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The first case of COVID-19 was reported in Mozambique on 22 March 2020. As of 26 May, Mozambique had 194 confirmed cases of COVID-19, of which 168 were locally transmitted. The country’s capital, Maputo, and the province of Cabo Delgado are curren
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tly the epicentres of the outbreak in Mozambique, with Pemba and Afungi registering more than 50 percent of the overall cases. Other provinces affected are Manica, Inhambane, Gaza, Tete and Sofala.
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The humanitarian crisis in Yemen is the worst in the world, with over 80 per cent of the population estimated to be in need of humanitarian assistance. The protracted crisis has displaced millions of Yemenis, placing pressure on host communities with limited capacity to support displaced populations
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.
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En diciembre del 2019 se comunicó a la Organización Mundial de la Salud (OMS) la ocurrencia de varios casos de neumonía en Wuhan, una ciudad situada en la provincia China de Hubei.
As of 21 May 2020, 4.8 million confirmed cases of Coronavirus disease 2019 (COVID-19) have been reported globally. In South America, COVID-19 was first detected on 26 February 2020, when Brazil conf
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irmed a case in São Paulo.
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This revision to the Disaster Management Team’s (DMT) multi-sector response plan for COVID-19 is meant to align the multi-sector plan with the Department of Health’s COVID-19 Emergency Response Plan issued on 24 April 2020.
This document summarizes preparedness and response activities to address the coronavirus disease (COVID-19) outbreak in South Sudan through the end of 2020. The addendum includes the activities and financial requirements of the updated National COVI
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D-19 Response Plan. Originally issued in March prior to identification of the first person confirmed with COVID-19 in South Sudan and with a focus on preparedness, the updated plan encompasses a significantly scaled-up national response.
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he central Sahel region—Burkina Faso, Mali and Niger—is facing a severe humanitarian and protection crisis.
Massive displacement, most of it driven by intense and largely indiscriminate violence perpetrated by a range of armed actors against civilian populations, is taking place across the regi
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on. While internal displacement is on the rise substantial numbers of refugees have fled to neighboring countries, and the situation risks spilling over into the coastal countries of Benin, Côte d'Ivoire, Ghana, and Togo.
This context is exacerbated by the COVID-19 pandemic, which is already affecting areas hosting refugees and IDPs
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As this report shows,
reports of child abuse and of children
witnessing violence between their
parents and caregivers have increased.
Ending violence against children is
increasingly within our reach. D
The Global Status Report on Preventing Violence Against Children 2020 - Executive Summary
recommended
The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violenc
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e against children. The report signals a clear need in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
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The Global Status Report on Preventing Violence Against Children 2020 - Russian
Цель доклада состоит в том, чтобы документально установить в какой степени государства вып
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лняют следующие виды деятельности:
• принятие национальных планов действий, стратегий и нормативных актов, соответствующих примерам передового опыта, приведенным в комплексе INSPIRE;
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El informe se encamina a documentar si los gobiernos:
• tienen planes de acción, políticas y leyes nacionales en consonancia con aquellos cuya eficacia se ha comprobado en el contexto de INSPIRE;
• están contando los incidentes violentos mortales y no mortales con exactitud;
• han establ
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ecido valores de partida y valores a alcanzar que les permitan monitorear su progreso hacia la erradicación de la violencia contra los niños;
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This technical guidance outlines current evidence, knowledge and best practice relating to incidences of violence and injuries among refugees and migrants in the WHO European Region. It highlights key principles, summarizes priority actions and challenges, maps existing international commitments and
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frameworks and provides practical policy considerations for preventing and responding to such challenges. Specific areas for intervention include ensuring safe passage for migration; addressing causes of violence and injuries in transit and destination countries, including changing norms and values; identifying victims and providing care and protection; investigating and prosecuting perpetrators; and strengthening the knowledge base. While the main intended audience of this technical guidance series are policy-makers across sectors at local, national and regional levels, the contents of this publication will also be of value for health-care practitioners and law enforcement and border protection officials.
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Primary care health centers and providers who care for individuals with hypertension and cardiovascular disease have an important role to play in ensuring continued access to care, reducing the risk of coronavirus infection, and appropriately managing people with these co-morbidities who acquire COV
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ID-19. This guidance includes these considerations
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Das Papier gibt einen Übersicht zu Anzahl und Zusammensetzung von Geflüchteten in Deutschland, zu Asylanträgen, Herkunftsländern, Schutzquoten, der Aufenthaltsbeendigung und Regeln des Asylverfahrens sowie dem Zugang zu Bildung und Arbeit für Geflüchtete in Deutschland
Depuis début janvier 2018, le Burkina Faso est confronté à une insécurité grandissante qui a engendré des mouvements massifs de population. Outre la crise sécuritaire qui touche le pays, les premiers cas de personnes infectées par la pandémie de la covid-19 ont été confirmés le 9 mars
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2020. Au 1er juin 2020, 883 cas ont été confirmés dont 322 femmes, enregistrés dans neuf régions du pays - le Centre, les Hauts Bassins, le Centre-Nord, la Boucle du Mouhoun, le Plateau Central, les Cascades, le Centre-Sud, le Sud-Ouest et le Sahel.
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UNAIDS Data 2020
recommended
Start Free Stay Free AIDS Free - 2020 report
recommended
This progress report reviews recent gains, new developments and remaining challenges as countries approach the 2020 targets of the Start Free Stay Free AIDS Free framework.
Immunizations are an essential health service that protect susceptible individuals from vaccine-preventable diseases (VPD).2 By providing timely immunizations, individuals and communities remain protected and the likelihood of a VPD outbreak decreases, Preventing a VPD
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outbreak not only saves lives but requires fewer resources than responding to the outbreak and helps reduce burden on a health system already strained by the COVID-19 pandemic, While committing to sustaining immunization systems, countries should use approaches that respect the principle of do-no-harm and limit transmission of COVID-19 while providing immunization activities, Immunization visits can also be used as opportunities to disseminate messages to encourage behaviours to reduce transmission risk of the COVID-19 virus, to identify signs and symptoms of COVID-19 disease, and to provide guidance on what to do if symptoms emerge
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Objectifs 2020 : des avancées disparates. Le rapport de l’ONUSIDA sur l’épidémie mondiale de sida fait état d’un échec accentué par la COVID-19. Depuis 2015, 3,5 millions d’infections au VIH et 820 000 morts supplémentaires liés au s
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ida sont imputables à des objectifs non atteints. Elles auraient été évitées si les objectifs 2020 avaient été réalisés. La riposte pourrait également revenir dix ans en arrière au moins, si la pandémie de COVID-19 interrompt gravement les services de lutte contre le VIH.
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Key highlights from January to April 2020 (Syria situation)
Across the MENA region, UNHCR is receiving alarming reports of increasing mental health issues among the forcibly displaced. Mental health and psychosocial support (MHPSS) activities are b
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eing stepped up by UNHCR and partners to address this new dangerous trend.
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Depuis que le COVID-19a été confirmé au Tchad le 19 mars et les premiers cas de transmissions communautaires, les autorités tchadiennes ont pris des mesures de prévention et de réponse qui ont des conséquences sur le contexte et la nature des opérations humanitaires. Ainsi, u
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n ajustement des plans, des cibles et des besoins financiersdes clusterss’est révélé opportunpour répondre non seulement à la crise sanitaire mais aussi aux impacts indirects de la pandémie sur la situation de million de personnesdéjà ciblées par l’aide humanitaire avant l’apparition du COVID.
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Also available in a Myanmar language version
As of 29 June 2020, there have been 299 confirmed cases, including six fatalities and 218 recoveries across the country. The rate of local transmission has been low so far with cases confirmed mainly among people returning from abroad.
La información actualizada sobre numerosos países ha hecho posible estimar el hambre en el mundo con mayor precisión este año. En particular, los datos a los que se ha tenido acceso recientemente han permitido revisar la serie completa de estimaciones anuales de la subalimentación correspondien
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tes a China desde el año 2000, lo cual ha dado lugar a una importante variación a la baja de la serie relativa al número de personas subalimentadas en el mundo. No obstante, la revisión confirma la tendencia sobre la que se ha informado en ediciones anteriores: el número de personas afectadas por el hambre a nivel mundial ha ido aumentando lentamente desde 2014
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There is no secret to our procedure: the daily scanning of the literature helps us to stay afloat in the never-ending waves of new publications about SARS-CoV-2 and COVID-19. Many papers discussed in the Top 10 will eventually make it into subsequent editions of COVID Reference.
A new reportshows that people in some 25 countries are set to face devasting levels of hunger in coming months due to the fallout from the COVID-19 pandemic. While the greatest concentration of need is in Africa, countries in Latin America and the Caribbean, and in the Middle East and Asia – inclu
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ding middle-income countries - are also being ravaged by crippling levels of food insecurity
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El Plan de Respuesta Humanitaria con Panorama de Necesidades Humanitarias Venezuela 2020 tiene por objeto proporcionar asistencia humanitaria a 4,5 millones de venezolanos y venezolanas vulnerables. Para ello, hace un llamado de $762,5 millones de d
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ólares. El Plan se basa en la labor humanitaria que se llevó a cabo en 2019 mediante tres objetivos estratégicos: prestar asistencia de emergencia para salvar vidas; asegurar los medios de vida mediante un mejor acceso a los servicios básicos; y garantizar la protección de los más vulnerables.
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La crisis de personas refugiadas y migrantes venezolanos es una de las mayores crisis de desplazamiento externo en el mundo. La pandemia COVID-19 ha agravado la ya desesperada situación de muchas personas refugiadas y migrantes, así como la de los países de acogida, poniendo a prueba los sistemas
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nacionales de salud y asistencia social, así como la capacidad de los países para apoyar a su población vulnerable.
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The UNAIDS 2020 global report is a call to action. It highlights the scale of the HIV epidemic and how it runs along the fault lines of inequalities.
UNAIDS report on the global AIDS epidemic shows that 2020 targets will not be met because of deeply unequal success; COVID-19 risks blowing HIV progress way off course. Missed targets have resulted in 3.5 million more HIV infections and 820 000 more
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AIDS-related deaths since 2015 than if the world was on track to meet the 2020 targets. In addition, the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services.
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Across Zimbabwe, 7 million people in urban and rural areas are in urgent need of humanitarian assistance, compared to 5.5 million in August 2019. Since the launch of the Revised Humanitarian Appeal in August 2019, circumstances for millions of Zimbabweans have worsened. Drought and crop failure, exa
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cerbated by macro-economic challenges and austerity measures, have directly affected vulnerable households in both rural and urban communities. Inflation continues to erode purchasing power and affordability of food and other essential goods is a daily challenge. The delivery of health care, clean water and sanitation, and education has been constrained and millions of people are facing challenges to access vital services.
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The Government of Republic of Zambia reported the first confirmed cases of COVID-19 on 18th March 2020. As of April 27th, 2020, there were 89 confirmed cases, three deaths and 42 recoveries. Confirm
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ed cases are located in three provinces: Lusaka (83 cases), Copperbelt province (5 cases) and Central (1 case). Zambia introduced a series of measures including closure of three international airports, closure of all schools, movement restrictions and closure of non-essential services such as restaurant, bar, gym and public gatherings to curb the transmission rate.
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Tại nhiều quốc gia, cú sốc của làn sóng kiểm dịch thứ nhất đã lắng xuống, số ca bệnh cũng đã giảm, việc gỡ bỏ các lệnh phong tỏa đang được xem xét hoặc đã được thực hiện ở nhiều nơi. Vũ Hán đã mở cửa trở lại. Nhưng ph
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ải chăng ta đang bị đánh lừa bởi vẻ ngoài? Liệu làn sóng dịch bệnh thứ hai có xảy ra không, và nếu có thì khi nào chúng sẽ đến?
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This report presents three scenarios on the impact of COVID-19 in Africa using economic growth forecasts, mortality and efforts to ameliorate impact through social grants. Likely effects are examined on per capita income, poverty and the attainment of selected Sustainable Development Goals targets.
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Africa’s development trajectory has suffered a severe setback, with extreme poverty rising in all the scenarios. The pandemic threatens Africa in several ways, and the report provides policy recommendations to reduce vulnerability and strengthen resilience.
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Este plan está basado en las demandas y necesidades del Gobierno de Colombia al Sistema de las Naciones Unidas (SNU), bajo el liderazgo de la Oficina de la Coordinadora Residente, para complementar los esfuerzos nacionales de la respuesta a la COVID-19. Asimismo, se encuentra alineado con los princ
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ipios establecidos en el Marco de Cooperación de las Naciones Unidas para el Desarrollo Sostenible UNSDCF 2020-2023.
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WHO published the first COVID-19 Strategic Response and Preparedness Plan (SPRP) on 3 February, 2020. This report highlights the main points of progress that were made up to 30 June 2020 under the t
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hree objectives outlined in the SPRP: scaling up international coordination and support; scaling up country preparedness and response by pillar; and accelerating research and innovation. The report also discusses some of the key challenges faced so far, and provides an update on the resource requirements for the next phase of WHO’s response as part of an unprecedented whole-of-UN approach to the pandemic.
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For COVID-19, as for many infectious diseases, the true level of transmission is frequently underestimated because a substantial proportion of people with the infection are undetected either because they are asymptomatic or have only mild symptoms and thus typically fail to present at healthcare fac
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ilities. There may also be neglected or under-served segments of the population who are less likely to access healthcare or testing. Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities). Cases may also be misdiagnosed and attributed to other diseases with similar clinical presentation, such as influenza.
Differences in mortality between groups of people and countries are important proxy indicators of relative risk of death that guide policy decisions regarding scarce medical resource allocation during the ongoing COVID-19 pandemic. This document is intended to help countries estimate CFR and, if possible, IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation
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Remote Psychological First Aid during COVID-19 – May 2020
IFRC Reference Centre for Psychosocial Support
IFRC Reference Centre for Psychosocial Support
(2020)
CC
Psychological first aid (PFA) is a method of helping people in distress so they feel calm and supported to cope better with their challenges. It is a way of assisting someone to manage their situation and make informed decisions. The basis of psychological first aid is caring about the person in dis
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tress and showing empathy. It involves paying attention to reactions, active listening and, if needed, practical assistance, such as problem solving, help to access basic needs or referring to further options for assistance. PFA helps normalize worry and other emotions, PFA also promotes healthy coping and provides feelings of safety, calming, and hope. These guidelines can be used by Red Cross Red Crescent National Societies to set up and run different kind of remote services for the public during the time of a COVID-19 response. It should be noted that the target group for the guidelines are adults.
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The results of a WHO survey conducted to assess the impact of the COVID-19 pandemic on up to 25 essential health services in countries show disruptions of essential health services in nearly all countries, and more so in lower-income than higher-income countries. The great majority of service disrup
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tions were partial, which was defined as a change of 5–50% in service provision or use.
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This paper aims to provide aid agencies with initial analysis and guidance to inform the design, implementation and adaptation of conflict-sensitive humanitarian and development responses to the COVID-19 pandemic. It presents a series of overarching considerations to take into account when determini
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ng how to build a conflict-sensitive approach into COVID-19 response activities, before outlining some initial, sector-specific considerations. Recommendations are presented throughout.
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La región amazónica esta siendo actualmente impactada significativamente por la COVID-19, no solo amenazando la vida y los medios de subsistencia de su población, sino además presentandose como una amenaza latente a las comunidades indígenas que allí habitan.
Ethiopia saw a six-fold increase in confirmed COVID-19 cases between June and August, with 5,689 cases by end June compared to 34,058 cases as of 19 August. Ethiopia also registered more than 13,000 recoveries and more than 600 deaths. As of the last week of August, Ethiopia was leading eastern Afri
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can countries with the highest number of cases.
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Au cours des derniers mois, la situation sécuritaire et humanitaire s'est rapidement détériorée dans les régions du Nord, du CentreNord, du Sahel, de la Boucle du Mouhoun et de l’Est du Burkina Faso. Cette dégradation a entraîné un accroissement substantiel des déplacements internes et ag
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gravé l'accès déjà très limité aux services sociaux de base dans un contexte d'extrême pauvreté dans ces localités. Alors que l'insécurité augmente progressivement depuis 2017, l’année 2019 a été particulièrement violente, provoquant une augmentation sans précédent des besoins humanitaires. 2,9 millions de burkinabè sont dans un besoin humanitaire de plus en plus croissant dans tous les secteurs. Parmi ces 2,9 millions de personnes, plus de 920 000 étaient des déplacées internes au 30 juin 2020 et plus de 1,5 millions étaient directement privées d’un accès aux soins de santé et d’éducation
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Le Plan de réponse humanitaire (PRH) 2020 a été révisé et publié en mai 2020 afin d’intégrer l’impact de l’épidémie de COVID-19 sur les besoins humanitaires existants et sur les activ
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ités des partenaires humanitaires.
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La pandémie causée par le coronavirus s’est propagée au Niger le 19 mars, date de la notification du premier cas. A la date du 21 juillet 2020, le pays avait enregistré 1 113 cas, dont 1 1018 guéris, 26 sous traitement et 69 décès. Selon l
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analyse des données effectuée par le Ministère de la santé publique, la pandémie a atteint un pic le 9 avril avec 69 cas enregistrés en une journée pour ensuite connaitre une courbe descendante. Cette tendance se maintient en dépit de la progression de la pandémie à Zinder, ainsi que dans les régions d’Agadez et de Diffa, qui étaient, jusqu’au 30 avril 2020, les seules régions épargnées par la COVID-19, et le fait que 169 agents de santé, soit 18,4% de cette catégorie de personnel, figurent parmi les cas confirmés.
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Le Plan de réponse humanitaire (PRH) 2020 a été révisé et publié en mai 2020 afin d’intégrer l’impact de l’épidémie de COVID-19 sur les besoins humanitaires existants et sur les activ
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ités des partenaires humanitaires.
Dans le contexte de l’épidémie de COVID-19, la portée de l’analyse du PRH 2020 a été mise à jour afin d’intégrer les nouveaux besoins et activités liées à la réponse humanitaire au COVID-19 et d’ajuster les priorités humanitaires en prenant en compte l’évolution du contexte opérationnel.
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The International Organization for Migration (IOM) and partners from 27 humanitarian and development organisations and governments are appealing for USD 84 million to provide life-saving assistance to hundreds of thousands of African migrants and host community members affected by COVID-19 in the Ho
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rn of Africa and Yemen. The many partners include the UN Children’s Fund (UNICEF), Save the Children, among others.
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At the time of writing, the novel coronavirus pandemic had reached every region of the world, with millions of infections globally and untold disruptions to nearly every aspect of daily life.
The COVID-19 pandemic is a multiplier of vulnerability, compounding threats to food insecurity, while exposing weaknesses in food and health systems. It is severely undermining the capacity of communities to cope in times of crisis and has become a stress test for political and economic stability.
Available in Arabic, Chinese, English, French, Portuguese and Spanish
https://apps.who.int/iris/handle/10665/334254
Conflict, climate crisis and COVID-19 pose great threats to the health of women and children.
La République Démocratique du Congo connait une fragilité sociale issue de divers conflits communautaires qui ont déstabilisés le tissu économique du pays sans épargner le secteur éducatif depuis plusieurs années. Les sources de fragilité sont aussi liées à la pauvreté de la population
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et à l’insécurité alimentaire (15,5 millions de personnes en 2019). De plus, le pays fait face à d’autres crises comme les catastrophes naturelles et différentes épidémies y compris le Cholera, la maladie a virus d’Ébola et COVID19.
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COVID-19 has resulted in an unprecedented global crisis. As the pandemic spreads and countries around the world continue to struggle to contain its health and socio-economic consequences, UNRWA is issuing a new humanitarian appeal from August through December
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2020 to address the worst impacts of the pandemic on Palestine refugees across the Agency’s five fields of operation. Through this appeal the Agency seeks US$ 94.6 million. The funds requested in this appeal are additional to the previous UNRWA COVID-19 appeal for March to July.
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Accessed on 20.10.2020
L͛analyse des tendances récentes montre que le Burkina Faso a enregistré une réduction significative de la mortalité infanto-juvénile. Même si aucune des cibles des OMD 4 et 5 n͛a été atteinte par le pays, le taux
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de mortalité infanto-juvénile est passé de 129 pour mille naissances vivantes en 2010 à 82 pour mille naissances
vivantes en 2015, soit une baisse de 7.3% par an. Ceci est en grande partie dû aux progrès enregistrés en matière de lutte contre la mortalité au bénéfice de la tranche juvénile (de 1 à 4 ans). Cependant, comme près de la moitié des enfants âgés de moins de cinq ans continuent de mourir au cours de leur première
année de vie, il reste beaucoup à faire pour l͛atteinte de la vision globale d͛élimination de la mortalité infanto-juvénile évitable et de réduction de la mortalité des mères comme partie prenante des Objectifs de Développement Durable (ODD).
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This third regional report discusses gaps and challenges in reducing the harmful use of alcohol and how countries can reverse current trends in a cost-effective and expedited way.
Addendum: 2020 mid-year COVID-19 revision,summary of the reprioritisation & additional requirements in response to COVID-19
In June and July 2020, a mid-year revision of the
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2020 Burundi Regional Refugee Response Plan (RRRP) was undertaken as an inter-agency consultative process to discuss and document the reprioritization of activities and corresponding budgets for the rest of the year, taking into account the impacts of COVID-19 and other developments.
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CYCLE DE PROGRAMMATION HUMANITAIRE 2020-2022
Ce document est consolidé par OCHA pour le compte de l’Équipe humanitaire pays et des partenaires humanitaires. Il présente les priorités et les paramètres de la réponse stratégique de l’Équi
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pe humanitaire pays, basés sur une compréhension partagée de la situation.
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Addendum: 2020 mid-year COVID-19 resvision, summary of the reprioritisation & additional requirements in response to COVID-19
In June and July 2020, a mid-year revision of the
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2020 South Sudan Regional Refugee Response Plan (RRRP) was undertaken as an inter-agency consultative process to discuss and document the reprioritization of activities and corresponding budgets for the rest of the year, taking into account the impacts of COVID-19 and other developments.
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Available in English, Spanish and Portuguese
There is no secret to our procedure: the daily scanning of the literature helps us to stay afloat in the never-ending waves of new publications about SARS-CoV-2 and COVID-19. Many papers discussed in the Top 10 will eventually make it into subsequent editions of COVID Reference.
Thefirst report on Latin America and the Carribean presents key indicators on health and health systems in 33 Latin America and the Caribbean countries. . Analysis is based on the latest comparable data across almost 100 indicators including equity, health status, determinants of health, health car
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e resources and utilisation, health expenditure and financing, and quality of care. The editorial discusses the main challenges for the region brought by the COVID-19 pandemic, such as managing the outbreak as well as mobilising adequate resources and using them efficiently to ensure an effective response to the epidemic.
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Panorama de la Salud: Latinoamérica y el Caribe 2020 presenta indicadores clave sobre la salud y los sistemas de salud en 33 países de Latinoamérica y el Caribe. Esta primera edición del Panorama de la Salud sobre Latinoamérica y el Caribe fue
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preparada en conjunto por la OCDE y el Banco Mundial. Los análisis se basan en los datos comparables más recientes de alrededor de 100 indicadores sobre equidad, situación de salud, determinantes de la salud, recursos y actividades, gasto y financiación, y calidad en la atención de salud. El editorial discute los principales desafíos para la región en el contexto de la pandemia de COVID-19, incluyendo tanto el manejo de la epidemia como la movilización y el uso eficiente de recursos para asegurar una respuesta efectiva
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Intra-African migration remains a dominant trend in contemporary African migration. The Strategy frames the Organization’s new orientation with Africa at policy and strategic levels. It is consistent with the goals and objectives of the Global Compact for Safe, Orderly and Regular Migration (GCM)
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to which almost all African countries adhere, as well as the 2030 Agenda for sustainable development, the IOM strategic vision, and IOM Migration Governance Framework (MIGoF).
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The Bolivarian Republic of Venezuela has been facing a sociopolitical and economic situation that has negatively impacted social and health indicators. There have been intensified population movements both within the country and to other countries, particularly to Argentina, Brazil, Chile, Colombia,
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Costa Rica, Curaçao, Dominican Republic, Ecuador, Guyana, Mexico, Panama, Paraguay, Peru, Trinidad and Tobago, and Uruguay. Since 2017, an estimated 5.2 million Venezuelans have migrated to other countries, including an estimated 4.3 million who have gone to countries in Latin America and the Caribbean.
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