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WHO's Response in Liberia and Ukraine

This presentation discusses the World Health Organization's response to the Ebola outbreak in Liberia and the UN's presence in Ukraine. It highlights the role of WHO in providing support and implementing strategies to combat the health crisis. The presentation also addresses the need for reform within WHO to better respond to future emergencies.

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WHO's Response in Liberia and Ukraine

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  1. Global Health International Advisors - GHIA September 29, 2015 Presentation: World Health Organization in Liberia and Ukraine Michael Boorstein Sources of information are from public web sites from WHO and other public sources. Views expressed are my own

  2. The United Nations in Liberia 15 UN Agencies in Liberia: FAO ILO OHCHR UNAIDS UNDP UNESCO UNFPA UNHCR UNICEF UNIFEM UNMIL UNOPS WFP WHO World Bank The United Nations in Liberia

  3. WHO in Liberia The Ebola Response March – June 2015

  4. WHO COUNTRY OFFICE, LIBERIA • Pre-Ebola – 25 Liberian National, 5 International Staff • Ebola Response – 175 staff, mostly international, mostly consultants • Skill sets – • Community Engagement, including mental health, psychosocial, and anthropology • Surveillance • Laboratory • Contact tracing • Case Management • Epidemiology • Logistics • Safe and Dignified Burials/Dead Body Management • Core Services – budget and finance, administration, procurement • Awards management and external relations – outreach to Partners The WHO Country Office in Liberia

  5. Terms of Reference: Special Advisor to the WR for External Relations and Awards’ Management:1. Awards’ Management – develop a system to track financial and technical reporting requirements – 50 %2. Core Services: Advise the WR on provision of administrative services for operations and to support to Ebola-related staff: HR, Budget and Finance, Procurement, Logistics, Security and Accommodations – 25 %3. Advise on strategic planning related to Ebola response for current and future requirements – 10 %4. Advise on management information systems to support the Ebola response internally and externally with partners and the Government of Liberia – 15 %

  6. FUNDING SOURCES FOR EBOLA RESPONSE 2013-2015: $82 Million in Extra Budgetary Funds for the Ebola Response Top Donors: USAID, The World Bank, The African Development Bank and the UN Multi-Donor Trust Fund (UNDP serves as the Secretariat for this pooled fund) (Note: Additional funding from other sources during the outbreak, managed by WHO and other entities, is not included in this figure. Main sources were CDC and the US Department of Defense, other governments and other UN agencies. Additional funding was not finalized as of June 2015 that will be used by WHO and its partners on health recovery, health infrastructure improvements and capacity building.)

  7. African Region of WHO • Definition: The Transformation Agenda for the WHO Secretariat in the African Region or “The Transformational Agenda” Link • A vision and a strategy for change aimed at enhancing the performance of the WHO Secretariat in support of its Member States towards improved health outcomes. • Objective • To develop the WHO secretariat in the African region into an appropriately resourced and equipped regional health organisation that is foresighted, proactive, responsive, results-driven, transparent and accountable; an organization that is a clear leader in health in the Region and meets the needs and expectations of its stakeholders • Contents • Strategic Focus Areas • Expected Results • Strategic Actions

  8. WHO HEADQUARTERS AND EBOLA RESPONSE WHO’s response to Ebola has been widely criticized • Too slow to react, inadequate structure and resources to address emergency of this magnitude; World Health Assembly mandated WHO to develop structure to increase capacity to deal with future emergencies Ebola Situation Report 7 October 2015 (update since presentation on 29 September 2015)Link • Background and Path Forward for Ebola Response • WHO Strategic Response Plan, West Africa Ebola Outbreak Link • Report of the Ebola Interim Assessment Panel Link • WHO Secretariat Response to the Report of the Ebola Interim Assessment Panel Link • Ebola Response Phase 3 Link • Path Forward • Advisory Group on Reform of WHO’s Work in Outbreaks and Emergencies with Health and Humanitarian Consequences Link • Roadmap for Reform of WHO’s Work in Emergencies Link

  9. UNITED NATIONS PRESENCE IN UKRAINE • About UN in Ukraine • The United Nations Country Team (UNCT) in Ukraine is composed of representatives of 16 UN funds and programmes, specialized agencies and other UN entities accredited to Ukraine as well as representatives of the Bretton Woods institutions. • Areas of cooperation and partnership between the UN system and the Government of Ukraine were most recently outlined in the Partnership Framework (PF) for 2012-2016, the common strategic planning basis for UN development operations and assistance at country level. It is a collective, coherent, and integrated response by the United Nations to national priorities as encompassed in key national documents. The PF has been shaped by a human rights-based approach, which is focused on strengthening the capacity of the Government and civil society to advance the human rights and rule of law agenda, as well as social and economic development in Ukraine. The PF period coincides with the last five-year period of the MDGs and identified PF priorities reflect the aspirations of the Millennium Declaration and Millennium Development Goals. • Responding to the challenges created by recent developments in the country, the UN in Ukraine is working in three directions simultaneously, in short, medium and long-term programs: • - Humanitarian Response, including for conflict-affected regions and for internally-displaced persons (IDPs); • - Recovery, stabilization and rehabilitation for the East and other regions;  • - Supporting longer-term country-wide governance reforms to promote the rule of law and strengthen social stability and democratic governance. • All members of the United Nations system in Ukraine - the IAEA, IFC, ILO, IOM, UNAIDS, UNDP, UNICEF, UNFPA, UNHCR, UNOCHA, UNODC, UNV, UN Women, WFP, WHO, and the World Bank - are united by one collective vision and approach which aims to better meet the needs of the population, including the new and more demanding humanitarian, socioeconomic, governance, security and political needs in the short, medium and long-term. • Building on the UN’s uninterrupted assistance to Ukraine during its first two decades of transition following independence, the UN has scaled up a range of activities to ensure that it not only brings added value to the Government but also makes a difference in the lives of the people in Ukraine.

  10. UN Agencies in Ukraine

  11. UKRAINE – WHO COUNTRY OFFICE • WHO Country Office Link • The role of a WHO/Europe country office is to respond to requests from the host country to support policy-making for sustainable health development, taking a holistic health-system approach. This includes providing guidance, building up local relationships to implement technical cooperation, making standards and agreements, and ensuring that public health measures are coordinated and in place during crises. • The WHO Country Office, Ukraine was established in June 1994 in Kyiv to maintain effective link between WHO/Europe and Ukraine and to help in development of the effective international cooperation in the field of health with widespread involvement of the international community. • The Office is the focal point for WHO activities in Ukraine. The country team consists of 25 people, including 15 experts on: HIV/AIDS, immunization and vaccine preventable diseases, maternal and child health, noncommunicable diseases, tobacco control, tuberculosis, communications and IT. • The priorities for the Country Office are set out in the biennial collaborative agreement between WHO/Europe and the host country. The Office implements the agreement in close collaboration with national institutions and international partner agencies.

  12. Alexander Kvitashvili, Minister of Health of Ukraine, and Dorit Nitzan, WHO Representative in Ukraine spoke at a press conference about the polio cases in Ukraine on 1 September 2015

  13. POLIO OUTBREAK IN UKRAINE • Circulating vaccine-derived poliovirus type 1 confirmed in Ukraine • On 28 August 2015, the WHO Regional Office for Europe was notified of two confirmed cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) in Ukraine. The two cases have a genetic similarity, which indicates that active transmission of cVDPV1 is ongoing. WHO and UNICEF are supporting the Ministry of Health of Ukraine in conducting an urgent, robust response. • The strain was isolated from two children in Zakarpatskaya oblast, in south-western Ukraine. One child was 4 years old and the other 10 months old at the time of onset of paralysis; neither had been vaccinated against polio. • Circulation of cVDPV occurred because of the low immunization coverage in Ukraine since 2008. In 2014, only 49% of children were fully vaccinated against polio. Currently, the rate of vaccination against polio among children under 1 year old is only 14.1%, because of a shortage of vaccine.  • WHO and UNICEF are providing the Ministry of Health with both technical and on-site support in planning and implementing large-scale supplementary immunization activities with oral polio vaccine (OPV) to rapidly stop circulation of the virus. OPV is the most effective vaccine for stopping the spread of poliovirus and ensuring collective immunity.  • WHO recommends that all countries, in particular those from which there is frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for cases of acute flaccid paralysis and maintain high routine immunization coverage. All travellers to polio-affected areas should be fully vaccinated against polio.

  14. Emergency Response Needs in Ukraine • Ukraine, as a country of 45 million people, has a land area slightly smaller than Texas • The unrest in eastern Ukraine has caused a significant number of internally displaced persons who are in need of medical attention and with other needs similar to refugees. • The health needs of the internally displaced people, as well as the recent Polio outbreak are placing a tremendous burden on WHO’s Country Office. • Many similarities on the fast-changing needs of the Ukraine CO to that of the Ebola countries in West Africa, based on discussions with the WR. • A major challenge for the EURO Office of WHO.

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