According to a new report by the Food and Agriculture Organization (FAO) and the World Food Programme (WFP), South Sudan and Yemen, two of the world’s biggest ongoing food insecurity emergencies, are being joined by Nigeria’s North East and Burkina Faso in West Africa’s Sahel region, with conditions edging closer to famine.
The report, ‘FAO-WFP early warning analysis of acute food insecurity hotspots’, published on Friday, outlines a toxic combination of conflict, economic decline, climate extremes and the COVID-19 pandemic, that is driving millions further into the emergency phase of food insecurity.
People in the four hotspots of highest concern are already experiencing a critical hunger situation, with the report warning that escalations in conflict, as well as reductions in humanitarian access, risk the onset of famine.
The FAO-WFP report says these four countries are far from being the only red flag on a world map that shows acute food insecurity levels reaching new highs globally, driven by a combination of factors. Another 16 countries are at high risk of rising levels of acute hunger.
The report calls for urgent action to avert a major emergency, or series of emergencies, in the next 3 to 6 months, WFP has said in a statement.
Urgent action today
“This report is a clear call to urgent action”, said Dominique Burgeon, FAO’s Director of Emergencies and Resilience. He expressed deep concern about the combined impact of several crises which, he said, “are eroding people’s ability to produce and access food, leaving them more and more at risk of the most extreme hunger”.
Burgeon stressed the need to access these populations “to ensure they have food and the means to produce food and improve their livelihoods to prevent a worst-case scenario”.
Catastrophe, or famine, is the most severe of five phases used by the Integrated Phase Classification (IPC) system to chart escalating degrees of food insecurity.
Margot van der Velden, WFP’s Director of Emergencies, said, “We are at a catastrophic turning point”. “When we declare a famine it means many lives have already been lost. If we wait to find that out for sure, people are already dead”.
Another Somalia of 2017?
Comparing the situation in the critical countries to that of Somalia in 2011 when 260,000 people died, she said, “We cannot let this happen again. “We have a stark choice — urgent action today, or unconscionable loss of life tomorrow.”
The FAO-WFP report points to a total of 20 countries and contexts that are at “further risk of deterioration of acute food insecurity”. The key drivers of hunger include expansion and intensification of violence, economic crises exacerbated by COVID-19 socioeconomic impact, weather extremes, transboundary threats such as desert locusts and a lack of humanitarian access. (Source: FAO-WFP)
Pope Francis has donated a pectoral cross to the International Crucifix Museum in the Sicilian town of Caltagirone. The Museum was opened this year on 14 September, the feast of the Triumph of the Cross.
The Pope’s gift will be presented by the Bishop of Caltagirone, Calogero Peri. After celebrating the Mass for First Friday, Bishop Peri will entrust the pectoral cross to Father Enzo Mangano, the founder of the Museum.
The idea for a museum dedicated to making the spirituality of the Crucifix better known came to Fr Mangano during Lent, as he reflected upon the Covid-19 pandemic and its consequences. Father Mangano then appealed to friends and artists to donate works of art and other memorabilia focused on the Passion of Jesus.
Pope Francis responded to the call by means of a letter, signed by the Substitute of the Secretariat of State, in which the faithful and pilgrims to the ancient Sanctuary of the Passion are encouraged “to adhere ever more intensely to Christ, the Way, the Truth, and the Life.”
Crucifix donated by Bishop Calogero Peri
Meditating upon the Crucifix
The International Museum of the Crucifix of Caltagirone is dedicated to Bishop Peri, who was one of the first to donate a crucifix: a small reproduction of a San Damiano Cross found in the hospital room where the prelate was being treated for the coronavirus. During his illness, Bishop Peri said, the crucifix was a point of reference for his questions and prayers. When he was finally discharged, Peri asked to take the crucifix with him; he later decided to donate it to the Museum as a sign of gratitude to God for his recovery.
More than 150 works are already on display at the Museum, which is housed in the Sanctuary of Santissimo Crocifisso del Soccorso. The shrine is dedicated to a crucifix found in 1708 by a local farmer on the site of the Church of the Madonna del Succorso (Our Lady of Succour), which had been destroyed in an earthquake 15 years earlier.
New WHO analysis finds that out-of-pocket payments for health are a major source of financial hardship for people in Albania. Around 8% of households are pushed into poverty or further impoverished after paying out of pocket and 12% experience catastrophic health spending. The financial hardship caused by out-of-pocket payments is heavily concentrated among poorer parts of the population and is increasingly driven by household spending on outpatient medicines.
A large gap in population coverage and heavy co-payments undermine financial protection
Entitlement to most publicly financed health care in Albania is linked to payment of contributions to the mandatory health insurance fund. This makes it difficult to cover the whole population in the context of a large informal sector. As a result, about a third of the population is uninsured and must pay for almost all health services out of pocket. This is just one reason why financial protection is weak and levels of unmet need for health and dental care are high. The Government of Albania has taken steps to improve access to primary care for uninsured people, offering them free annual check-ups in 2015 and free visits to general practitioners in 2017. These measures are welcome, but do not address other important gaps in coverage.
Uninsured people pay the full cost of diagnostic tests, medicines and non-emergency specialist care, while those who are insured pay co-payments of up to 50% of the reference price for outpatient-prescribed medicines. Although pensioners and disabled people are exempt from these co-payments, there are no exemptions specifically targeting low-income people or most people with chronic conditions; nor is there an annual cap on co-payments. During the period under analysis, out-of-pocket payments for outpatient medicines grew from 53% to 76% of all household spending on health.
Everyone in Albania should have access to needed health services, regardless of health insurance status
Poor households in Albania are at high risk of being uninsured, facing financial barriers to access and experiencing catastrophic health spending. Because of this, steps to reduce unmet need and financial hardship must prioritize people in poverty. Three protective measures are key. First, de-linking entitlement to health insurance from payment of contributions, so that the mandatory health insurance fund automatically covers everyone. Collecting contributions is a tax not health policy responsibility. Second, exempting low-income people and people with chronic conditions from co-payments, including co-payments for outpatient medicines. And third, increasing public investment in the health system, so that the priority Albania gives to health when allocating government spending is no longer among the lowest in Europe.
WHO supports countries to move towards universal health coverage – leaving no one behind
Financial protection is at the heart of universal health coverage, which means that everyone can use the quality health services they need without financial hardship. Linked to WHO’s General Programme of Work, the European Programme of Work places universal health coverage at the core of the WHO Regional Office for Europe’s work. Through the WHO Barcelona Office for Health Systems Strengthening, the Regional Office undertakes context-specific monitoring of financial protection in over 30 countries, including Albania.
The Barcelona Office also provides tailored technical assistance to countries to reduce unmet need and financial hardship by identifying and addressing gaps in coverage.
The European Securities and Markets Authority (ESMA), the EU’s securities markets regulator, has today updated its Questions and Answers on the implementation of investor protection topics under the Market in Financial Instruments Directive and Regulation (MiFID II/ MiFIR).
The Q&As on MiFID II and MiFIR investor protection and intermediaries’ topics includes three new Q&As on ‘product governance’ that aim to give guidance on how firms manufacturing financial instruments should ensure that:
financial instruments’ costs and charges are compatible with the needs, objectives and characteristics of the target market;
costs and charges do not undermine the financial instrument’s return expectations;
the charging structure of the financial instrument is appropriately transparent for the target market, ensuring that it does not disguise charges or is too complex to understand.
The purpose of the MiFID II/MiFIR investor protection Q&As is to promote common supervisory approaches and practices in the application of MiFID II and MiFIR.
ESMA will continue to develop this Q&A document on investor protection topics under MiFID II and MiFIR, both adding questions and answers to the topics already covered and introducing new sections for other MiFID II investor protection areas not yet addressed in this Q&A document.
Each euro invested in cancer treatment is a step closer to patients’ health, so Europe should not cut corners and leave patients alone in their fight, centre-right MEP Bartosz Arłukowicz told EURACTIV in an interview.
In this regard, the reduction of the EU4Health programme could, for example, hamper the joint purchases of deficient oncological drugs. “EU4Health could help us fight with the shortages of medicines overall, so its worth cannot be overstated,” he said.
Bartosz Arłukowicz is a former health minister of Poland and the incumbent chair of the European Parliament’s special committee on Beating Cancer (BECA).
In your first speech at the BECA committee, you said that citizens have high expectations of the committee. What outcome would you be satisfied with at the end of these 12 months of work?
I will be pleased if we can work out a final document in which we will suggest, as a committee, common standards of cancer treatment for the entire European Union.
Let’s make an example: access to cancer prophylaxis. There is no reason why women in Eastern Europe should have worse access to mammography or cytology than women in the West.
We cannot have a situation where a patient needs to wait many weeks for a full diagnosis in one country while in another one it can be done in a shorter time
Every country in the EU has something that has worked well in the past and it still works well. Our task is to collect all the good solutions and practices in cooperation with patients, doctors and health care managers and, in the end, create this conclusive document
So, do you think there is an East-West divide in cancer treatment in Europe?
There are certainly differences in access to treatment methods or modern drug technologies. On the other hand, when I was the Minister of Health in Poland, I introduced the so-called oncology package, the main assumption of which was a fast oncological path.
In a nutshell, this programme funds oncological treatments without limits, provided that the diagnosis and the beginning of treatments will take place within a strictly defined timeframe. This solution, despite the initial harsh criticism, has been successfully used in Poland to this day.
As you can see, it is also not the case that countries in this part of Europe do nothing about cancer treatment. We also have a lot to be proud of.
In her state of the union address, Commission President Ursula von der Leyen did not mention cancer at all. Is cancer still a top health priority for the EU, or do you feel that the COVID crisis has drawn all the attention away from it in the past few months?
I am convinced that cancer has been and continues to be a priority. The creation of the BECA committee is the best proof of this. Of course, COVID has changed a lot of plans, but the committee I am honoured to chair has just started its work and we are not going to slow down.
I am also sure that cancer, as a challenge facing all of Europe, has not disappeared from President von der Leyen’s sight. I can assure you that, with my activity, I will do everything to ensure that this topic remains high on the agenda.
President Von der Leyen also re-launched the idea of rethinking health competences, which are currently in the hands of member states. Do you think the EU should have greater responsibility for public health, perhaps starting with cancer?
If the EU has been able to successfully conduct, for example, the Common Agricultural Policy (CAP) for years, I see no reason why the same should not apply to public health or, more broadly, health protection. The COVID-19 pandemic has clearly shown that member states will not be able to cope with such challenges alone. We must be brave and establish that health issues have to be a matter for the EU institutions to a greater extent than before.
But what are your expectations for the Commission’s Beating Cancer Plan?
I am counting primarily on working out good solutions that will serve patients. The European Commission has the tools to develop, for example, mechanisms of financial support for member states in the fight against cancer. We should not make savings on healthcare and leave patients alone in their fight against cancer. Each euro invested in cancer treatment is a step closer to patients’ health.
However, the Council has proposed heavy cuts for health, and the initially ambitious EU4Health programme embedded in the recovery fund has almost disappeared.
This would be very bad news for patients all over Europe. I am an ardent supporter of the creation of this fund as I hope it will lead to joint purchases of deficient oncological drugs and thus protect the entire EU population which requires this kind of medical treatments. EU4Health could help us fighting with the shortages of medicines overall, so its worth cannot be overstated.
In her first State of the Union speech, European Commission President Ursula von der Leyen highlighted the need to build a stronger European Health Union, lashing out at the member states for having scrapped the ambitious EU4Health programme embedded in the recovery fund.
The recently disclosed chemicals strategy also focuses on cancer. What do you think about the contribution that other strategies can make to the fight against cancer?
All hands on deck. Every person, every institution, every document that aims to improve the effectiveness of the fight against cancer is worth its weight in gold. As I mentioned before, the BECA committee was created to gather all the effective and good ideas in one place. That is why I am glad to see the mention of cancer risk also in other policies. Awareness of this topic is growing systematically, and thanks to this, we can approach the fight against cancer more comprehensively.
November is lung cancer awareness month. Is there a need to pay special attention to lung cancer as symptoms are now masked by potential COVID-19 symptoms?
Of course, there is such a need. I would even call it a necessity and our duty as politicians. The more we talk about these types of challenges, the more people who can potentially become victims of this type of cancer can be saved. Of course, COVID has made it difficult to diagnose and treat all sorts of diseases, but cancer won’t wait. Cancer is not looking at whether the coronavirus pandemic is ongoing or not. Cancer must be fought as quickly as possible. Only then is there a good chance of a complete recovery of the patient.
According to the two UN agencies, immunization rates in some countries have fallen by as much as 50 per cent, with people unable to access health services because of lockdown and transport disruptions, or unwillingness due to fear of contracting COVID-19.
Polio and measles vaccination campaigns, designed to fill gaps in essential services, also had to be paused to prevent possible infection of health workers and communities, while protection measures were put in place.
“COVID-19 has had a devastating effect on health services and in particular immunization services, worldwide,” said Tedros Adhanom Ghebreyesus, Director-General of WHO.
“But unlike with COVID, we have the tools and knowledge to stop diseases such as polio and measles. What we need are the resources and commitments to put these tools and knowledge into action,” he added.
UNICEF and WHO estimate that about $655 million are needed to address dangerous immunity gaps in middle-income countries, which are not eligible for Gavi assistance. Of that figure, $400 million are needed to support polio outbreak response over 2020-2021, and $255 million to prepare for, prevent and respond to measles outbreaks over the next three years.
Issuing an urgent call to action, the two UN agencies warned that if left unchecked, the situation posed an “increasingly high risk of explosive outbreaks and potentially further international spread of both polio and measles.”
Henrietta Fore, Executive Director of UNICEF, said that the world “cannot allow” the fight against one deadly disease – COVID-19 – to impact the fight against other diseases.
“Addressing the global COVID-19 pandemic is critical. However, other deadly diseases also threaten the lives of millions of children in some of the poorest areas of the world. That is why today we are urgently calling for global action from country leaders, donors and partners,” she said.
“We need additional financial resources to safely resume vaccination campaigns and prioritize immunization systems that are critical to protect children and avert other epidemics besides COVID-19.”
Respond to emerging outbreaks
WHO and UNICEF also called on countries to respond urgently to emerging disease outbreaks, prioritize immunization in national budgets and strengthen collaboration with partners for increased synergies.
They also noted that new tools, including a next-generation novel oral polio vaccine and a forthcoming Measles Outbreak Strategic Response Plan are expected to be deployed over the coming months to help tackle these growing threats in a more effective and sustainable manner, and ultimately save lives.
The Q&As provide clarification on transitional provisions of the Regulation regarding critical benchmarks.
The purpose of this Q&A is to promote common supervisory approaches and practices in the application of the BMR. It provides responses to questions posed by the general public, market participants and competent authorities in relation to the practical application of the BMR. The content of this document is aimed at competent authorities under the Regulation to ensure that their supervisory activities are aligned with the common practices set out in the responses adopted by ESMA. The updated Q&As also provide guidance to market participants on BMR requirements.
Next steps
ESMA will periodically review these Q&A and update them where required.
“Most of my missions stand out in some way or another due to the nature of helicopter operations. They often entail emergencies either on a mountain or in inaccessible terrain, or otherwise involve serious patterned injuries or time-critical medical conditions,” explains Jacqueline Zbären, a helicopter paramedic nurse working in the Bernese Highlands in Switzerland.
“Something that has made quite the impression on me is that major accidents can occur in the most unremarkable day-to-day activities, like biking or getting groceries, or else during a simple day trip in the mountains. Healthy individuals of any age can suddenly develop life-threatening diseases, like pulmonary embolisms and heart attacks, or trip and sustain major injuries,” adds the 37-year-old, who works at one of the 12 helicopter bases of Swiss Air-Rescue (Rega) distributed across the country.
“Having witnessed how someone’s life can change abruptly has increased my awareness of my own health and well-being.”
“The team in the helicopter is made up of a pilot, a doctor and a paramedic nurse, and the operations centre we’re in touch with over radio. When we receive the emergency notification, when the weather permits take-off, we have as little as 5 minutes to be ready to be airborne. During winter and summer tourist seasons, the base I work at is open 24/7 and shifts can last 24 or 48 hours.
“In primary missions, which are almost 90% of the operations of our helicopter base, we rescue or deliver the first medical assistance on the scene of an accident, while secondary missions involve relocating a patient from one health-care facility to another. In all our operations, the decisive factor is time.
“I’ve always known I wanted to work in the medical field, and I chose the nursing profession because it offered a wide variety of specialization options. The emergency setting fascinated me, which is why I specialized in anaesthesia after my 4-year nursing degree and then proceeded to a 2-year training to become a paramedic nurse. After working for 8 years in paramedicine, I switched to helicopter rescue operations about a year ago, after completing a Helicopter Emergency Medical Services Technical Crew member training.
“The biggest difference from working in a hospital is that in many hospital settings, you have several patients for whom you are responsible. As a paramedic nurse, you have only 1 or 2 to focus on, and while the care is limited in time, it is very intense.”
Managing the unpredictable
“The most defining elements of my work are its unpredictability and the diversity of my tasks. We can be requested to fly to the scene of a car accident, to rescue someone injured in the mountains or to transfer critical-care patients.
“I can be discussing expected medical needs with the emergency physician en route, but then the situation on the ground turns out to be entirely different. Or else, in rare cases, I am required to leave the doctor at a scene while the pilot and I must leave for another mission where I have full autonomy.
“In flight, I oversee medical, technical and operational tasks. I care for the patient’s well-being in close dialogue with the doctor, assist the pilot by operating the navigation devices and radio, and handle the hoist to lower down the doctor or a helicopter rescue specialist from the Swiss Alpine Club when we cannot land.
“I have to slip in and out of various roles and mindsets – I may be thinking of the medical equipment needed upon landing, then help the pilot reach our destination, and moments later think strategically about how best to transport the patient to the helicopter.
“We undergo continuous training to hone our medical, technical and operational skills and, above all, to be prepared for every eventuality.”
UK Prime Minister Boris Johnson has dismissed EU accusations that Britain was deliberately procrastinating over Brexit trade talks to wait until the winner of the US presidential election has been determined, reportsThe Sun.
No 10 Downing Street rejected as “simply untrue” speculations that UK concerns that an administration led by Democrat Joe Biden might adopt a tougher stance on a US-UK trade deal could prompt London to grant more concessions to Brussels in order to get a deal done with the EU.
A source was cited as brushing off such claims by officials in Brussels as no more than “wishful thinking” and “desperate stuff”.
‘Mass Bargaining Session’
Following almost two weeks of intense negotiations between the EU and the UK that have not resulted in any breakthrough on major sticking points, Chief EU negotiator Michel Barnier is claimed to have rejected London’s calls to elevate ongoing Brexit talks to leaders’ level.
A handout photograph released by the UK Parliament shows Britain’s Prime Minister Boris Johnson speaking in the House of Commons in London on November 2, 2020 on new coronavirus lockdown measures.
Warning that they were on a “trajectory” for a No Deal scenario, he was reported to have denounced the UK’s attempts to turn the current stage of talks on shaping the post-Brexit relationship between the sides into a “mass bargaining session”.
Some EU officials were claimed to have accused Britain of calling time on talks early this week amid the tight US election race between President Donald Trump and his Democratic rival Joe Biden.
Sources were cited by the outlet as suggesting that at a private briefing to senior MEPs Michel Barnier railed against No10 gearing up for a “big tug of war at the end”, with as many as 30 issues open for further discussion.
European Union’s Brexit negotiator Michel Barnier wears a protective face mask as he arrives at 1VS conference centre ahead of Brexit negotiations in London, Britain October 24, 2020.
The French politician serving as the European Commission’s Head of Task Force for Relations with the UK reportedly fears that Boris Johnson hopes to wangle more concessions in a direct showdown with president of the European Commission Ursula von der Leyen and German Chancellor Angela Merkel.
Key contentious issues up for debate between the sides have been access to UK fishing waters by EU boats and the need to have common regulatory standards and fair competition.
On fishing, the UK has urged that opportunities be calculated on the basis of ‘zonal attachment’ – a move that would increase the amount of fish caught in UK waters by British boats, while the EU says reaching a “fair deal” on fisheries is a pre-condition for a free trade agreement.
Referring to London’s tactics, Barnier is claimed by sources as having told European diplomats:
“I keep telling them that’s not going to happen… You can’t have things going up to that level that haven’t been gone over with a fine toothcomb.”
The official is cited as having added that unless Downing Street changes its approach to negotiations with Brussels, next week, a deal won’t be reached.
Updating @Europarl_EN & Member States on ????negotiations today.
Despite EU efforts to find solutions, very serious divergences remain in Level Playing Field, Governance & Fisheries. These are essential conditions for any economic partnership.
?? is prepared for all scenarios.
— Michel Barnier (@MichelBarnier) November 4, 2020
Currently, British and EU negotiators are taking a three-day break from talks and are scheduled to reconvene in London on Sunday.
Both sides have been trying to strike a trade deal since the UK left the EU on 31 January in time for the agreement to be ratified by the end of the year, when a post-Brexit transition period ends.
