 Hello from the World Economic Forum. My name is Adrian Monk. Welcome to this Africa media briefing with the World Health Organization. Delighted to be joined from Brazzaville in Congo by Dr Machedizo Muetti and her colleague Dr Michelle Yao. We'll also be joined for this call by the Minister of Health and Population from the Central African Republic. I'm Dr Pierre Somsay by Patrick Youssef, the Regional Director for Africa with the International Committee of the Red Cross in Geneva and from Dadaab Camp in Kenya, Adio Actual Diuquep, who is a South Sudanese refugee. Of course, we want your questions. Please use the Q&A function on Zoom to get them over to us. But we'll start, if we can, by talking to Dr Muetti and getting an update on the very latest situation across the continent. Dr Muetti. Yes. Thank you very much, Adrian. It's my great pleasure to be joined by the Honourable Minister of Health and Population of the Central African Republic. Welcome, Mr Minister and the Regional Director for the ICRC in Africa and by Ms Adio Actual Diuquep, a young lady, refugee and university student, to discuss the impacts of this pandemic on people living in very challenging, difficult and precarious settings and the urgent need to improve for COVID-19. South Sudan and Africa hosts more than 26 per cent of the world's refugees and around 19 million internally displaced people who have fled their homes due to violence and conflict. During this global crisis, these are among the most vulnerable people in the world to the COVID-19 pandemic. Due to challenges in accessing some of the difficult and humanitarian settings, cases of COVID-19 are possibly under reported and public health capacities for surveillance, testing, isolation, care and contact tracing are being scaled up wherever it's possible. In Ethiopia, for instance, community engagement including in surveillance and infection prevention and control activities is ongoing in other refugee camps and sites where internally placed people are living. In the Democratic Republic of the Congo, in complex settings in North and South Kivu and in Turi provinces, laboratories are equipped to diagnose COVID-19, building on capacities strengthened during the Ebola response. I'd like to mention here that the government and partners in the DRC, while responding to COVID-19, are also dealing with an Ebola outbreak in the Ecuador province. You will recall that's where we had an outbreak two years ago. There are now 56 cases and this is of great concern, particularly as it is now surpassing the previous outbreak in this area which was closed off and controlled at a total of 54 cases. Some cases are located in remote areas surrounded by rainforests demanding additional capacities and resources for the response. And this just illustrates the fact that countries have to, at the same time as responding to the pandemic, then deal with other health problems, epidemics. Returning to humanitarian settings in the crowded and sometimes very low resource settings such as camps and settlements, the basic preventive measures for COVID-19 or physical distancing and frequent handwashing can be incredibly challenging to implement. The WHO recommends health screening for new arrivals, temporary isolation facilities for suspected cases, adopting activities like food distribution to limit gatherings and strengthening infection prevention and control practices, including ensuring access to water, supplies and handwashing stations, and importantly, ensuring essential health services for other diseases and conditions continue to be provided. This week, the United Nations will launch an update to the Global Humanitarian Response Plan to scale up access to life essential services for health, water and sanitation and food and nutrition for vulnerable populations. This action is urgently needed. Already, funding shortages have resulted in reduced food rations in some settlements and imminent threats of increases in acute malnutrition, stunting and anemia. As a reported COVID-19 cases on the African continent, past 640,000 with 14,000 people having lost their lives, global solidarity is needed more than ever in fighting this epidemic. And I'd like to just say here that we are seeing many governments ease the lockdown measures that had been put in place and bought some time in scaling up the public health capacities. So we should be expecting that in some countries there will be an increase in cases and we will all have to work together to then control what happens as far as those increases are concerned. For at least three months now, vulnerable communities have been experiencing socio-economic difficulties exacerbated by COVID-19. It is in the interest of peace, international security and equity that all countries and partners do more to assist the civilians affected by the violence and conflict. I therefore call on all parties to conflict to implement the UN Security Council resolution on COVID-19 focusing on our common enemy, the virus, and seizing hostilities. I have to say here that we have a formidable ally and leader in Hon. Minister Somseh who has actively pursued using health as a bridge for peace in his country in the last couple of years. So I look forward very much to our discussion today and thank you once again for joining us. Thank you. Minister, can I turn to you in the Central African Republic and could you give people on the call an update and an overview on the situation that you're dealing with there? Thanks a lot. Thanks a lot. Thanks, Dr. Moiti, for your leadership. It's with great pleasure that I'm responding to the request of Dr. Moiti, my friend and sister, the director-original of WUHU for Africa. I'm happy to share with you our perspective on how the novel coronavirus is affecting my country and the challenge that the country is facing as a country in post-conflict situation. The first case of COVID in the Central African Republic was detected on 14 March. It was a murder case coming from Italy. Until the end of April, we were facing sporadic, mainly important cases from Europe with some limited local transmission in the capital, Bangi. And we started to scream systematically travelers at the road check point. Unfortunately, we were not able to maintain the benefit of all screening at the main airport when the major important cases were coming from Europe. Because soon after, with the explosion of the epidemic in the Cameroon, which is one of the neighboring countries which maintain a very close relationship with the country, really resulted in a huge cross-border transmission if many cases coming by road from Cameroon. This has resulted now in the explosion of the epidemic which has now become a local transmission epidemic with community implementation. And many cases occurring. We have for the last three months, we have been registering around 150 cases a day only in Bangi. Now we have been working according to WHO recommendation strategy, which is to isolate the test, careful cases and trace. Unfortunately, in the context of humanitarian crisis and post-conflict, it is difficult to confine people. So the main measures that are implemented in Western countries, which are essentially based on confinement, could not be implemented in the country here. And now what we are doing is to really do the politics of our means. This politics is based on, first, the challenge for implementing confinement. That is due to many factors, cultural factors. For example, people continue to organize funeral. The second one is people continue to go to market because we don't have a supermarket like in Western countries where you can regulate. When you can implement distancing policy, we don't have a mask at the disposal of everybody. So what we have decided to do is to have a very unique approach, which is to concentrate mainly on preventing death. Because what we have seen is that an increasing number of deaths with most of them happening in the community. Because of delay in transfer to the hospital or because of denial, the denial is still huge. The recognition of the epidemic is still just among the very small number of people. So what we have done and you have a huge COVID is happening in a context of a very weak health system and many diseases, an epidemic of noncommunicable diseases, are the high risk factors for COVID, for mortality, hypertension, diabetes, sickle cell. And not to mention that half of the population is suffering of chronic malnutrition, which means an important factor of vulnerability if you consider that one of the major mechanisms by which people are dying of COVID is lack of oxygen. So and half of the people are living in a humanitarian crisis, a humanitarian situation. Almost one third of them in this place come. So what we have done is to really focus on looking for those who are at high risk and making sure that they are detected early enough. And brought to hospital in order to avoid them having complications. And one thing that I want to mention before I end this overview is that as a country in crisis, we have in the context of this global solidarity of COVID, we are really experiencing a real challenge in accessing supplies. We have been functioning so far, thanks to Chinese donation. So this is a very important point that while we are all talking about global solidarity, this is not being experienced really by people in the Central African Republic in a way that it is actually present. My recommendation here is that it is really important that this conversation results in greater satisfaction and advocacy for small and fragile states like the Central African Republic so that we can access supply, we can access funding and support. We have the support of W2 but of course the global platform is not functioning. Thanks a lot. Minister, thank you for that very important testimony and for that update on the situation in your country. I'm going to turn now to Patrick Yusef who is the ICRC's Regional Director for Africa and also I'm very pleased to say a member of the World Economic Forum's community of young global leaders. Patrick, you're looking at the humanitarian situation across the continent. What is the situation that you're seeing from your position? How is the ICRC making sense of what's happening to very vulnerable people who are now facing this additional burden of a pandemic? Thank you, Adrian, and I'm very honored to be on this panel with prominent speakers. His excellency had just made impressive remarks about a country that indeed is living the effects of a situation of violence and war since the number of years. So as you know, Africa's wealth and diversity deems a thorough look at clusters of situations rather than a generalization of the effect of COVID or other crisis on the whole of the continent. As you can imagine, I'll focus really on half of the continent that's not accurate, but half of the continent which is bleeding because of those situations of violence. Because of political violence, intercommunal violence as well as wars like in Somalia and northern Mozambique today, the Nigeria's north eastern part, the Sahel, the ICRC or South Sudan which as you know has been living three waves of huge offensive in the Zhonglei region, which are very preoccupying and where I would say the impact of COVID has been disproportionate compared to other countries, stable countries who have lived through the pandemic and probably went stronger after this pandemic. So the fear here is certainly on the knock on effects, the social economic impact of that pandemic beyond the predicted fatalities that we may have on the continent. I want to zoom in on this notion of refugees and displacement and migration. You know, out of the 27 million refugees and IDPs on the continent, I want to remind everyone that almost 5 million were registered as newly displaced people who have left everything behind and ran either within their country or outside the borders of their country to take refuge. 5 million and the numbers are in rising as we speak today in the Sahel and Libya which means that violence continues and hampers the delivery of health services in the most sensitive places where as you know social distancing or physical distancing is impossible where a liter of water for handwashing is simply a luxury. So violence also as we know creates a fertile ground for the virus to take hold and spread. So all in all conflict and violence in many parts of Africa is continuing is driving death and injury over hundreds of people per day are injured or killed as we recently saw in the Lake Chad region where our surgical teams on the ground work like never before. And I want to make a point here because we're also surrounded by health professionals. Health workers are not spared as you know by this violence if Africa starts losing its health workers, which are anyway too few already. The entire system will struggle and will have an impact not only on covid responses, but on all other diseases. So this is a shared responsibility for the implementation the application of relevant laws in the different contexts to make sure that this wealth of expertise we have is really maintained. I want to end by saying that with our Red Cross and Red Crescent partners, our commitment is to continue helping those who suffer in silence, either in prisons, people who we don't see who we call off the grid or displaced more camps. We're living under a 45 degree Celsius sun today in the Sahel where we have just asked our donors for more support for all not only support for covid response, but also on other reads needs because of dual effects of climate and conflict. Our efforts are really directed to assisting and accompanying and coaching on the job forensic experts in 31 countries, supporting health facilities health structures water pumping stations. But we also want and need to learn from this covid crisis as from the ICRC. We're reaching out to other partners and working together in complementarity in order to support more systemic support and general governance to help us achieve better results in the next in the next crisis. Thanks. Thanks, Patrick. I want to go to Nairobi in Kenya, if we can, and hear from Adio Achul Diu Kwe. Adio, you're originally from the Dab refugee camp in North of Kenya, which is the size of a reasonable city. In fact, how are people in camps like the dub hoping with the pandemic situation, given the incredible limitations that Patrick's just outlined on health on water provision on sanitation. How are they managing. Thank you so much, Mr. Andrea. Yeah, so in the dark. I used to stay in Kakum and then moved to that, but I'm currently in Nairobi. For educational purpose. So I will start with the old school. The fact that everywhere around the world, the school up close. So the same thing to do that to all school up close. And most of the learners are facing the challenge for online learning, which they are used to classroom. So it's a bit challenging. And the other thing is the business have declined because of inflation. For example, we used to buy one kg of beans was 100 chili, but today it's more than that is 200 Kenya shillings. They are telling that we are having mostly is there a social physical contact is much it's not much being observed because of limited space. Yeah, because of limited housing space in the camps. For example, we have been shorted of shelter. Most of the youth are sharing the rooms, which make it hard for obtaining social physical contact. The other thing is increase of team pregnancy. Not it only in the camps both come that is come into that, but also in the nation across the nation that is in Kenya. The other thing is increase in crime because youth are idle. They have they have nothing to do. They are just indoors and that thing is bringing issues like somebody thinking of like, I don't even know how I'm going to support myself. So they are resulting in stealing with that one. We have UNSCR and other agencies coming up with how to help us. The refugees in both come that is in Kakuma and Adab. So the UNSCR has collaborated with Kenyan government to make sure that wherever visit they come that is in Adab or Kakuma should go for a solution quarantine area for 14 days. And having to have and before being released to the community they have to go through a thoroughly test that is either you are positive or negative. If you are negative then you will be released and they come after that. Before if you are fine that you are positive then they will have to take you to a hospital whereby you will be treated. Both host communities and refugees are working together to achieve this. The other thing is humanitarian agencies have set up hand wash and sanitization in the entries of each block and marketplace. And in addition to that its household is having a sanitation station in their own compound to make sure before you come into the compound you have to wash your hands after getting outside of the compound you have to wash your hands. The shopping place that is the marketplace is free people can they start freedom of movement in the camp you can go to the market and come back. There is no that total lockdown in the camp. Well its only coming in the camp is an issue but inside the camp you can go to the market freely and come back. The other thing is the UN and local communication companies have collaborated to make sure the refugees students can gain access to learning online by providing affordable data. That is for the tertiary level school refugees that is in higher education of university and for the primary and high school that is the secondary school. The humanitarian agencies have distributed radios and tablets to learners for easy assessing the education program. The radio the radio only work with energy that is the solar it doesn't need electricity or battery it's actually very easy to use. The other thing is the refugees themselves are helping in the fight of conflict 19. Some refugees are helping in the fight of conflict 19 sponsored by for instance some sponsored by Albert Esteem German Academic Refugee Initiative are distributing some masks and food items not only to refugees but also to the house community. Both Nairobi and Kappuma ended up. Thank you so much. Thank you very much. We can take some questions now and I think we can go live to Cara Anna from the Associated Press in South Africa. Hi can you hear me okay. We can hear you. Hi thank you for this. Dr Somseh when you say the global platform for supplies is not functioning. Can you explain what you mean by that and give more details. And a second question is for any of you. What are the most striking examples of stigma you've encountered and how is that challenging your work in this pandemic. Thanks. Minister can we just turn to you for the first question. I said I don't know how it is for over countries that first you are not in the list of priority countries. And so this has resulted in the ask the being completely overlooked in the in you know in the chance for access to. To possibility for. Purchasing. Good. A second one is. We have. All the supplies. All the. All the. All the. All the. All the. All the. All the. All the supplies. All the. Equipment and. And test and we are still waiting. We are waiting because I believe that. This is due to global competition which is well known. Which we can't understand because we keep. We keep hearing on the radio that for example in the UK you. Or in a similar country you have around. Thousands of million of tests being conducted every day. But here we are dealing with. You know you know a hundred of a hundred of tests barely 200 tests. Every day and. We are in a you know in a in a scarcity scarcity. Of tests. We have to rely on Chinese donation has not been the Chinese donation. We would have not have done. You know nothing. Nothing at all. Even you know where we are in the epidemic how much cases we have. If the virus is circulating on. So. This is what I mean. And I believe that this is a big. Ethical issue. A big inequality. Crisis. Which make which you know point to the discrepancy. Between speech. And talk. And the reality. Has it. To our case. Here. Thank you minister. I think that question. Second question. Yeah I think that question. I'm going to turn to Adio perhaps to answer that question. Really I think talking about any examples of stigma that you faced in. Or that you've encountered. In during this pandemic. Thank you so much. Free food is natural. People that are traumatized because most of the refugees flee home because of war. So the most recent. Situation that stuck my me or other refugees is the hearing of COVID-19. And that actually it's in the camp and some of our people the people I know have it have contracted the disease. It was really traumatizing because we just felt like there's no it's like the end of us. But at the end of the day we find out that the UN is here and other humanitarian agencies are working together for our own protection. They're protecting us and us also being involved in the decision making and also doing their sanitization in the blog and all this really come us down. But that was the most most traumatizing. Situation ever. Thank you. Thank you for joining in Nigeria for her question. Thank you very much. With respect to all that has been said regarding. Global solidarity. I'd like to find out what are the areas of humanitarian responses for what the World Health Organization has discovered that if expanded in scale would help healthcare workers particularly so that organizations can start to channel all of their focus all of their energies within these areas. Thank you. Thank you. Thank you very much. Let me just point out we're having huge problems with connectivity in Brazzaville and missing some of the conversations. I hope our connectivity will be stable for a while. In WHO we're putting communities very much at the center of our response strategy to COVID-19. And so it's important that response strategies of member states supported by WHO and the partners take into consideration the health needs of communities and adapt accordingly planned actions. So we're working very much within the UN in the definition of the actions that have to be taken in the humanitarian space. And really trying to urge that link between the humanitarian work in health and the needs of the people of the pandemic and among the populations that are affected. So some of the adaptations that I mentioned earlier and I very much liked the ideas and the innovations that the minister talked about that instead of in a way taking a realistic view of the possibilities of some of the interventions let's rather try to focus on those people most vulnerable. The bad outcomes and put our efforts there in ensuring that those outcomes don't come about. We work very much with humanitarian partners in an ongoing way in countries where the situation is bad like in the CR in South Sudan in parts of Ethiopia. So it's what we are doing is making sure that we adopt part of what we've been doing on an ongoing basis to the context of the COVID-19 response and especially to make sure that those basic services that the minister was alluding to so for people with chronic diseases for other infectious diseases for immunization are also taking into account as we work with the health systems with the health workers of our partners, partner agencies to make sure that services are available for people. Thanks for bearing with us everyone through those connectivity issues. I know it's not easy in Brazzaville to catch everything and also online. I want to go to David Andalman if we can from CNN opinion. David, do we have you on the line? Yes, thank you. How much of Africa's comparatively restrained numbers on COVID-19 compared to other parts of the world is due to the lack of testing and is simply concealing for our deeper problems that could help reseed other parts of the world this fall or winter? I think, minister, you touched on the difficulties that you have in testing large numbers of people. Perhaps I can turn to you first for an answer to David's question and he's asking is that lack of testing hiding a much bigger public health problem? What's your perspective, Dr. Samseh? Yes. Can you hear me? We can hear you, thank you. Yes. Yes, we suspect that it's hiding a major public health problem because we cannot really have the real situation throughout the country. We have an indication based on the small majority of testing that we have because we have been using the test very strategically. I think the question remains through our strategic approach that we need to take care of those most vulnerable because what matters the most in this epidemic? What matters the most is that we avoid high mortality and impact, human impact and economic impact. In a country like Central Aftkan Republic, a country which is highly vulnerable, highly fragile, economically, politically, security-wise, it is almost the whole population that is vulnerable. Among them, those who are the most vulnerable are having those comorbidities and those diseases. If you could have a possibility for testing them, at least testing half of the population, which is the third of what the amount of testing done in the UK or I don't know how many million it is being done now in the U.S., we would be able to really to contain the epidemic. So, yes, it is a real hindrance to a response to our response. Thank you, Minister. Dr. Moetti, given the constraints that we have heard of from Minister Samsay on testing, how concerned are you at the WHO that we are really missing out on the vast extent of this potential problem? Just checking. You are on mute, I think, Dr. Moetti. Okay. Okay. Yes, thank you. Our connectivity really is problematic. I just want to check that you can hear me. We can hear you, thank you. I don't know if you caught the question there, which was about, is the lack of testing hiding a much bigger problem across Africa? Yes, I think there is no doubt that the lack of testing kits is particularly in some of the low-income countries that are very much dependent on international support for procurement, but increasingly in other countries who can afford to pay but don't have access to the supplies. There is some degree of underestimation of the cases because the testing then is limited to those who are exhibiting symptoms in most of the countries who are coming to a health facility. There has been some attempt in some of the other countries to try and promote early testing, people who have been contacts of others to come forward themselves and be tested. No doubt that there is an underestimation. But we have seen that in some of the countries that have managed to increase their testing capacity. It's not in all countries that you get a commensurate increase in the proportion of tests that come back positive. So there is a diversity in the situation. There are countries where the more you test, the more you find in terms of some of the percentages coming back positive, being up to sometimes 10%, 8%. In many of the countries, say in Senegal, there is an increase in the number of tests that come back positive. So there is an increase in the number of tests that come back positive. And then it expanded significantly their testing. The proportion of those who were positive did not go up. So it meant that the testing wasn't uncovering hidden cases. I think that it is a mixed situation. There is a certain degree of underestimation. There is an increase in the number of tests that come back positive. There is an increase in the number of tests that come back positive. So I would say there is some underestimation. I don't think that we have a massively underestimated situation where thousands of people are dying undetected from this virus in African countries. I very much agree with Mr. President. I think that the more we are getting these rapid tests, we are suggesting that those should be... Dr. Mathew, we lost you there for a moment. We will try and get the connection with Brasoville back up and running. In the meantime, can we go to Mike Moanicki from Kenya, Medi-media services. I don't know if we can get Mike up live. We can't hear him. Perhaps we can hear you now. Mike, your question. We are still struggling. We are having a real connectivity day today. Mike's question is how many cases of COVID deaths have been reported at DADAB refugee camp and how are camp officials ensuring physical distancing is being observed bearing in mind the levels of congestion in the camp? Patrick, how do you manage to get any kind of physical distancing in conditions in camps like the DADAB? And how do you protect both refugees and people working in camps? I think there is no simple answer. When we see 10 families living under one tent, it's just simply impossible to apply certain norms that we can easily see happening to different levels of success in other environments. So the first and initial response is indeed enabling the displaced, the host communities, all those around displacement camps to have access critical for information. So information is considered as aid. And that was done indeed with the support of the myriad and the number of Red Cross and Red Cross and volunteers even in the most remote areas. I would say also that there has been infection control measures that were put in place in these camps where we had distribution of hygiene kits and other forms of assistance to enable those people living in these places to get the proper preventive measures right. And I would say the third is adapting the food assistance because that hasn't stopped or any other form of assistance to respect these preventive measures. So meaning including during distributions of food assistance or water supplies, etc., that these measures are being respected. But I would say again that for many these measures have been implemented. Some cases maybe have occurred, but we don't know all the truth but we do try to do even in places of detention as those, you know, ferry boats where one case, when one case is detected, the whole boat is basically infected. In these places where physical distancing is impossible, information has been considered as a major vector, passing on the information in local languages as we did, in local languages with local radios in order to create proximity and most importantly learn from other crises that we have to live through in Liberia or in the DRC related, for example, to the Ebola crisis. Thanks for that. Just very quickly before going to Adio, I just want to take Kevin Kelly from the nation media group in Kenya. Kevin, can we just get your question in? Yeah, are you able to hear me? Yeah, I'm able to hear you. I was just asked about the extent of the cases in the DAB. I'd like to ask the refugee woman herself to what extent is the UN being forthcoming with reporting on the infections and the death rate in the DAB. The last I saw, which is about a month ago now, the UN was saying there were nine cases in the DAB which seems kind of low given the situation in Kenya and throughout Africa generally. Thanks. We'll ask Adio. Thanks for that. Adio, can we just turn to you? I mean, obviously, you're in Nairobi now but anecdotally, perhaps, what are your experiences talking to people who are still in the DAB and maybe in Kakuma? Yes, thank you so much. I'm communicating. I do communicate with those in Kakuma and those in the DAB. Yes, I have a family in the DAB happening in the DAB and in Kakuma. And yes, it has been reported that in the DAB we had nine people. These are people who are coming in from Somali. They were put in a quarantine for 14 days, an isolated area. And after some time they have to go to test before they were released to the community. And at the end of the day, they were positive. It was too fast and then the rest joined in with the positive results. So they were put into a quarantine place, an isolated place for medication. And so far so good. Everything is fine. They have recovered and we don't even have any case at the moment in the DAB. The same thing to Kakuma. The people that we, the case we had in Kakuma, these are the new arrival who are coming from the other part of Somali going into Kakuma. They're also put in quarantine for 14 days, an isolated place. So when they tested positive, they were taken to hospital and so far two have recovered and they have been released to the community. So I think the medical facilities being UNCR and the UN, and the Kenyan government collaborating together with the refugees as well. It's actually bringing a very positive image to the community and also to the humanitarian agents. So I can do this in all that everything is fine. Everything is being catered for. Thank you. Thank you very much. And for our French speakers, is it possible that Dr Yao gives us a summary in French with the new developments? Excuse me for my French. Thank you very much. The French is not perfect. Today we are referring to the situation in terms of people moving, especially in a humanitarian context. And in this situation, obviously, the aspect of COVID constitutes a major issue. And the populations who live in a certain promiscuity, which makes it difficult to measure physical distancing and prevention measures. And so this requires a particular approach, in particular, the increase of the rain on certain measures, such as the point of sea waves, the access to water, and possibly also the distribution of certain entrants as well as possible entrants such as masks. This has been done by an IOM agency at the level of Kenya. There is also that COVID limits the access to certain basic services. And so this also requires a certain mobilization so that we can continue to have access to basic services such as treatment, for example, of certain diseases, as well as vaccination services. And so these are all the aspects for which a necessary mobilization is necessary. At the level of Africa, we have an increase of four. We have exceeded 600,000 cases, 13,000 deaths. And so there is a certain variety at the level of countries. And for these countries, some countries have an access as well as entrants of laboratories such as the Minister of Central Africa mentioned. And this also requires a certain mobilization and solidarity. And the OMS works with certain partners to respond to this critical need. This is how we can sum up the debate that took place from the beginning. And now we have a question from Mr. Ishihara from the ICBM of Japan. Mr. Ishihara, can we turn to you for your question? Thank you so much, everyone. My question is under the current situation of coronavirus, I believe the refugee or IDP camps are one of the most difficult places in the world. And the refugees are getting more difficult just for going to the camps or field or just going to approach the refugees. So in that situation, how has the international organization like UN, NGO or international Red Cross have changed the way of approach or operation and support for them after the outbreak in Geneva with the ICRC and then perhaps also hear from the minister about how governments on the ground are able to work with some of those NGOs. Patrick. So containing the virus is certainly the most complex issue we have to deal with since years. And containing the virus and trying to create a cordon connection between the two locations, the placement camps and prisons again. Those are the two most prominent places where we would want to avoid at all costs the spread. So then we really have to adapt our ways of working. I would also want to insist on the impartiality of humanitarian action and trying to get as much as possible to have a dialogue with all actors on the ground and to have a dialogue with all actors on the ground. So then we have to talk about the internal displacement. We speak about a war. We speak about warring parties mostly non state on groups with whom the ICRC wants to continue having a dialogue to get access not only to the camps close to the capital but also to the most remote places where COVID has spread. And we have to use this opportunity to say that as much as humanitarian actors are giving that space to get access to these places and make sure that preventive measures are also spread that can help the delivery of humanitarian services. But we have also to say that we need to work with local actors for the shakes, for the religious circles in order to get that message across. We have to work with local actors in order to get access to these places of stigmatization that we have to work through and work around including with local actors which brought us into a different notion of proximity with those who can help us meaning the communities who can help us deliver these services while protecting ourselves and we shouldn't forget the duty of care that we owe ourselves and our teams and our volunteers on the ground. Thank you. I think that's a great time magazine in South Africa for her question. Aaron. We have been discussing some of the inequities when it comes to access to testing, prevention and treatment here in Africa. Are there concerns that the same inequities will be perpetuated when it comes to the distribution of a potential vaccine? What are the difficulties your country has been having in getting kits and getting equipment and getting resources? When it comes to a potential vaccine, how concerned are you that the Central African Republic needs to be included in the first list of those able to access it? We are fundamentally concerned about those who issued a petition declaration in order to require equality in access to vaccine. We have just signed a request to indicate our willingness to be part of those who would benefit from the vaccine as soon as it is available. But the situation in accessing basic supply, basic good is a source of concern. So we don't know how this will be different for vaccine. So it's a real question, the real question that is raised. I would like to take this opportunity to also tell you that we have experienced in terms of addressing the issue of in the refugee camp or displaced camp. Humanitarian actors are doing a good job in our country. They are providing those camps with water, with tons for isolation of cases. But the challenge is that one denial is there and people and culture, people don't accept to be separated from the community to live in isolation in a tent. At the same time, external actors are stigmatized because as you know, initially the disease is considered as being brought by westerners, by people from abroad. So humanitarian are stigmatized for that. So what we do is that we are de-dramatizing the disease because I think what has happened also is that the TV and the news and the way the issue were presented from outside has really created more panic than it should be. What we are trying to do here coping with our situation is a situation that caused us to be more pragmatic when someone is detected, the person can remain if it is a very mild case. The person can remain among the family in the same house where masks and battery take precaution to stay aside and it works. We don't see full blown, we don't see contamination across the family. So in those camps where people are packed it is and people are afraid you cannot take someone outside the community which is already scared and put the person outside it raises suspicion. So I think from government perspective from my perspective I think we have to de-dramatize we have to simplify this disease is not so highly targeted. People can have the infection where masks be just of self-serve desensitization from the family with some education and psychological support it should work. Thanks for that. Thanks Minister. We've had three encouraging but very early breakthroughs in South Africa. I want to go to you to close today's briefing in just a moment if I may. Perhaps you can comment on that question regarding the provision of vaccines globally. But I want to turn if I can to last question to Mary and Issa from Fin Week in South Africa. Mary. Thank you very much for taking my question. I think we have a lot of questions about the health of the continent. We broke the 300,000 mark today and we're recording more than 10,000 new infections a day. However, our fatality rate thankfully has been much lower than the global average. It's been about 1.5% so far. And I wondered in that case the early fatality projections that we got here would have been considerably lower than the global average. So I think that's a good question. I think the next question has more up-to-date projections. The related question is . Thanks for that. We're down to our last two minutes of the briefing. So if I can, I'll just give Dr. Moti a chance to come in on that question and also perhaps to close on the question. So we're going to talk about the health of the continent . The health system compared to many countries does have the capability of providing care for people in terms of outcomes and the case fatality rates. And South Africa has been able immediately to leverage the capacity of the private sector as well as the use of the public sector. So we've seen fatality rates, but the other side of things has been pretty slim and even the minister has said, they're hesitating to put numbers to things, but they think it's going to peak around September. I've not looked at the numbers at which they think there will be. This is something we will work on, but it's a very serious situation, driving the pandemic in the region at the moment certain actions being taken, Gavi working with other international partners and WHO has devised a means of trying to, if you like, pull countries' capacity together to secure some of the supply. Clearly, Gavi is going to be in this usual way supporting the Gavi-supported low-income countries in order to then create shape, if you like, a market for access to the vaccines for the countries they're supporting. They've also contacted middle-income countries that are not supported by Gavi directly in terms of financing and asked them to indicate an interest and to start to, if you like, make a contribution so that the financing for procuring the vaccine of the future can be joined between Gavi for low-income countries and middle-income countries having indicated an interest. It's going to be difficult, I think. Let's acknowledge it. And here, again, is our plea, I'll join the Minister, for global solidarity. This is one area where we really will need global solidarity in action by those countries that have the capacity to capture the supplies because they have the funding to do so. Dr Muhti, thank you very much. We've come to the end of today's briefing. A big thank you to Minister Somseh for joining from the Central African Republic and providing a very pertinent update on the reality of the situation that he and his country are experiencing. A big thank you, too, to Adiyo Achuldiu-Quep for joining from Nairobi, Kenya and providing a perspective from a refugee background. To Patrick Yusef in Geneva from the ICRC, a big thank you. Thanks most of all to Drs Muhti and Yao for battling connectivity to stay with us for the full hour. Thanks to everyone for joining from all of us on the call. Have a good rest of your day and look forward to seeing you at future briefings. Thank you.