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Southern Africa: Regional Consolidated Appeal

UN Office for the Coordination of Humanitarian Affairs (OCHA)

Date: 29 Jul 2003

SARPN acknowledges permission from OCHA and WFP to post this executive summary. Website: www.reliefweb.int
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Note: The full text of this appeal is available on-line in Adobe Acrobat (pdf) format and may also be downloaded in zipped MS Word format, from: http://www.reliefweb.int/w/rwb.nsf/9ca65951ee22658ec125663300408599/2a2aca804bee940ac1256d71004ca1c3?OpenDocument

Executive Summary

While humanitarian response efforts and a reasonable agricultural season may have taken southern Africa off the critical list in terms of food availability this year, the region remains in serious trouble. Short-term gains have been made, but most of the recovery so far has been fragile. Over 6 million people remain in need of critical lifesaving assistance, and millions more are highly vulnerable, mostly due to the combined effects of Human Immune-deficiency Virus / Acquired Immune-Deficiency Syndrome (HIV/AIDS), extreme poverty, and food shortages. The goal of the UN and its partners over the next twelve months is to respond to the populations requiring immediate emergency assistance, while at the same time initiating actions to address long-term needs so that vulnerable populations do not slip back into crisis. Without this simultaneous push, southern Africa will not be able to break out of the vicious cycle of vulnerability and humanitarian crisis.

As a whole, more food will be produced in southern Africa this year, but this does not mean that everyone will have access to it. Because of the crop failures of the past few years, people have been forced to employ negative coping strategies that have depleted their reserves of assets. Livestock and possessions have been bartered or sold in exchange for food and other critical items. The result is that vulnerability differs among countries of the region, as well as within countries. The challenge for the humanitarian community is to find the 'hotspots' of vulnerability - the districts, communities and households in trouble - and offer an appropriate assistance package.

HIV/AIDS is fuelling the vulnerability seen in the region, by attacking the core of people's lives and livelihoods. The world has never witnessed a disease that is capable of causing such massive social and economic breakdown. Today, Acquired Immune Deficiency Syndrome (AIDS) has just that capacity, especially in Africa. Because of HIV/AIDS, decades of development gains have been lost and efforts to reduce poverty and improve living standards have been severely undermined. Fighting chronic food insecurity is now even more of an uphill struggle when the number of HIV/AIDS orphans is soaring and the number of farmers, rural workers and agricultural extension officers is plummeting. HIV/AIDS is, for the foreseeable future, changing the demographic profiles of the countries of the region as it ravages the productive generation.

The impact of HIV/AIDS on children is also dramatic. There were 3.2 million children worldwide under the age of 15 living with HIV/AIDS in 2002, of whom 610,000 have died. In the 6 countries covered in this Appeal, there are over 3 million AIDS orphans. As HIV/AIDS kills productive-age adults, elderly grandparents are assuming the burden of care for these increasing numbers of orphans. In the absence of any adults, children are forced to fend for themselves.

The short-term scenario is troubling, but the longer-term is even more chilling and can hardly be over-estimated. The decimation of the social services could cause massive school dropouts, total collapse of the already weak health system, and complete loss of the state's tax base and much of its functioning bureaucracy. At the same time investment in these economies from foreign sources of capital could slow down as employment drops and consumers become unable to purchase goods or services, or are simply not there anymore. 'Brain drain' will further impair the functioning of the public and private sectors as educated people leave the continent in search of better opportunities.

In this respect, the strategy at the country and regional level, is to implement the vision of the UN Special Envoy (SE) as presented in his report, 'Next Steps for Action in Southern Africa'. The SE calls for the UN and its partners "to do more to save people's lives and their livelihoods in southern Africa". This Appeal follows this approach and presents a programme of activities over the next twelve months aimed at quantifying and further preventing the loss of life and supporting the efforts to address the underlying causes of this deepening vulnerability. In the food sector, a regional programmatic approach will be taken which builds on the partnerships and structures established over the past year. The operation will continue to meet acute food needs, particularly in Zimbabwe and Mozambique, and place emphasis on the transitional needs of populations who have been unable to recover their coping mechanisms and resume productive livelihood. In other sectors, projects have been designed to protect self-reliance systems and resources at the household level while supporting the strengthening vital social services. Central to all activities is the recognition to address the needs and roles of people living with AIDS, particularly women, in prevention, care and treatment of HIV/AIDS.

This Appeal comes on the heels of a humanitarian response in the face of massive food shortages in 2001/2002. Over the past year, generous donor support allowed humanitarian organisations to respond quickly to the crisis, focusing on saving lives with food assistance and stabilising the nutritional situation. By July 2003, approximately 73% of the US$ 656 million requested in the revised 2002 Consolidated Appeal (CA) had been funded. However, there was a major shortfall in the response to the social service sectors, where only 31% of the requirements were met. This lack of contributions for activities that provide essential lifelines for communities have meant that little progress has been made to address the fundamentals that make such large numbers of people in the region so susceptible to shocks.

The Appeal for 2003/2004 seeks US$ 530 million, significantly less than the 2002/2003, reflecting mainly reduced food needs. Major sectors in addition to food that require assistance in this Appeal include Water and Sanitation, Education and Health. Agencies have cooperated closely since the Mid- Year Review (MYR) of the 2002/03 Appeal to better integrate programmes and to ensure complementarities. For example, food provision in schools and assistance to improve school facilities, firstly to encourage children to return to school, and secondly to provide an environment conducive to learning, are programme features in more than one of the appealing countries. Donors are encouraged to support this complementary approach and to maintain or increase their generosity with food assistance and also to support all social service sectors.

The commitment to ensure that the region does not return to a 'business-as-usual' approach demands that the international system rises to the challenges that HIV/AIDS, poverty and food insecurity across the region pose to the traditional paradigms of international assistance. While over the past year, the UN and its partners have successfully averted large-scale deaths from starvation, the assistance community is under no illusion that the people in the six countries at most risk can be expected to sustain their survival. Indeed it is critical that continued urgent multi-sectoral assistance is provided over the next 12 months to enable people in the region to survive and to put in place the capacities that will enable them to better cope with the inherent risks that they face.

Project Summaries for the Southern Africa Regional Appeal can be found on http://www.reliefweb.int/ and in the Southern Africa CD-Rom under "Compendium of Projects for Southern Africa Appeals".

  1. Year in Review

    Background


    In June 2002, UN agencies estimated that 12.8 million people were in the brink of disaster due to a combination of factors including unfavourable climatic conditions, food shortages, HIV/AIDS, poor social services and deteriorating political and economic conditions. Over half of those in need were children. In response, the UN, in collaboration with its partners, launched the Regional Consolidated Inter-Agency Appeal in July 2002 that focused the attention of the international community on the severity of the crisis and highlighted the need for massive food aid and other humanitarian requirements to avoid a humanitarian crisis in the region.

    In September 2002, results from vulnerability assessments indicated that the number of people in need of direct food assistance until the main harvest in April 2003 had increased to 14.4 million, primarily due to insufficient grain imports, high and inflationary prices and the limited coping mechanisms available to households and communities affected by HIV/AIDS. In late 2002, it became increasingly evident that food insecurity in southern Africa was but one symptom of a crisis characterised by the scourge of HIV/AIDS, increasing poverty and the breakdown of social services.

    A first mission of the Special Envoy for Humanitarian Needs in southern Africa in September 2002 emphasised the impacts of HIV/AIDS as a fundamental and underlying cause of vulnerability in the region and the single largest threat to the lives and social economic development of its people and societies. Subsequent missions by the Special Envoy for HIV/AIDS in Africa in November 2002 and jointly by the above Envoys in January 2003, highlighted the impacts of the disease, particularly on women - the primary care giver and resource provider in Africa's society - and stressed the need to work collectively to tackle the HIV/AIDS problem.

    Generous donor support allowed humanitarian organisations to respond quickly to the crisis, focusing on the immediate goals of saving lives with food assistance and stabilising the nutritional situation. As a result, famine was averted and mass starvation and death were avoided. By July 2003, approximately 73% of the US$ 656 million requested in the revised 2002 CA had been funded. The shortfall in the response has been largely due to limited contributions from donors to social service sectors. This imbalance in support must be redressed in the coming year and in recognition of the need to address long-term objectives simultaneously with action to address immediate needs.

    Recent assessments confirmed that food security in most, but not all, countries has improved especially in terms of agricultural production and availability of food. However, significant vulnerability remains and the worsening of the situation in much of Zimbabwe and parts of Mozambique is of particular concern, e.g., fragile improvements elsewhere and many households that sold assets to cope with the situation last year that have not yet fully recovered.

    Agencies are fully cognisant that the improvements, where they exist, are not sustainable in an environment of increasing vulnerability with the numbers of chronically food insecure and those requiring nutritional support likely to increase over the medium to long-term due to the impact of HIV/AIDS. As HIV/AIDS continues to erode household and community structures, the notion of whether or not recovery is possible depends on the fuller understanding of the impact of HIV/AIDS on food security, the redefinition of vulnerability and the design and implementation of appropriate programmes at all levels.

    Summary of the Response and Achievements: July 2002 - June 2003

    Coordination

    A Special Envoy for Humanitarian Needs in southern Africa was appointed by the UN Secretary General in July 2002 to raise awareness of the crisis and provide recommendations on how to improve the humanitarian response. While UN Humanitarian/Resident Coordinators retain primary responsibility for coordinating the humanitarian response within their respective countries, RIACSO was established in Johannesburg under the leadership of a Regional Coordinator for the Special Envoy to provide regional leadership, support the Special Envoy, strengthen information flow between countries and enhance strategic planning and fund raising. Agencies represented within RIACSO include Food and Agriculture Organization (FAO), International Federation of Red Cross and Red Crescent Societies (IFRC), Office for the Coordination of Humanitarian Affairs (OCHA), United Nations Development Programme (UNDP), United Nations Programme for AIDS (UNAIDS), United Nations Population Fund (UNFPA), United Nations Children's Fund (UNICEF), World Food Programme (WFP) and World Health Organization (WHO).

    RIACSO has successfully achieved its main aim - to enhance the response of the UN system to the humanitarian crisis in southern Africa, by improving cooperation between the agencies involved, by ensuring much greater cohesion in their programmes and by providing crucial technical support at both national and regional level. This has contributed to an improvement in the scope and effectiveness of joint programmes between UN agencies

    The office also played a key role in supporting the work of the UN Special Envoy for Humanitarian Needs in Southern Africa, Mr. James Morris, notably facilitating the two missions he undertook to the region. These missions drew the attention of the UN system on the crisis, mobilised donor support for the affected countries and highlighted the devastating impact of HIV/AIDS.

    RIACSO has helped improve information management and sharing through the regional information management system (SAHIMS) where critical information about the continuing crisis particularly reports and material gathered by UN agencies are stored and shared. This is improving access to information and enhancing responses to it. The hosting of regular stakeholders' meetings (donors, NGOs etc) has strengthened external relations and improved awareness of the numbers of people in need.

    Assessments and Situation Analysis

    Combined analyses from a series of assessments have provided at least two broad benefits. First, is key information for targeted, evidence-based programming across the region and baseline information for future vulnerability assessment, monitoring and surveillance. Second, and just as importantly, these assessments have shown the value of a more coordinated approach by the multiple regional and national players.

    Several agencies provided support to the southern African Development Community (SADC) Food, Agriculture and Natural Resources (FANR) Regional Vulnerability Assessment Committee (RVAC) to coordinate a series of vulnerability assessments. As a result, national VACs (NVAC) and partners conducted three rounds of vulnerability assessments between July 2002 and June 2003. For the first time, data was disaggregated and analysed according to HIV/AIDS proxy indicators, yielding further insight into the linkages between HIV/AIDS and food security and recommendations for programming, policy and further research.

    In addition, Crop and Food Supply Assessment Missions were led by FAO and WFP during April and May 2003 to estimate macro-level food crop production, livestock conditions and cereal import / aid requirements for 2003-2004. The results from the vulnerability assessments conducted by the NVAC provided an analysis of food security at the household level. In Malawi, Zambia and Zimbabwe, this information has been further augmented by assessments undertaken by the Consortium for Southern Africa Food Security Emergency (C-SAFE) consortia of 15 NGOs undertaken in March and April.

    Specifically on nutrition, UNICEF and partners conducted a series of provincial and district level nutrition surveys in all six crisis-affected countries. These surveys informed a comprehensive nutrition review to establish the impact of the humanitarian crisis in southern Africa on the nutritional situation among children under-five. The findings from these assessments were presented at RIACSO Stakeholder meetings in April and June 2003.

    Delivery Performance

    Approximately 785,000 metric tonnes (MTs) of food aid were delivered to more than ten million beneficiaries between July 2002 and June 2003 with WFP's assistance in conjunction with implementing partners. A complementary pipeline was established in early 2003 by the Non-Governmental Organisations (NGO) consortium C-SAFE with a focus on targeted supplementary feeding to vulnerable groups, and transitional programming such as Food-for-Work (FFW). First shipments arrived in the C-SAFE countries in February and March, with distributions beginning in force in March and April. Approximately, 15,300 MTs had been distributed by the end of April providing 1,650,000 rations for an average of 826,000 beneficiaries per month.

    Strategy Development and Orientation

    The UN system has taken significant strides to develop the concept of a sustainable recovery framework for the region since the issuance of the CA in July 2002. This has been driven by a variety of different actors and over the course of the past 12 months has converged, in the immediate period, around the approach laid out by the UN Special Envoy for Humanitarian needs in Southern Africa in his paper "The Next Steps for Southern Africa". At a country level, much has been achieved under the lead of the Resident Coordinator system with support from agencies based in RIACSO who have provided support in the six affected countries and to identify activities that will fast track recovery. For example, discussions led by the Resident Coordinator with all partners at national levels is enabling a redefinition of the strategies included in Common Country Assessment (CCA), UN Development Assistance Framework (UNDAF) and Poverty Reduction Strategy Papers (PRSPs) to make them more attuned to the inter linkages of HIV/AIDS, Governance and Food Security.

    In addition to this work, and in view of the magnitude of the challenge, the UN Secretary General has requested the High Level Committee on Programmes to prepare a policy paper to provide an analysis of the inter-linkages between Food Security, HIV/AIDS, and Governance and develop an overall policy framework in which UN organisations, within their own mandates, could contribute in addressing, in a coordinated manner, the inter-linked aspects of the crisis. This process further highlights the commitment of the UN system to ensure that the efforts to reduce vulnerability are sustained.

    Lessons Learned

    Coordination and Partnerships

    • Strong coordination at a regional and national level is key in view of the complexity of the crisis and the plethora of actors involved in the response. This demands strong leadership and vision through RIACSO, heads of agencies, Government counterparts, SADC, Special Envoys and requires the delineation of a framework for response that pulls together all actors.
    • Partnerships, especially with the development community, Governments and SADC are essential given the broad scope of work, the protracted nature of the crisis and the huge efforts required to address vulnerability resulting from HIV/AIDS and social sector deterioration.


    Policy Environment

    • The nature of the protracted crisis, which centres around social sector deterioration, worsening poverty, governance issues and a weak policy environment outlines the need for an integrated, multi-sectoral and sustained response.
    • The classical 'emergency' response with short-term inputs based on short-term emergency funding does not address the fundamental issue of vulnerability that forms the basis of a chronic emergency environment requiring a long-term, deeply embedded response.
    • Policies need to facilitate and promote the mainstreaming of activities designed to address the impact of HIV/AIDS. The epidemic, in its own right, warrants emergency programming.
    • Inadequate national policies hamper private investments in the agricultural sector. National governments, and regional bodies, such as New Partnership for Africa's Development (NEPAD), Common Market for Eastern and Southern Africa (COMESA) and SADC and others need to continue their work in developing and implementing comprehensive policies for market reform that will facilitate broad access to food for consumers while at the same time stimulating the agricultural sector.
    • Discussion around Genetically Modified Organism (GMO) food aid and potential planting of maize grain underlined the possible risks associated with the application of modern technologies to increase productivity. Moreover, it emphasised the need for open dialogue and that the ultimate responsibility for formulating policies rests with national Governments, supported by an Advisory Committee from SADC.


    Understanding Vulnerability

    • The Regional and National VACs have contributed to the establishment of a common understanding among stakeholders in the region about the magnitude and nature of vulnerability in the region. The VACs should be further strengthened, especially in terms of institutional structures, analytical capacities, and coordination.
    • The link between HIV/AIDS and food insecurity underlines the need to broaden the definition of vulnerability and improve the assessment tools to better identify and target the most vulnerable.
    • Inadequate support for key sectors, including agriculture, health, water and sanitation confirmed the need to increase advocacy with donors for funding to address vulnerability arising through inadequate social services and insufficient social safety nets.
    • The poor access to and utilisation of contraceptive methods, particularly condoms, underlined the need for an effective commodities security strategy at country level.
    • There is a need to stimulate income generation as a means of reducing household vulnerability. This is being addressed through the development of local markets including the option for procuring food aid locally or regionally, whenever possible, monetisation schemes, cash for work, voucher systems and other options for using assistance to stimulate local growth for income generation.
    • Limited capacity of local institutions to support key functions and services throughout the region due to depletion of human resources confirmed the need to develop strategies to invest in human capacity, ensure the minimum provision of and access to basic social services and ensure sustainability of interventions.


    Targeting

    • The situation is not uniform, with intense hotspots, both geographic and demographic, at the sub-national level. Identification and targeting of hotspots is paramount.
    • Inadequate national capacities to address vulnerability in 'hotspots' including the provision of treatment to acutely malnourished children, underpins the need for providing a minimum and integrated package of interventions in hard-hit areas. Interventions need to include the expansion of therapeutic and supplementary feeding programmes, as required.
    • Insufficient community support mechanisms to help reduce vulnerability in hotspots, especially the increased vulnerability of women calls for the need to improve community resilience to further shocks.
    • Evidence that women and girls are disproportionately affected by HIV/AIDS points to the need to develop community-based strategies that will provide them with integrated services in health, education, food, agriculture and income generation and to consolidate gender responsive efforts in all areas including gender based violence.
    • Women relief committees trained by WFP in food distribution should be used as an entry point to address sexual reproductive health issues, as well as issues of sexual abuse and exploitation.
    • The increasing number and heightened vulnerability of orphans and child-headed households underlined the need to implement multi-sectoral and comprehensive interventions that identify these children and target them in an effort to address their needs.
    • Older orphaned adolescents (15-19 years age group) who often assume the responsibility of heads of households need support to continue their education and acquire knowledge on how to stay HIV negative.
    • Evidence that HIV-infected populations have heightened nutritional needs underlined the need to provide an enriched food basket as well as micronutrient-fortified blended foods to address micro-nutrient deficiencies that affect the frequency, severity and rate of recovery from HIV/AIDS-related opportunistic infections and extend the quality of life for People Living with HIV/AIDS (PLWHA).
    • Decreased school participation during the crisis underlined the need to better understand the impact of the crisis on education systems, identify and target high-risk communities with appropriate interventions (including activities that will promote the attendance of girls).
    • Indications that the most vulnerable populations continue to have limited access to adequate health care and services highlights the need to improve health surveillance, strengthen existing health facilities and expand outreach services and home-based care systems.
    • The negative impact of HIV/AIDS on agricultural production underlined the need to develop agricultural strategies that lessen or spread the workload of HIV/AIDS-affected households such as mechanisation, conservation farming, crop diversification and winter cropping.


  2. Context for Assistance

    Despite expectations for improved food security following the 2002-2003 agricultural season, critical vulnerability remains primarily due to the complex linkages between the spread of the HIV/AIDS pandemic, food insecurity, governance and the decline of social service provision. While varying across countries, the region as a whole has regressed in terms of economic and social development and the number of people living below the poverty line has increased.

    As the epicentre of the global HIV/AIDS epidemic, the region has the highest prevalence rates in the world, with up to 33% of the adult population HIV positive in some countries. An estimated six million people, of whom 58% are women, are living with HIV/AIDS in the six countries, and there are indications that prevalence rates have not yet peaked.

    The pandemic is driving households and communities to levels of poverty from which they cannot recover. Furthermore, governance, the policy and socio-economic environment and the burden of illness and deaths resulting from the pandemic is undermining the capacity of national institutions to assume and fulfil their roles in the delivery of adequate services to the entire population. For a variety of reasons, the region has suffered setbacks in terms of political, economic and social development with the numbers of people living below the poverty line increasing.

    Recent studies indicate dramatically increasing levels of adult and child morbidity and mortality as a consequence of HIV/AIDS. The following table indicate the most recent estimates on HIV/AIDS prevalence and mortality.

    Country Population (millions) Adult prevalence rate Estimated number of PLWA AIDS orphans AIDS deaths 2001
    Lesotho 2.0 31 360,000 73,000 25,000
    Malawi 11.6 15 850,000 470,000 80,000
    Mozambique 18.6 13 1,100,000 420,000 60,000
    Swaziland 0.9 33.4 170,000 35,000 12,000
    Zambia 10.6 21.5 1,200,000 570,000 120,000
    Zimbabwe 12.9 33.7 2,300,000 780,000 200,000

    Source: UNAIDS, Report on the global HIV/AIDS epidemic, 2002

    Humanitarian Conditions

    Information from across the region indicates the following statistics:

    • 415,000 children less under-five died over the last year;
    • 2.2 million children under-five are malnourished;
    • 5 million people live on less than 1 US$ a day;
    • 2 million children under-fifteen are orphans;
    • 3.3 million children age 7-13 years are out of school;
    • 6 million people are living with HIV/AIDS currently and 600,000 were infected last year.

    Furthermore, the following information was gathered from a series of assessments undertaken between July 2002 and June 2003:

    Food

    • Despite an increase in cereal production, more than 6.5 million people living in rural areas will require food assistance until the next harvest in April 2004.

    Agriculture

    • Despite improved harvests in some countries, agricultural production remains uneven throughout the region and within countries. Trade barriers and poor infrastructure continue to hamper the transfer of agricultural surpluses and accesses to markets, reducing regional and in-country capacities to respond to localised food shortages.
    • In areas where agricultural production has increased, improvements were due primarily to favourable weather and better availability of agricultural inputs.
    • Climatic variability, soil deterioration, ineffective water control, inadequate farming techniques and lack of extension services, as well as HIV/AIDS related morbidity and mortality continue to undermine agricultural production.
    • Livestock is depleted beyond normal levels in several areas, notably in the southern provinces of Mozambique and in Zambia primarily due to disease, and in Zimbabwe due to the socio- economic situation.
    • HIV/AIDS has a negative impact on household food production and purchasing power, increasing vulnerability to chronic and acute food insecurity.

    Nutrition

    • The current HIV/AIDS pandemic will directly and indirectly increase young child malnutrition and household food insecurity.
    • Areas with a higher prevalence of HIV/AIDS showed greater deterioration in nutrition status.
    • In several areas, depletion of economic capital and increased unemployment force populations to reduce expenditures on agricultural inputs and social services and modify their consumption and income strategies, leading to a deterioration of nutritional status, disruption of families and communities and environmental depletion.
    • In most countries, the national trends of improvement of the nutritional situation that was observed in the early nineties has now either slowed down or reversed.
    • Younger children are more affected by malnutrition than older children, indicating that food insecurity is not the sole determinant of malnutrition.
    • Nutritional status is worse among children who are orphaned.

    Health

    • HIV/AIDS is one of the root causes of crisis leading to health deterioration and consequent increase in mortality.
    • Mortality rates in affected countries have reached frightening levels. However, due to inadequate surveillance systems, much of this goes unreported and is therefore hidden. Life expectancy in several countries has dropped by 10-20 years.
    • Morbidity rates are increasing according to anecdotal reports from health service staff, but again hard information is missing.
    • Quality of service is declining as a result of staff attrition from a number of reasons, e.g. lack of local managerial and logistic capacity and inadequate government funding. In particular, there is insufficient local technical capacity in prevention and clinical management of conditions due to inadequate nutrition.
    • Access to care is worsening as resources available to families fall and services are cut back to accommodate falling staff capacity.
    • A general lack of reported information has resulted in inadequate humanitarian assistance to this crucial sector, which is thus unable to maintain the status quo, much less respond adequately.


    These findings confirm that the combination of the food crisis of the past year coupled with severe poverty and HIV/AIDS has placed millions of people through the region at a point where traditional coping mechanisms are nearing exhaustion. The UN and its partners believe that there is a clear obligation to continue on an emergency basis with a programme of activities over the next twelve months aimed at quantifying and further preventing the loss of life and supporting the efforts to address the underlying causes of this deepening poverty. While healthy food aid pipeline and support to agricultural strategies are key for food security, without action in health, education, water and sanitation that address the effects of the crippling HIV/AIDS pandemic, gains in food security will not be translated into the needed improvements in livelihood security.


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