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AP Exclusive: WHO spends $200m Million on travel than Aids and malaria

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LONDON (AP) — The World Health Organization routinely spends about $200 million a year on travel — far more than what it doles out to fight some of the biggest problems in public health including AIDS, tuberculosis or malaria, according to internal documents obtained by The Associated Press.

As the cash-strapped U.N. health agency pleads for more money to fund its responses to health crises worldwide, it has also been struggling to get its own travel costs under control. Despite introducing new rules to try to curb its expansive travel budget, senior officials have complained internally that U.N. staffers are breaking the rules by booking perks like business class airplane tickets and rooms in five-star hotels.

Last year, WHO spent about $71 million on AIDS and hepatitis. On malaria, it spent $61 million. And to slow tuberculosis, WHO invested $59 million. Still, some health programs do get exceptional funding — the agency spends about $450 million trying to wipe out polio every year.

On a recent trip to Guinea, where WHO director-general Dr. Margaret Chan praised health workers in West Africa for triumphing over Ebola, Chan stayed in the biggest presidential suite at the Palm Camayenne hotel in Conakry. The suite has an advertised price of 900 euros ($1,008) a night. The agency declined to say who picked up the tab, noting only that her hotels are sometimes paid for by the host country.

But some say that sends the wrong message to the rest of the agency’s 7,000 staffers.

“We don’t trust people to do the right thing when it comes to travel,” said Nick Jeffreys, WHO’s director of finance, during an in-house seminar on accountability in September 2015 — a video of which was obtained by the AP.

Despite WHO’s numerous travel regulations, Jeffreys said staffers “can sometimes manipulate a little bit their travel.” He said the agency couldn’t be sure they were always booking the cheapest ticket or that the travel was even warranted.

“People don’t always know what the right thing to do is,” he said.

Ian Smith, executive director of Chan’s office, said the chair of WHO’s audit committee said the agency often did little to stop misbehavior.

“We, as an organization, sometimes function as if rules are there to be broken and that exceptions are the rule rather than the norm,” Smith said.

Earlier that year, a memorandum was sent to Chan and other top leaders with the subject, “ACTIONS TO CONTAIN TRAVEL COSTS” in all-caps. The memo reported that compliance with rules that travel be booked in advance was “very low” and also pointed out that WHO was under pressure from its member countries to save money.

Travel would always be necessary, the memo said, but “as an organization we must demonstrate that we are serious about managing this appropriately.”

In a statement to the AP, the U.N. health agency said “the nature of WHO’s work often requires WHO staff to travel” and said costs had been reduced 14 percent last year compared to the previous year — although that year’s total was exceptionally high due to the 2014 Ebola outbreak in West Africa.

But staffers are still openly ignoring the rules.

An internal analysis in March, obtained by the AP, found that only two of seven departments at WHO’s Geneva headquarters met their targets, and concluded the compliance rate for booking travel in advance was between 28 and 59 percent.

Since 2013, WHO has paid out $803 million for travel. WHO’s approximately $2 billion annual budget is drawn from the taxpayer-funded contributions of its 194 member countries, with the United States the largest contributor.

After he was elected, U.S. President Donald Trump tweeted : “The UN has such great potential,” but had become “just a club for people to get together, talk, and have a good time. So sad!”

Some health experts said while WHO’s travel costs look out of place when compared to some of its disease budgets, that doesn’t necessarily mean that travel expenses are inflated.

Michael Osterholm, an infectious diseases expert at the University of Minnesota, has frequently been flown to WHO meetings — in economy — on the agency’s dime.

“This may just speak to how misplaced international priorities are, that WHO is getting so little for these disease programs,” he said.

During the Ebola disaster in West Africa, WHO’s travel costs spiked to $234 million. Although experts say on-the-ground help was critical, some question whether the agency couldn’t have shaved costs so that more funds went to West Africa , where the three stricken countries couldn’t even afford basics like protective boots, gloves and soap for endangered medical workers or body bags for the thousands who died.

Dr. Bruce Aylward, who directed WHO’s outbreak response, racked up nearly $400,000 in travel expenses during the Ebola crisis, sometimes flying by helicopter to visit clinics instead of traveling by jeep over muddy roads, according to internal trip reports he filed.

Chan spent more than $370,000 in travel that year, as documented in a confidential 25-page analysis of WHO expenses that identified the agency’s top 50 spenders. Aylward and Chan were first and second on that list. Three sources who asked not to be identified for fear of losing their jobs told the AP that Chan often flew first class.

WHO said the travel policy, until February, “included the possibility for the (director-general) to fly first class.” It said Chan flew business class and requested the policy be changed to eliminate the first-class option.

“There’s a huge inequality between the people at the top who are getting helicopters and business class and everyone else who just has to make do,” said Sophie Harman, an expert in global health politics at Queen Mary University in London.

Other international aid agencies, including Doctors Without Borders, explicitly forbid staff from traveling in business class. Even the charity’s president flies economy class, a spokeswoman said. With a staff of about 37,000 aid workers versus WHO’s 7,000 staffers, Doctors Without Borders spends about $43 million on travel a year.

The U.S. Centers for Disease Control and Prevention would not provide its travel costs but said staffers are not allowed to fly business class unless they have a medical condition that warrants it. The U.N. children’s agency UNICEF, which has about 13,000 staffers, said it spent $140 million on global travel in 2016.

“When you spend the kind of money WHO is spending on travel, you have to be able to justify it,” said Dr. Ashish Jha, director of the Global Health Institute at Harvard University. “I can’t think of any justification for ever flying first class.”

Jha warned that WHO’s travel spending could have significant consequences for fundraising. Several weeks ago, WHO asked for about $100 million to save people in Somalia from an ongoing drought. In April, it requested $126 million to stop the humanitarian catastrophe in Yemen .

“If WHO is not being as lean as possible, it’s going to be hard to remain credible when they make their next funding appeal,” Jha said.

Health

Somalia, UN seek to vaccinate over 700,000 children against polio

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XINHUA — Somalia’s health ministry and two United Nations agencies on Sunday launched a three-day oral polio vaccination campaign, targeting 726,699 children under five years of age in two districts.

A joint statement issued in Mogadishu said the campaign backed by the World Health Organization (WHO) and UNICEF is taking place in Banadir and Lower and Middle Shabelle regions.

Ghulam Popal, WHO Representative for Somalia said the campaign will be conducted in two rounds through house-to-house visits by vaccination teams, noting that no cases of polio have been detected in Somalia since August 2014.

“However, as a preventative measure; it is imperative that all children under five years of age in targeted locations, whether previously immunized or not, receive two drops of oral polio vaccine,” Popal said.

Banadir region reported the highest number of wild poliovirus cases in Somalia (72 out of 199) during the Horn of Africa outbreak in 2013-2014.

“We urge all families to get their children vaccinated to protect them against this dangerous disease,” he added.

The UN health agencies said the first and second round will involve the use of oral polio vaccine for children under five years of age.

Inactivated polio vaccine (IPV) will be used in the third round to boost immunity among children between 2 and 23 months of age.

According to the UN, conflict and insecurity in South and Central Somalia especially has continued to hinder access to children during polio immunization campaigns in 2017, with about 240,000 children under five years of age reported as not accessible for more than a year.

“This campaign has been carefully planned to make sure that all children in the chosen areas, particularly those who have been missed in previous vaccination campaigns, are reached this time,” said UNICEF Somalia Representative Steven Lauwerier.

The UN agencies said over 4,400 vaccinators and monitors, and around 800,000 doses of vaccine have been mobilized to conduct the activity.

The Horn of Africa nation has been polio free since August 2014, when the last case of polio was reported from Hobyo district of Mudug region.

The declaration by WHO two years ago keeps Somalia outside the last group of countries which still record cased of polio in the world.

WHO has however warned Somalia remains at risk of importation of the virus from these countries.

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Can your blood not be moved for Somalia?

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On Oct. 14, I was participating in “Somali Studies in Canada: Resilience and Resistance,” a multidisciplinary colloquium held at Carleton University.

It was the first of its kind in Canada, and more than 50 brilliant, bright and eager academics, artists, frontline workers, and grassroots activists from Ontario and Quebec gathered to discuss the Somali diaspora’s resilience and resistance over the past 30 years in Canada.

But that was abruptly interrupted as attendees began to hear news of a massive explosion in Mogadishu, Somalia. Two hundred casualties were immediately reported; in just a few hours, more than 300 people were believed to be dead. It is being described as the deadliest attack to take place in the region.

Just two weeks later, on Oct. 28, a car bomb detonated in front of a busy hotel and restaurant as gunmen took hostages inside; later that day, a vehicle carrying government troops triggered a roadside bomb planted by the militant group al-Shabaab. In the end, at least 23 people were declared dead in Mogadishu.

For those of us in Canada who arrived in the early 1990s and who left family and people behind, stories of death and violence have become achingly familiar.

Families that have made difficult decisions to leave loved ones and a homeland behind are constantly forced to relive them in the immediate moments after horrific events have taken place.
It felt like I had barely been given a moment to breathe before I began to call family members and friends to make sure everyone was accounted for. This in-between place—of frantic calls, racing hearts, guilt for the relief that everyone is just fine, frustration, anger and fatigue—was eerily familiar.

Since the explosion, the question at the top of the general public’s mind is: “will your community mobilize?”

To me, the question isn’t worth asking. Over the summer, thousands in Somalia were displaced and put at risk of starvation due to a rapidly escalating drought. According to the UN Office for the Coordination of Humanitarian Affairs, Somalia is facing a humanitarian crisis and is at risk of a severe famine—all of this coming just six years after the last deadly drought.

They note that between November 2016 and May 2017, an estimated 739,000 people were displaced by the drought; more than 480,000 of the displaced, or 65 per cent, are younger than 18.

Shortly after learning this information, a vast majority of the Somalis I knew in Canada mobilized. Elders added extra remittance payments to their monthly spends; young people coordinated events and fundraised money. Even those who could not give money retweeted, shared statuses and ensured the public was aware of the dangerous situation Somalia was in. Young Somalis became #FamineResistors with many in our city doing the work to garner attention, collect donations and forward to the appropriate hands in Somalia.

The question, then, is not whether we will mobilize. The question is: will you?

On Oct. 8, just six days before the horror in Mogadishu, 16-year-old Zakariye Ali was killed in a Toronto junior high school parking lot; three days before that, 29-year-old Abdulkadir Bihi was shot to death in Etobicoke: Allahu naxariisto. Mustafa Mattan, 28, was fatally shot through the door of his apartment building on Feb. 9, 2015; no killer has been apprehended.

He is just one of at least 100 young Somali men between Toronto and Alberta whose deaths continue to go unsolved by local police despite active work by community members and agencies such as Positive Change that have worked to address the lack of information provided by RCMP and other authorities. Somalis continue to be deported by the Canadian government by Immigration Minister Ahmed Hussen. Despite Hussen’s identification as Somali, it’s important to remember that representation does not always mean we are allowed to stay.

On top of this, Somalis continue to face negative media depictions that work to present the general public with correlations to terrorism, piracy, and gangsters. Media narratives like Vice’s documentary This is Dixon and the now-discontinued CBC drama Shoot the Messenger which looked to fictionalize the Rob Ford crack scandal.

This scandal saw “Project Traveller” come to a head in June 2013 when police stormed an apartment building on Dixon Road in pre-dawn raids that resulted in more than 60 arrests of primarily young Somali men. When the Canadian public and media only know us through the analysis of violence and terror—a characterization all too frequently and easily deployed—there is only attention granted to us in our deaths.
Why do you only want us when we are dead?

In early October 2017, our mothers cried on camera for the kids they raise here. In July 2017, they wept while they watched Abdirahman Abdi be brutally murdered by police. This week, they weep silently for the family they have lost back home. This middle place they’ve come to reminds them they are not wanted—and still, all everyone offers is prayer.
What happens when the prayers are not enough?

After every death, every drought, every instance of violence, I am hard-pressed to feel grateful that Somalis are granted prayers. We did not get here all by ourselves. We get up and face the onslaught: “Your community again? But how are you feeling?” The answer does not change, and the emotions are the same each time: grief, relief guilt, fatigue, rage, frustration.

We will pray for Somalia, politicians tell us; we will not forget you. But you can not forget those you do not remember. The City of Toronto may light the Toronto sign blue and white, but Mayor John Tory rarely makes commitments to address the violence that lies at the doorsteps of Somali communities.

Somali-British poet Warsan Shire reminds us that “in Somali, when we see injustice, we say ‘dhiiga kuma dhaqaaqo?’ which translates into ‘does your blood not move?’ ”

Can your blood not be moved?

For those of you who are willing to pray and willing to gather in vigil, try something different. Call out false narratives of terror and deficit when you see them. Ask the Ontario Ministry of Children and Youth Services what specific long-term and sustainable services they are allocating to Somali youth in Ontario. Pressure the Toronto Police Services, Ontario Provincial Police and the RCMP to appropriately investigate the deaths of young Somali men.

Stand in the streets when we tell you the Minister of Immigration has deported us. Pay attention to the counter violent extremism programs that criminalize Somali youth that are being funded by Public Safety and Emergency Preparedness Canada.
Prayer is an act of empathy; action is an act of solidarity. We need both if any of us are to survive.

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Health

Somalia Opens First Forensic Lab Dedicated to Rape Investigation

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Somalia has opened its first forensic laboratory to process rape kits. Sexual assault is widespread in the country, according to human rights groups, but few victims come forward and few perpetrators are punished. The new forensic lab in Somalia’s Puntland region has been hailed as a step in the right direction, but a long road remains to end impunity for gender-based violence. Neha Wadekar reports for VOA from Garowe, Somalia.

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