Dr Gro Harlem Brundtland, Director-General of WHO, will today appeal for US$2.5 billion to sustain the lives of more than 33 million people caught in humanitarian crises worldwide. Under this year’s theme of ‘Reaching the Vulnerable’, the 2002 Consolidated Inter-Agency Appeals (CAP) were launched in New York on 26 November by the United Nations Secretary-General, Mr Kofi Annan, and today in various European centres by the heads of UN humanitarian and partner agencies.
The appeals cover Afghanistan, Angola, Burundi, Democratic People’s Republic of Korea (DPRK), Democratic Republic of the Congo (DRC), Eritrea, Ethiopia, Great Lakes Region and Central Africa, Indonesia, North Caucasus (Russian Federation), Somalia, Southeastern Europe, Sudan, Tajikistan, Uganda and West Africa (including Guinea, Liberia and Sierra Leone).
The case of Afghanistan illustrates the plight of the forgotten and the vulnerable. Three months ago, the fate of the ‘forgotten’ people of Afghanistan as they faced a humanitarian disaster of mass proportions - caused by ongoing civil strife, relentless drought and starvation - would have gone largely unnoticed. If not for the events of 11 September and their aftermath, the people of Afghanistan would simply have continued to suffer this winter in silence, hidden from the world.
"Afghanistan is not a unique case. Several emergency countries, such as Sudan and DRC, are now in the same situation as Afghanistan before September 11. Around the world at least 30 million people live each day in conflict zones, often living in appalling humanitarian conditions. From Angola to East Timor, entire populations are subjected to the brutal effects of war and extreme poverty. Substantial support is needed to provide water, food, medicines and other essentials these populations need to survive. Addressing these problems now means preventing greater crises tomorrow," said Mr Paul Grossrieder, Director-General of the International Committee of the Red Cross, who launched the CAP in Geneva with Dr Brundtland.
In any crisis, health is one of the first casualties of the affected population. Vulnerable groups of society, including children, the elderly, pregnant women, the disabled and the chronically ill, are particularly susceptible. Many children in humanitarian crises are malnourished, increasing their risk of succumbing to infectious, life-threatening diseases. Pregnant women face the prospect of delivery in unsafe and unhygienic conditions, increasing their chances of dying in childbirth.
Yet public health remains one of the most poorly funded sectors of emergency relief. The overall response to the Consolidated Inter-Agency Appeals is not improving – only 50% of requirements have been met this year (compared to 55% in 2000 and 67% in 1999). Distressingly, the World Health Organization (WHO) only received 12.5% of the sum requested for 2001.
‘We know from experience of responding to emergencies that prompt attention to health issues - through the provision of effective interventions - saves many lives. Low-cost public health actions, such as measles vaccinations, or bednets and tuberculosis (TB) drugs, or simple measures to combat children’s malnutrition and maternal health, are highly effective," said Dr Gro Harlem Brundtland. "This is particularly the case in complex emergencies and during the humanitarian consequences of wars and conflicts. The resources need to meet the health needs of affected populations are as much as US$79 million. It is difficult to think of a better way of spending US$79 million. My appeal to all governments is: Please give generously, and please give in ways that enable us to cover the full range of emergencies."
Despite underfunding, on-going emergency health activities continue to make a difference. WHO is one of the international agencies that has continued working during the complex emergency in Sierra Leone. An emergency programme to Make Pregnancy Safer was launched to improve the survival of pregnant women and their children. In the South Sudan, WHO provided an early warning of epidemics through surveillance systems. These efforts are paying off. Targeted health responses in crises can - and do - save lives.
In complex emergencies, 75% of deaths are due to communicable diseases. WHO is working to reduce deaths and disease among vulnerable populations: ensuring diagnosis and treatment of TB in Somalia, Sudan, Liberia, DR Congo, Uganda and DPR Korea; developing Roll Back Malaria partnerships in DRC, Sudan, Liberia and Angola; and training local epidemiologists on communicable disease control in Kosovo. WHO supports the development of a minimum package of HIV/AIDS interventions to accompany all relief activities targeting refugees and internally displaced persons.
Once crises have subsided, follow-up health support is vital. WHO works to ensure the seamless transition to well-functioning health systems – which are crucial to ensuring the supply of essential drugs, immunization services and training and support of local health personnel. In East Timor, WHO health expertise has led the reconstruction of health services in the lead-up to independence.
CAP documents, available in full at www.reliefweb.int, describe the main concerns, priorities and goals of multilateral humanitarian action in each affected country or region, and detail the manner in which to meet them. They also outline the requirements of all appealing agencies and organizations to carry out activities to achieve these goals.