some humanitarian partners reported that they are now able to reach only one of every four people previously assisted, as the increased prices and delays in procurements drained their budgets. Fuel shortages have also affected timely transportation and delivery of aid, which could lead to fewer people being assisted by the end of the year.
Organizations providing cash-transfers to vulnerable families must constantly adjust the amount disbursed, impacting their limited budgets. Even with these adjustments, many families are no longer able to purchase everything they need with the cash received. As result, even people receiving assistance may have to resort to negative copying mechanisms to survive.
During 2020, the cost of health services increased by 90 per cent and, according to National Medical Supply Fund, only 57 per cent of essential emergency were available by September. The arrival of COVID-19 has exacerbated these challenges, resulting in a dramatic drop in health services coverage, including immunization programmes, treatments for malnutrition or maternal care. Underfunding led to a reduction of nearly 20 per cent of measles vaccinations across the country and around 10 per cent of the Penta 3 vaccine, which protects children against tetanus, diphtheria and polio. The low immunization is one of drivers of the vaccine-derived polio outbreak affecting Sudan, caused by low levels of immunization of children under age 5.
The urgent national immunization campaign to stop the ongoing vaccine-derived polio outbreak is facing challenges due to high fuel prices and availability of vehicles. The response to the outbreak must include vaccinating every child under age 5 in the country with oral polio vaccine to stop transmission. The overall cost for the first round of the campaign to reach the nearly 9 million children targeted by the campaign is now estimated in around US$10 million. More than $5.3 million will be needed for transport costs alone, based on the official exchange rates, which is used for humanitarian operations. With the extremely limited funding available, any further increase in costs would impact the Government and humanitarians’ capacity to carry out the exercise.
The economic situation, compounded by the historic flooding affecting over 830,000 people in all Sudan’s states, have also impacted access to water, hygiene, sanitation (WASH) and health services, increasing risk of communicable disease.
Humanitarians are reporting major challenges as they rush to repair thousands of water points and latrines damaged during the rainy season. According to WASH partners, the prices of locally-procured supplies have increased by 300 to 400 per cent, and, in some cases, the services had to be stopped.
The situation is expected to further deteriorate over the coming months, increasing the number of people who need assistance and hampering humanitarian’s capacity to respond. The gradual reduction of fuel subsidies planned by the Government is likely to push inflation further up and negatively impact vulnerable families, as well as increase costs of humanitarian assistance.
UN Office for the Coordination of Humanitarian Affairs
To learn more about OCHA's activities, please visit https://www.unocha.org/.
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Adolf Ratzka: National Personal Assistance Policies – what we need and how to work for it | European Network on Independent Living - ENIL.
On 14 September we organised an online members’ meeting. Adolf Ratzka, a pioneer of the Independent Living Movement in Europe, gave a great speech on how to effectively advocate for PA legislation. It is already mentioned in the respective article, but we decided to publish it also separately because of the high interest of people. You can read it below:
“We need to work for national personal assistance policies in our countries. What features must they contain in order to empower us, and how can we work for such policies?
First, what do we expect from such a policy? What can personal assistance do for our lives? There are many examples of how assistance users have managed to live with the help of their assistants but here is my story.
In 1961, at the age of 17, I contracted Polio. As a result, I have been using a ventilator, an electric wheelchair, and increasing assistance with the activities of daily living ever since. In 1966, after five years in a hospital, a scholarship enabled me to move from the hospital ward in Munich, Germany to a dormitory room at the University of California in Los Angeles.
The transition from patient to student was made possible by the scholarship that not only covered my expenses as a student but also contained direct payments for personal assistance. With that money, I hired, trained, paid, scheduled, and supervised fellow students as my assistants. I was able to pay them competitive wages, i.e. wages that they would have earned for working on campus at the libraries or cafeterias. They assisted me with everything I needed to concentrate on my studies and to enjoy life as a young adult living by myself for the first time. I had to learn to express my needs, had to learn to be the boss. That was difficult and I made many mistakes. But my mistakes have been valuable lessons.
In 1973, I moved to Sweden to work on my dissertation. Again, I hired people there as personal assistants. With their help, after completing my academic training, I worked as a researcher at the university.
Throughout the years, I must have employed hundreds of students, immigrants, and people between jobs to work for me. They not only enabled me to study and work but also to live the way I wanted, with a rich social life, with many interests, romantic relationships, with travel for work and pleasure. With their help, I became involved in disability work nationally and internationally. I founded several organizations, traveled and lectured widely, was recruited for research positions overseas, and headed international projects.
Personal assistance was also the key for me to getting married. My wife and I were confident that, with the help of my assistants, I not only would take care of myself, independently of my wife, but could also share household chores and work around the house, on an equal basis. (That was the plan but it has not always worked out that way, I’m ashamed to admit.) My wife would not be my life-long, unpaid nurse. We wanted a relationship where we both, independently of each other, could develop and grow, pursue our interests, and have a meaningful career. For example, we both traveled in our work to meetings and conferences in Sweden and abroad. When we did travel together it was because we choose to so and not because I needed her as an assistant. The decision to have a child was also based on my personal assistance. My assistants would enable me to have an active part in raising and being close to my child. For instance, as a small child my daughter and I went shopping for groceries or fishing. My assistant would stay behind us and only interfere to prevent an accident.
The Swedish social security system pays me a monthly amount of money for which I employ seven part-time assistants to provide me with 18 hours of personal assistance a day. I can pay competitive wages. With that money, I have been able to live in the community despite my extensive disability. I am a profoundly ordinary person. There is nothing special about me, I have no exceptional gifts or talents. Many, many people in my situation could have equally fulfilling lives. What is special about me is that I have had personal assistance throughout my entire adult life. That is, sad to say, very special. In countries without personal assistance services – that is, in most parts of the world – I would not have had any self-determination. With only help from my family, I would have been very limited. In a residential institution, I probably would have died decades ago.
From my experience with personal assistance since 1966, I conclude that a personal assistance policy that is to enable you to live with the same choices and conditions as your non-disabled brothers and sisters, friends and neighbors must meet three main conditions.
[Continue reading in source article]
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Field investigation and response to a vaccine-derived poliovirus pre-tOPV switch in Southwest Nigeria, October 2015 | Pan African Medical Journal | PubMed Central.
[Open Access] [Published online 2020 Sep 2]
A vaccine-derived poliovirus (VDPV) was isolated in an acute flaccid paralysis (AFP) case reported from Ile-Ife, in Osun state, Southwest Nigeria. We investigated the epidemiological characteristics of the polio event and described the immediate public health response that followed. We interviewed the primary caregiver of the case and conducted active case searches for additional AFP cases in the communities in Ife East Local Government Area (LGA) of Osun state. Stool samples of contacts and non-contacts were collected and sent for laboratory investigation. A public health response with mass supplementary immunization in the affected areas followed immediately in the ward the case was located in October 2015. Also, we reviewed the administrative record of the oral polio vaccine (OPV) coverage in the LGA in the previous four years. The VDPV case was a female, one-month-old child with adequate vaccination history for her age. However, the environment of the child was relatively filthy with inappropriate facilities. Laboratory reports from contact samples were negative for VDPV or any polio isolates. A missed AFP case was found from active case searches and a high proportion of under-five children was immunized with tOPV. The OPV3 administrative coverage in the LGA peaked in 2014 (103%) and dropped in 2015 (67%). Efforts directed toward improving environmental hygiene in households and improving OPV coverage in subsequent routine and supplementary immunization are suggested.
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UK: England: Britain’s Preparing For A Second Wave. But Shielders Like Me Are Being Left Behind | The Huffington Post.
[28/09/2020] Jenni Elbourne writes:
I never really stopped shielding, but Boris Johnson simply saying ‘you do not need to shield’ feels like another way of saying ‘we’re not going to protect you.’
The country is coming to terms with the real threat of a ‘second wave’ and adapting to the latest government guidelines. For thousands of people like me who are clinically extremely vulnerable to coronavirus, it marks the beginning of a new and even more difficult phase in our national crisis.
A year ago, as a healthy 33-year-old I could never have imagined what the universe had in store for me. First, I was diagnosed with leukaemia and spent the autumn having intensive chemotherapy. Then in February I learned I would need a stem cell transplant, around the same time as the first few cases of Covid-19 were confirmed in the UK. I spent March in hospital having my failing immune system completely wiped out by radiotherapy, and had my lifesaving transplant on the day the WHO declared a global pandemic. Getting home after weeks in isolation should have been a relief, but with the virus killing hundreds of people every day, it was obvious my recovery wasn’t going to be how I’d imagined it.
I was advised to shield from the beginning of lockdown until 1 August, when shielding officially stopped in England. This advice has not changed or been broken down according to medical conditions, despite research showing that people with blood cancer are at higher risk of becoming seriously ill from coronavirus than almost any other condition. Personally I’ve continued to limit my activities to hospital visits and country walks, because I can’t bear the thought of catching the virus now, after all the sacrifices I’ve already made just to be alive.
I’ve not been to the pub since Christmas, so I don’t have much sympathy for anyone who’s complaining about a 10pm curfew.
As for the guidelines that were issued, the vast majority have no bearing on my life right now. I’ve not been to the pub since Christmas, so I don’t have much sympathy for anyone who’s complaining about a 10pm curfew, or only being allowed to meet five of their friends there.
Where work is concerned, the government made a u-turn on their previous advice to go back to the office, and now say everyone should work from home ‘if they can.’ I welcome this as a way to reduce the spread of the virus, but it is of little comfort to people who are clinically vulnerable and have jobs that can’t be done remotely. We need the legal right to work from home, or a specific furlough scheme to cover jobs where that’s not possible. In my own case, having previously been self-employed in an industry that’s no longer functioning, I’m looking for a job but it feels difficult to justify my work-from-home requirement when the official guidance says that I ‘do not need to shield.’
Because of my leukaemia I haven’t worked for a year, and I’m likely to continue suffering financially for as long as coronavirus is a part of all our lives. This is on top of the huge emotional burden of going through cancer treatment, cutting myself off from loved ones and dealing with the overwhelming uncertainty of simply being alive at this moment in history. I actually feel strangely glad not to have a job to go back to; if I did, I might have the added anxiety of having to choose between my income and my health.
It may seem like there are no good options at the moment, but I am sure that choosing to protect the most vulnerable in our society is the right thing to do.
I am as devastated as everyone else about the impact of Covid on jobs and the decimation of entire industries, but I know that if the country were to carry on as normal, I’d be fearing for my life this winter. I feel grateful every day to those who are making sacrifices to protect me and other high-risk individuals. It may seem like there are no good options at the moment, but I am sure that choosing to protect the most vulnerable in our society is the right thing to do. While I welcome this week’s new restrictions, the government must also commit to extending furlough and other support schemes (with specific considerations for working-age shielders) if the population as a whole is to get on board with the enormous sacrifices being demanded of them.
People who were shielded during the peak of this crisis were both legally protected and financially supported. Shielding was advice, not the law, but it meant that we didn’t have to go out to work, and we were able to request free food parcels. Now despite the increasing case numbers and the tightening of restrictions, nothing is being done for those who are most vulnerable to the virus. ‘You do not need to shield’ feels to me like another way of saying ‘we’re not going to protect or support you.’ The potential consequences of this are catastrophic.
Jenni Elbourne is a freelance writer.
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Pakistan: Karachi: Anti-polio drive achieves 94% of target | The Express Tribune.
[September 29, 2020] [APP]
The anti-polio campaign carried out in the city over the past week had achieved over 94 per cent of its set target, claimed Karachi Commissioner Sohail Rajput on Monday. The campaign, which began on September 21 and ended on September 28, achieved 9 per cent more of the set goal as compared to the drive conducted last month, revealed a report prepared by the anti-polio task force. As many as 1.7 million children under the age of five years were administered oral polio vaccines in different parts of the city, he shared. Moreover, around 287,739 children were administered the vaccination in the high-risk union councils, 15 per cent more than in the previous campaign in these UCs. Rajput announced that a three-day anti-polio drive would soon be launched for children who were not immunised during this campaign.
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Eradicating polio from Pakistan: Multiple doses of vaccine needed to ensure immunity, say experts | DAWN.
[28 Sep 2020] Shahzeb Ahmed writes:
In 2017, Pakistan was on the brink of declaring victory against the polio virus. That year, the country, one of the last bastions of the virus in the world, had reported its lowest number of cases in almost three decades.
Three years down the line, health authorities — both local and international — are scratching their heads over how to mitigate the crisis. In the current year so far, the country has reported 72 polio virus cases — a far cry from the eight reported in 2017. The preceding year was even worse, when 134 cases were reported in 2019, sounding alarm bells across the world.
According to the Pakistan Polio Eradication Programme (PPEP), “conflict, political instability, hard-to-reach populations, and poor infrastructure continue to pose challenges to eradicating the disease”.
At the same time, the refusal cases have done tremendous damage. Over the years, various conspiracy theories have been floated with regards to the polio vaccine, ranging from “it causes impotency” to “it is a conspiracy of the West”.
While the PPEP has made a lot of effort to dispel the rumours and raise awareness on the importance of getting children vaccinated, the number of refusals remains alarmingly high. Earlier this year, for example, a health official told Dawn that there were 38,000 refusal cases in January which rose to 51,000 in February in Peshawar district, one of the virus reservoirs in the country.
Why frequent vaccination campaigns are important.
In this case, the official attributed the rise in refusal cases to frequent vaccination campaigns. However, frequent vaccination campaigns are organised because children require a certain minimum number doses of the oral poliovirus vaccine (OPV) to ensure their adequate protection against the disease.
Child specialist Dr Iqbal Memon says that in a country like Pakistan “15 or more [doses of OPV] are considered adequate protection”.
The OPV, explains Dr Memon, is cheaper, widely available and easier to administer, hence it is recommended for use in developing countries. “Given multiple times … it leads to better control against wild polio virus in sewage as well,” he says. The only challenge to its delivery is ensuring that the cold chain supply is maintained.
In contrast, says Dr Memon, the inactivated poliovirus vaccine (IPV) must be administered intravenously, which is a challenge because it must be done through trained hands. It is also more expensive and much harder to procure. In the case of IPVs however, a couple of doses are enough to ensure immunity.
“In Pakistan, we need both [OPV and IPV],” says Dr Memon. “Hence both are part of Pakistan's essential immunisation programme. Ideally, if IPV is available, two doses along with an OPV course would be appropriate,” he explains.
According to Dr Ali Faisal Saleem, an infectious diseases expert at the Children's Hospital at Aga Khan University Hospital, "OPVs are administered as oral drops, which boost the child's immunity and are hence more important in a country like Pakistan, where the polio virus is still prevalent." The IPV, on the other hand, aids the OPV in such cases, says Dr Saleem. He adds that without the OPV, the IPV dose would be ineffective.
Safe for newborns.
Asked if the vaccines are safe to be administered to newborns, Dr Memon says there were no known side effects and that it is safe to administer multiple doses of OPV even to newborns.
Dr Saleem agrees, saying, "OPV is administered to all newborns in Pakistan at the time of birth. That is called dose zero. Thereafter, the vaccine is given to children at six weeks, 10 weeks and 14 weeks, after which they can be administered the vaccine every time there is a routine immunisation campaign." It is completely safe to administer as many doses of OPV as possible, he reiterates.
Stressing the importance of the vaccine further, Dr Saleem points out that globally, polio has been eradicated from almost all countries through the OPV. "In Pakistan too, all children are supposed to be administered the OPV as part of their routine immunisation at birth."
Can the vaccine be administered on a sick child?
To another question whether the vaccines were safe to be administered to a child who may be otherwise unwell, Dr Memon advises that in cases of mild illnesses, there is no issue with administering the vaccine.
However, he advises that if a child is sick enough to be admitted to a hospital, then it is recommended that the vaccine be administered once the child has recovered enough to no longer require hospitalisation .
With Nigeria having been declared polio-free last month, Pakistan and Afghanistan remain the only two countries that still have the disease.
The world’s eyes are focused on Pakistan and as are our health authorities in efforts to eradicate the virus. Now it's up to the parents and society as a whole to cooperate and encourage a culture of getting children vaccinated not only against polio but against all other vaccine-preventable diseases that can impact them.
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