All Network Cdr Pakistan

[Oliverio Gallman]

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Introduction: Familial hypercholesterolemia (FH) is a modifiable risk factor for premature coronary heart disease but is poorly diagnosed and treated. We leveraged a large laboratory network in Pakistan to study the prevalence, gender and geographic distribution of FH.

Conclusion: There is high prevalence of actionable LDL-C values in lipid samples across a large network of laboratories in Pakistan. Variable FH prevalence across geographic locations in Pakistan may need to be explored at the population level for intervention and management of contributory factors. Efforts at early diagnosis and treatment of FH are urgently needed.

Disaster Risk Financing (DRF) allows humanitarian organisations to be better prepared in advance of cyclical events by quantifying risks in advance of crises or disasters, pre-positioning funds, and releasing them according to pre-agreed protocols.

Contingency planning is central to a DRF system. Contingency plans tend to be developed at a sub-national level: either at district or livelihood-zone level, whichever delineation is appropriate to the context. The process uses participatory and inclusive approaches, working with people at risk and local groups and organisations to design and validate planned actions, and in some places, to enable local groups to have ownership of plan implementation. Contingency plans usually reflect three severity scenarios (mild, moderate, and severe at a minimum) including costs, and may also cover one or more windows of action such as preparedness, mitigation, and anticipatory response. Another crucial component of DRF is the preposition of financing - financing is realised when the agreed thresholds on the parametric model have been reached according to predefined operational protocols.

In creating the enabling environment for locally led decision making, a National Steering Committee (NSC) and three hazard-specific Technical Working Groups (TWGs) have been established. The National Steering Committee (NSC) is the highest decision-making body consisting of a Chair and representative Start Network members in Pakistan including 3 INGOs and 2 National Start Network member NGOs. The NSC includes representatives of three major influencing national humanitarian and development networks/consortiums i.e., National Humanitarian Network (NHN), Pakistan Humanitarian Forum (PHF), and Indus Consortium. Moreover, to support the programmes coordination and partnership with government agencies, a dedicated focal point has been officially appointed by the National Disaster Management Authority, NDMA Pakistan.

Thanks to funding provided by the UK's Foreign Commonwealth and Development Office (FCDO) and the Government of the Netherlands, Start Network is able pilot the first multi-hazard DRF system until the end of 2021 for the following three hazards.

These efforts to establish a DRF system in Pakistan are part of the wider efforts between Start Network members and the National Disaster Management Authority - NDMA, who have been working together since 2017 to unlock new forms of funding mechanisms to enable effective humanitarian assistance.

The overall aim is to build resilience to droughts in Pakistan. Most drought monitoring programmes in Pakistan focus on the summer monsoon and the availability of surface and sub-surface water. The secondary winter growing season is, however, also of economic and agricultural importance. Therefore the vulnerability of the communities to winter crop and pasture failures motivated Start Network to implement an agricultural drought DRF initiative for the Punjab and Sindh provinces.

Since March 2020, Start Network has been working with the University of Reading (UoR), to implement a drought Disaster Risk Financing (DRF) system for the Punjab and Sindh provinces, especially focusing on the winter growing season. Specifically, developing an anticipatory, operational drought model (based on the TAMSAT-ALERT system to predict NDVI), to trigger funds for early action intervention.

JBA was selected to provide scientific modelling expertise to develop a real-time and forecast flood model for the Indus River basin. The goal was to develop a fully-automated early warning system, which provides daily forecast of flood conditions on which a series of anticipatory actions can be devised to reduce overall humanitarian impact.

Using the Copernicus Global Flood Awareness System (GloFAS) with JBAs Flood Foresight technology the model outputs daily probabilistic forecasts of flood inundation extents and depths. From these digital maps the model can estimate the population at risk in the short, medium and long-term. The model quantifies the flood risk to the population through a traditional probabilistic catastrophe risk model. See feature article here.

The model runs for the whole of the Indus Basin, outlined in the map above. The percentage of Pakistan within the Indus River basin is approximately 58%; it includes 132 districts but does not include all of the area of each district. For example, the district of Karachi is included in the Indus Basin but the city of Karachi is not. To see a detailed map of which districts fall within the Indus Basin please see Flood Technical Report (appendix A).

Important note: the aim is not to replace what has been done at the national level, but rather to build on the metrics that have already been monitored and produced within the agencies in Pakistan. By building on the information already used, and is available, we can produce a model that is objectively actionable, for risk management and used by members. This provides a quantitative, probabilistic, and granular output, of the sort that is required for rapid release of pre-positioned funds via the DRF.

The overall aim is to build resilience to heatwaves in Pakistan. Heatwave conditions are the major cause of weather-related casualties in Pakistan. Heatwave is defined as the number of days when, for some consecutive days, the temperature is greater than a certain threshold, keeping in view the climatology of the station.

Extreme heat can lead to dangerous, even deadly, health consequences, including heat stress and heatstroke. Climate change drives temperatures higher, increasing the frequency and severity of heatwaves. The anticipated rise in temperatures and frequency of heatwaves in Pakistan highlights the need for inter-agency coordination to mitigate the impact of these disastrous events in the future.

During the hottest months, Start Network implements its heatwave Disaster Risk Financing system for several urban locations in Pakistan (Larkana, Karachi City, Multan, Sibi, Jacobabad, and Nawabshah). Specifically, an anticipatory, operational heatwave model (based on the NOAA GFS model to calculate heat index values) is used to trigger funds for early action intervention.

The model forecasted a heatwave event with a 6-day lead time predicting a maximum temperature of 45.3C and a minimum of 31.4C for the 26th of May. However, the maximum and minimum temperatures decreased by 5.6C and 3.3C respectively on the observed day.

In this first year of operation, many lessons have been learned, this includes the humanitarian impact of extreme heat in low-income countries with limited access to quality healthcare and informal dwellings which can trap heat. The Knowledge, Attitude and Practice survey report developed in collaboration between Start Network, HANDS Pakistan, and Welthungerhilfe analyses the knowledge, attitude, and practice of Karachi residents in relation to managing extreme heat. Conducted in 2020 following a messaging campaign led by HANDS related to extreme heat. The project was triggered through a disaster risk financing approach, using a heatwave model to trigger funding automatically when extreme heat was forecast.

Mr. Shoaib Sultan Khan, Chairman RSPN with Mr. Sartaj Aziz, Advisor on Foreign Affairs to the Prime Minister of Pakistan at the National Community Driven Development (CDD) Conference held in December 2015 in Islamabad

The RSPN is the largest development network of Pakistan, with an outreach to over 56.1 million ruralPakistanis. It consists of nine member Rural Support Programmes (RSPs), which have been operatingsince 1982.

Some jihadi terrorist organizations with even older roots may also be interested in this policy. LeJ has been operating in Pakistan since 1990 and, characterized by a sectarian quality, has much in common with ISIS. As a splinter of Sipah-e-Sahaba, which is an anti-Shiite movement founded by Jhangvi in the late 1980s, they aim to transform Pakistan into a Sunni Islamic state under Shariah law.

LeJ was led by Malik Ishaq, an overtly anti-Shiite militant involved in more than 100 murder cases of sectarian nature. On July 29, 2015, Malik Ishaq, along with his two sons and deputies, was killed in an alleged encounter at a forest near Muzaffargarh district of Punjab province after it was reported that Ishaq was to publicly pledge allegiance to Baghdadi.

On May 15, 2015, six armed men on motorcycles stopped an Ismaili-Shiite community service bus in Safoora and shot 43 Ismaili-Shiite civilians in cold blood, scattering ISIS leaflets before speeding off. After their arrest, the highly educated Islamist radicals of ethnic Punjabi origins revealed they were showcasing their resolve before pledging allegiance to ISIS. The cell was led by Tahir Minhas aka Saeen, a veteran al-Qaeda militant from Bahawalpur, who trained at al-Qaeda-run training camps in Afghanistan. Subsequent police raids also led the investigators to a network of 14 women involved in recruitment and logistics for aiding ISIS activities in Pakistan.

It issuspected that ISIS is penetrating the Baluchistan province of Afghanistan. This became evident when the Home Minister of Baluchistan province arrested 6 ISIS militants from the Noshki district and recovered a huge cache of arms, jihadi literature, and explosives in August 2016.

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