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Global Health Security AgendaCambodia
Comprehensive Roadmap, 2016‐2020
Developed June 2016
PleasenotethatallU.S.governmentactivitieswillbecarriedoutinamannerthatisconsistentwitheachorganizations’requirements,budgetauthorities,andmissionsofhostcountriesandGHSApartners.AllGHSApartnercountryforeignassistanceissubjecttoavailabilityoffundsandappropriationsbythegovernmentalprocessesofGHSApartnercountries.
Global Health Security Agenda Roadmap for Cambodia 2016‐2020
InstructionsforInterpretingtheRoadmap
ThisRoadmapmapscurrentandplannedactivitiesagainstasetofstandardizedmilestones.ThesemilestonesweredevelopedtochartthestepscountrieswouldneedtotaketoprogressthroughtheIHRcapacitylevels.
ForeachActionPackagethemilestonesstartfromthelevelthatcorrespondstothescoreRGCreceivedintherecentJEE(JointExternalEvaluation).TheJEEscoreishighlightedinpurple,asshownbelow:
eg.2
Foreaseofcomparison,theself‐assessedlevelishighlightedinblue,asshownbelow:
eg.3
Milestonescorrespondingtolowercapacitylevelshavebeenhiddeninthespreadsheetexceptforsomeindicatorswherecertainmilestoneshadnotinfactbeenachieved.Inthoseinstancesthelowercapacitylevelandcorrespondingmilestonesarevisible.
ActivitiesweremostlytakenfromtheCambodianNationalWorkPlanforEmergingDiseaseandPublicHealthEmergencytoAchieveIHRCoreCapacities (2016‐2020)(the‘NationalWorkplan’),aUSGinventorydevelopedbyUSGagenciesataworkshopinFebruary2016,USAID’sEmergingPandemicThreats2workplanandamappingprocessofotherdevelopmentpartneractivities.TotherightoftheworksheetaretheRGC,USGandotheragenciesinvolvedintheparticularactivity.Totherightofthatisacommentssectiontocaptureinformationregardingthescopeoftheactivity,forexample,wheretheactivityislimitedgeographicallyorwhereitrelatestoonlyarestrictednumberofpathogens.
Thefinalcolumnusesatrafficlightsystemtoindicatewhetheractivitieshaveeverythingrequiredtoproceed‐“green”;TAFunding
activitiesarepartiallycovered–“orange”;TAFunding
ordonothavetheadequateresourcesrequired–“red”.TAFunding
Insidethecoloredboxitisindicatedwhereexternalresourcesareinvolved,i.e.TA,funding,coordination.Wherenoexternalsupportisrequiredthenthereisablankgreensquare.Ayellowsquareindicatesthatsomeinformationwasmissing.
TheyearsinthespreadsheetfollowtheNationalWorkplanandfollowthecalendaryear.
TheRoadmapisintendedtobeaworkingdocumentthatcanbeupdatedasfurtheractivitiesareplannedorchanged,orfurtherinformationcomestohand.
Designated laboratories are conducting detection and reporting of some priority AMR pathogens
No FETP or applied epidemiology training program is established within the country, but staff participate in a program hosted in another country through an existing agreement (at
Basic, Intermediate and/or Advanced level)
Key JEE self assessment levelJEE external assessment level
O hYr Yr Yr donors/ Funding/ Type
Standardised Milestones Activity Yr 1 2 Yr 3 4 5 RGC USG stakeholders Comment of SupportIndicator 1
P.3.1 Antimicrobial resistance (AMR) detection
1No national plan for pathogens has been
detection approved
and reporting of priority AMR
AMR TWG
National AMR advisory committee with clear Terms of Reference (ToR) that meets regularly and includes One Health approach to advise or draft national plan is established. Plan includes key components of laboratory, surveillance, HCAI, and stewardship activities
AMR TWG performs this role x x x x x
MOH CDCInfection Prevention Control CommitteeDHS
and USAIDCDC
KOICA TBDProposal for technical support under consideration
Coordination
PHD
AMR and drug‐resistant TB‐related documents that contribute to writing a complete National Strategic Plan to address AMR are reviewed and assessed
Ministry of Health lead for AMR with clear ToR who coordinates activities with leads for Ministry of Agriculture and Ministry of Health Infection Prevention and Control (IPC) and stewardship is identified
Assessment of existing AMR and drug‐resistant TB laboratory capacity is completed
National AMR action plan for final approval from Ministries of Health and Agriculture is drafted using guidance from the advisory committee and other appropriate stakeholders and data from assessments. Plan includes key components of laboratory, surveillance, HCAI, and
National Action Plan to reduce the threat of AMR in agriculture drafted xMAFF (DAHP, dept engineering, FiA)
of ag FAO
Only covers health
animal TAFunding
stewardship activities
National plan is distributed to key stakeholdersSupport for implementation of national AMR policy and workplan for human health (support AMR TWG, annual conference, establish AMR committees in review preservice training)
and animal hospitals; x x x x x
AMR TWGMAFF (DAHP MOH CDC
(NaVRI))CDC USAID
WHOFAOKOICA TBD
Funding proposal under consideration
TAFunding
2 National plan for detection has been approved
and reporting of priority AMR pathogens
SOPs, protocols, and databases for surveillance data and system for reporting to Ministries Health and Agriculture, and analysis and reporting back to facilities and to WHO are established
of 17 microbiology pathogens
labs to test and report on 4 prioritiy pathogens; IPC reporting on viral x x x x x
AMR TWGMAFF (DaHP (NaVRI))NIPHBMLSMoH CDCProvincial labs
CDC
IPCDMDPWHOFAOKOICA TBD
TAFunding
t er
Prevent 1: Antimicrobial Resistance (17 Activities)‐ Decisive and comprehensive action to enhance infection prevention and control activities to prevent the emergence and spread of AMR, especially among drug‐resistant bacteria Nations will strengthen surveillance and laboratory capacity, ensure uninterrupted access to essential antibiotics of assured quality, regulate and promote the rational use of antibiotics in human medicine and in animal husbandry and other fields as appropriate, and support existing initiatives to foster innovations science and technology for the development of new antimicrobial agents
Target: Support work being coordinated by WHO, FAO, and OIE to develop an integrated global package of activities to combat antimicrobial resistance, spanning human, animal, agricultural, food and environmental aspects (i.e. a one‐health approach), including: a) Each country has its own national comprehensive plan to combat antimicrobial resistance; b) Strengthen surveillance and laboratory capacity at the national and international level following agreed international standards developed in the framework of the Global Action plan, considering existing standards and; c) Improved conservation of existing treatments and collaboration to support the sustainable development of new antibiotics, alternative treatments, preventive measures and rapid, point‐of‐care diagnostics, including systems to preserve new antibiotics. As Measured by: (1)Number of comprehensive plans to combat antimicrobial resistance agreed and implemented at a national level, and yearly reporting against progress towards implementation at the international level. (2)Number of countries actively participating in a twinning framework, with countries agreeing to assist other countries in developing and implementing comprehensive activities to combat antimicrobial resistance, including use of support provided by international bodies to improve the monitoring of antimicrobial usage and resistance in humans and animals.
AST testing at pilot facilities for country selected WHO priority pathogens is performed
NAVRINIPHOne Health AMR training and mentorship programs for national and county laboratories are Review pre‐service training; develop continuing education program for health USAID TBD Funding proposal TA
x x x x x BMLS KOICA TBDestablished professionals CDC TBD under consideration Funding
MoH CDCProvincial labs
Internal and external QA programs for designated laboratories are established
Designated laboratories are conducting detection and reporting 3 of some priority AMR pathogens
7 microbiology labs in referral hospitals
NIPH focusing on Internal and external quality assurance testing is performed and results to stakeholders are BMLS microbiology TA
Ongoing x x x x x DMDPreported MoH CDC CDC diagnostics under Funding
Provincial labs DMDP and 13 labs under SLMTANo animal testing
7 microbiology labs NIPH
in referral hospitals BMLS
DMDP focusing on MoH CDCSteps to strengthen lab capacity to sustainably identify and perform AMR and drug‐resistant CHAI microbiology TA
Ongoing x x x x x Provincial labs CDC TB testing are developed FHI360 diagnostics under Funding
CENAT USAIDCHC DMDP and 13 labs
NCHADSunder SLMTA
CNMNo animal testing
Designated laboratories have conducted detection and reporting of 4 all priority AMR pathogens for at least one year
Sustainable plan for laboratory supply chain is developed and implemented
AST testing is expanded to other clinical facilities
Population‐based denominators, such as those recommended by WHO GLASS are collected
Infection‐based case data, including enhanced patient clinical information are collected
FHI360Therapeutic efficacy studies on malaria resistance/ antimalarial drug resistance studies to USAID TA
x x x x x CNM CHCinform national drug policy and case management CDC Funding
WHO
Strategies for monitoring national AMR and drug‐resistant TB burden are developed and USAID TAARV resistance study x NCHADS CHAI
implemented CDC Funding
CENATUSAID TA
Conduct multi drug resistant TB National survey x Healthcare facilities (11 FHI360CDC Funding
sites)
Designated laboratories have conducted detection and reporting of 5 all priority AMR pathogens for five years with a system for
continuous improvement
Sustainable plan for laboratory supply chain is developed and implemented
Indicator 2
P.3.2 Surveillance of infections caused by AMR pathogens
National plan for surveillance of infections caused by priority 2 AMR pathogens has been approved
AMR TWGNIPH IPC
17 microbiology labs to test and report on 4 prioritiy pathogens; IPC reporting on viral TAx x x x x BMLS DMDP
pathogens CDC FundingMoH CDC WHOProvincial labs
SOPs, protocols, and databases for surveillance data and system for reporting to Ministries of Health and Agriculture, and analysis and reporting back to facilities and to WHO are AMR surveillance system to include private sector operators USG JEE review TA and Fundingestablished
TAAMR Lab surveillance assessment and AMR Lab mapping Tool in NaVRI x MAFF (DAHP(NaVRI)) FAO
Funding
AFRIMS‐GEISNAMRU‐2‐GEIS
Conduct bacterial healthcare associated infections (HAI) and multi‐drug resistant TAx Battambang hospital DMDP
organisms at multiple sites/ multiple pathogen types ‐ bacterial, parasites, malaria Funding
AMR surveillance at pilot or representative regional and referral hospitals is initiated AMR TWGNIPH
IPC17 microbiology labs to test and report on 4 prioritiy pathogens; IPC reporting on viral BMLS TA
x x x x x DMDP No animal healthpathogens MoH CDC CDC Funding
WHOProvincial labsDHS
AMR TWGFrom national
Training sentinel site staff on AMR surveillance in humans and animals x x x x MOH CDC WHO Fundingworkplan
DHS
BMLSNIPH
Training programs for data collection and reporting of AMR at national and regional levels are Provincial hospitalsdeveloped and initiated Hospitals (Preah Ket WHO
TAMentoring indiagnostic microbiology for surveillance x x x x x Melea Military Hospital, DMDP
FundingSvay Rieng PHD hospital, IPCKampong Cham PHD Hosital, Ream Naval Clinic
Designated sentinel sites are conducting surveillance of infections 3caused by some priority AMR pathogens
Working in eastern Cambodia, will
NIPH TAAMR testing on all pathogens (bacteria etc) as part of research projects x x x x x expand nationally ‐
MOH CDC Fundingdoesn’t include Flu or TB
AMR and drug‐resistant TB surveillance systems are evaluated, results are disseminated, and TAAMR surveillance conducted x x x x x USAID IPCaction plan for improvements is developed Funding
Surveillance of multi drug resistant organisms (respiratory, gastrointestinal, wound BMLS TAx x x x x CDC
infections); influenza resistance Laboratories Funding
KOICA TBD Funding proposal TANational surveillance system established and functioning, results published x x x x AMR TWG
WHO under consideration Funding
Improvements for AMR and drug‐resistant TB surveillance system as outlined by surveillance evaluation are implemented
TALab supplies and equipment for animal and human sentinel surveillance sites procured x x x x x AMR TWG ADB TBC
Funding
Provincial labsCDC 10 labs with AMR TASentinel sites equipped to conduct surveillance Support for flu sentinel surveillance x x x x x NIPH WHO
testing capacity FundingMOH CDC
TAInfluenza surveillance to detect and report different serotypes of influenza for predictive Fundingmodelling for vaccine development x x x x x
Monitoring of antibiotic‐resistance patterns, as well antibiotic usage and management AMR TWGFAO TA
practices, at multiple points in the production chain for food animals and retail meats is Assess antibiotic use and AMR for growth promotion for livestock x x x x MAFF (DAHP (NaVRI)) USAIDIPC Funding
enhanced. MOH DHS
Designated sentinel sites have conducted surveillance of infections 4caused by all priority AMR pathogens for at least one year
Southern and Sustainable support for AMR and drug‐resistant TB surveillance infrastructure is developed western Cambodia, TA
SMS‐based surveillance system (not for TB) x x x x x RCAF AFRIMS‐GEISand maintained extend nationally ‐ Funding
doesn’t include TB
AST testing is expanded to other clinical facilities
Population‐based denominators, such as those recommended by WHO GLASS are collected
Infection‐based case data, including enhanced patient clinical information are collected
Strategies for monitoring national AMR and drug‐resistant TB burden are developed and implementedDesignated sentinel sites have conducted surveillance of infections
5 caused by all priority AMR pathogens for five years with a system for continuous improvement
AMR surveillance is expanded to include other clinical sites and/or other areas of the healthcare system
Indicator 3
P.3.3 Healthcare associated infection (HCAI) prevention and control programs
1 No national plan for HCAI programs has been approved
WHONational AMR advisory committee with clear Terms of Reference that meets regularly and DHSRevise IPC policy and TOR for multidisciplinary, multisectoral committees that include IPC Development TA
includes One Health approach to advise or draft national plan is established. Plan includes key x IPC Committeeprofessionals partners Funding
components of laboratory, surveillance, HCAI, and stewardship activities PHDKOICA TBD
AMR and drug‐resistant TB‐related documents that contribute to writing a complete National Strategic Plan to address AMR are reviewed and assessed
IPC technical group WHO TA
MoH lead for IPC with clear ToR who coordinates activities with leads for MoH AMR and annual IPC meeting for information sharing and updating IPC guidance x x x x x (National and PHD/RH Global Fund Funding
stewardship is identified level)
Assessment of national infection prevention and control (IPC) programs, policies, practices, and supply chain is completed
National AMR action plan for final approval from Ministries of Health and Agriculture is drafted using guidance from the advisory committee and other appropriate stakeholders and
TA and Fundingdata from assessments. Plan includes key components of laboratory, surveillance, HCAI, and stewardship activities
Develop IPC strategy (2021‐2025)
National plan is distributed to key stakeholders
2 National plan for HCAI programs has been approved
Revise general IPC guidelines; develop SOPs for isolation precautions and SOPs for MOH DHSprevention of nosocomial infection procedures; establish national infrastructure IPC technical working
National IPC technical guidelines are established standards; include IPC equipment and consumables in essential medical list; develop x x x group (National and WHO TAstandard procurement procedures; develop operational and maintenance procedures for PHD/RH level)IPC equipment HCF staff
DHSDevelop appropriate triage and isolation room in identifed health care facilities for
RH WHOinfectious diseases; routine surveillance of nosocomial infection and needles/sharps x x DOD CTR‐CBEP 40,000 per facility est Funding
PHD DMDPinjuries
OD
HCAI programs, including AMR prevention and airborne infection control, at designated MOH DHS TAProvision of basic equipment and minor repairs of wards x x x ADB Part of upcoming facilities are implemented Hospitals TBC Funding
GMS health security project. Details TBC
Only in those referral hospitals where TA
Clinician mentors support application of guidelines in hospital wards x x Provincial hospitals DOD CTR‐CBEP DMDPDMDP supports labs Funding(6 provinces)
MOH DHSGap: no waste
IPC TWG WHOmanagement, no TA
Revise general IPC training curriculum and train healthcare workers x x x PHD Global Fundtraining of private Funding
OD DMDPfacility staff
RH
MOH DHSTrain healthcare facility technical staff for operation and maintenance of equipment x x x PHD Funding
MOH DHSWHO TA
Develop IPC professional training curriculum and conduct training x x x x IPC TWGGlobal Fund Funding
National hospitalsInfection prevention and control training programs, including both pre‐service and in‐service, and covering , including AMR prevention, at designated facilities are developed
UHSDevelop IPC module for medical and health sciences x x x WHO TA
MOH DHS
MOH DHSTraining in hospital hygiene and case management x x x ADB
Hospitals TBC Part of upcoming GMS health security project. Details TBC
TATraining on safe injection practice x x MOH DHS CDC
Funding
3 Designated facilities are conducting some HCAI programs
Monitoring and evaluation of HCAI prevention programs are conductedHealthcare facilities carry out self‐needs assessment and develop IPC action plan; conduct M&E of IPC center of excellence and identified healthcare facilities for infectious diseases
x x x x x
HCFsMOH DHSIPC TWGIPC professionals
WHODevelopment partners
TA
Improvements to HCAI prevention programs are implemented
4 Designated one year
facilities have conducted all HCAI programs for at least
Sustainable plan for IPC supply chain is implementedInclude representative of financing and budgeting (DGFA/ DBF) in national IPC steering and IPC provincial committees; conduct resource mobilisation and advocacy strategy with RGC, donors and others
x
IPC CommitteeMOH DHSPHDRHOds
HCAI prevention programs are expanded to other clinical facilities
HCAI prevention programs accreditation bodies
are incorporated into national regulatory framework, such as Include IPC measures in QA questionnaire and hospital accreditation systems x x
IPC and QCAT Committees
Steering WHODevelopment partners
Strategies for monitoring national HCAI burden are developed and implemented As a result of M&E efforts listed above, surveillance and reporting of HAI
strategies developed in TWG for routine x x x x x IPC TWG
5 Designated facilities have conducted all HCAI with a system for continuous improvement
programs for five years
IPC Programs that includes QI training/methodology at designated facilities are established and operationalized
Indicator 4
P.3.4 Antimicrobial stewardship activities
1 No national plan for antimicrobial stewardship has been approved
National AMR advisory committee with clear Terms of Reference that meets includes One Health approach to advise or draft national plan is established. components of laboratory, surveillance, HCAI, and stewardship activities
regularly and Plan includes key
AMR and drug‐resistant TB‐related documents that contribute Strategic Plan to address AMR are reviewed and assessed
to writing a complete National
MoH lead for antimicrobial stewardship for MoH AMR and IPC is identified
with clear ToR who coordinates activities with leads
Assessment of national AMR stewardship authority, using a One Health approach is
policies, including completed
regulatory framework and
National AMR action plan for final approval from Ministries of Health and Agriculture is drafted using guidance from the advisory committee and other appropriate stakeholders and data from assessments. Plan includes key components of laboratory, surveillance, HCAI, and stewardship activities
National plan is distributed to key stakeholders
2 National plan for antimicrobial stewardship has been approved
SOPs, protocols, and databases animals are established
for monitoring antimicrobial consumption in humans and Develop guidelines for appropriate use of antibiotics in human, animals and food products x x x AMR TWG USAID/ CDC TBD
KOICA WHO
TBD Funding proposal under consideration
4
3
5
Antimicrobial stewardship programs, including monitoring of antimicrobial consumption, education/ communication, and other interventions to improve antibiotic use, at designated centers are implemented
Stewardship program Clinician mentors encourage appropriate use of antibiotics in hospital wards
x x x x
DHSProvincial hospitalsSihanoukville Hospital Center of HopeNational hospital
DOD CTR‐CBEP
WHODMDPInst of Tropical Medicine, Antwerp
Working in provincial referral hospitals where DMDP supports provincial labs
TAFunding
Designated practices
centers are conducting some antimicrobial stewardship
Monitoring and evaluation of stewardship programs are conductedAMR TWG track progress with national policy implementation during quarterly meetings; establish integrated information system ‐ all MPA modules currently being reviewed; stewardship committees in health care facilities
x x x x x AMR TWGWHOKOICA TBD
Funding proposal under consideration
Information, education, and communication materials on drug resistance and drug use including the use of evidence generated from AMR surveillance to inform antibiotic‐use practices are developed and disseminated across both human and animal sectors
Designated centers have conducted all antimicrobial stewardship practices for at least one year
National regulatory framework for antimicrobial use is implemented
Support TB drug adherence/compliance x x x CENATUSAIDCDC
FHI360TAFunding
AMR awareness campaignMOH DHSBMLS
USAID/ CDC TBDWHOKOICA TBD
Funding proposal under consideration
Develop IEC materials; organise awareness activities; conduct KAP survey x x x xAMR TWGMAFF (DAHP (NaVRI))
USAIDWHOFAOIPC
TAFunding
Antimicrobial stewardship activities are expanded to other centers Designated 7 stewardship centres X X X XTAFunding
Strategies for monitoring adherence to stewardship practices and regulations are developed and implemented
Designated centers have conducted all antimicrobial stewardship practices for five years with a system for continuous improvement
Antimicrobial stewardship adherence is monitored and regulated
Key JEE self assessment levelJEE external assessment level
Prevent 2: Zoonotic Disease‐ Implementation of guidance and models on behaviors, policies and practices to minimize the spillover, spread, and full emergence of zoonotic disease into or out of human populations prior to the development of efficient human‐to‐human transmission. Nations will develop and implement operational frameworks‐ based on international standards, guidelines, and successful existing models‐ that specify the actions necessary to promote One Health approaches to policies, practices and behaviors that could minimize the risk of zoonotic disease emergence and spread.
Target: Adopted measured behaviors, policies and/or practices that minimize the transmission of zoonotic diseases from animals into human populations.
Standardised Milestones Activity Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 RGC USGOther donors/ stakeholders Comment
Funding/ Type of Support
Indicator 1P.4.1 Surveillance systems in place
for priority zoonotic diseases/pathogens
2Country has determined health concern but does place
zoonotic not have
diseases of greatest national animal zoonotic surveillance
public systems in
Points of contact have been designated for surveillance reporting procedures for confirming priority zoonotic diseases and conditions at target facilities
Update points zoonotic
of contact for surveillance reporting procedures for confirming priority X X X X X Coordination
Procedures for reporting priority zoonotic diseases of PHEIC to the IHR Focal Point and to the district and national levels have been improved
Develop SOP Focal Point
for Procedures for reporting priority zoonotic diseases of PHEIC to the IHR X X X X TA Funding
Functional mechanisms for inter-sectoral collaborations have been established that include animal and human health surveillance units and laboratories
Training curriculum, SOPs, tool-kits, best-practices, and procedures have been developed that ensure routine feedback on zoonotic data quality and completeness
Training Develop SOP the IHR Focal Point
for Procedures for reporting priority zoonotic diseases of PHEIC to X X X X TA Funding
Timely and systematic information exchange has been established between animal surveillance units, human health surveillance units and other relevant sectors regarding potential zoonotic risks and urgent zoonotic events
Laboratories are stocked with zoonotic diagnostic equipment and supplies for detection of priority zoonotic diseases
3Zoonotic surveillance systems in place for 1‐4 pathogens of greatest public health concern
zoonotic diseases/
A national, multi-sectoral zoonotic surveillance strategic plan has been developed to enhance timely detection and reporting of zoonotic outbreaks with final approval from Ministry of Health or equivalent
Dissemination and implementation of 5‐year zoonotic plan x x x x xMAFF (DAHP MOH CDC
(NaVRI), FA)USAID
FAOConsortium DavisIPC
led by UC
Zoonosis strategic plan 2014‐2018 exists not signed or approved. Gaps exist in plan.
TA Support to TWG
Strengthen policies related to promotion of safe information sharing (Cambodia and Vietnam)
livestock trade at border and x MAFF (DAHP (NaVRI)) USAID FAO
TAFunding
Protocols (that adhere to biosafety/biosecurity measures) for select zoonotic agents have been developed
Test viral
wildlife and human family protocol
samples, facilitate testing of livestock samples using PREDICT x x x
MAFF FAMoEUHSNIPH
(DAHP (NaVRI))
USAID
FAOConsortium DavisIPCWCS
led by UC TA Funding
Develop and zoonoses
publish SOPs for joint/coordinated surveillance activities for priority x x x
MAFF (DAHP (NaVRI)), MOH (CDC, PHD, OD, health facilities)RUAUHS
CDCDOD CTR‐CBEPUSAID
IPCWHOWCSOIEFAODMDP
Will require support to TWG decision‐making
TAFunding
WHOGARC (Global Alliance
MOH CDC TARabies control strategy implemented; rabies control materials produced x x x CDC for Rabies Control)
MAFF (DAHP (NaVRI)) FundingIPCFAO
Conduct limited syndromic surveillance to identify FVBI pathogens including malaria as CNMTargeted surveillance for reportable and potential epidemic diseases of zoonotic or vector- DOD‐GEIS/NMRC‐Asia/ well as respiratory and diarrheal diseases and provide timely updates to USG and x MOH CDCborne origin in selected regions NAMRU2regional partners in Cambodia, Laos, Malaysia and Vietnam NIPH
IPCDOD CTR‐CBEP WHO
Agreement finalized to foster collaboration between laboratories in Cambodia in MAFF (DAHP (NaVRI))USAID WCS TA
Zoonosis Strategic Plan; enhance laboratory capacities to support coordinated zoonoses x x x MOH CDC Joint lab collaborationNAMRU2 OIE Funding
control NIPHFAODMDP
Laboratory training workshops for staff for diagnosing and reporting priority zoonotic diseases have been developed for use at the national level and in selected regions
IPC TA Laboratory training for animal health surveillance x x x MAFF (DAHP (NAVRI))
EU LACANET Funding
Kampong Cham National DOD DTRA CBEP TA
Lab training listed under Detect1 National Laboratory School of Agriculture (Cooperative Biological Funding
(KCNSA) Engagement Program)
MAFF (DAHP (NaVRI))IPC
MAFFResearch on human behaviours and practices influencing zoonotic disease risk, modeling WCS
FA TA of spillover and transmission risks based on surveillance data, identify risk prevention x x x USAID EU LACANET
RUA Fundingstrategies AFD ComAcross
UHSUC Davis
NIPHProcedures for data analysis to improve public health action have been developed for use at the district and national levels
Longitudinal sampling of wildlife, at‐risk human populations in 2 sites, identification of IPC TAx x x x x MAFF (DAHP (NaVRI)) USAID
epi zones and pathways for disease emergence, evolution, amplification and spread WCS Funding
IPC TAResearch on H5N1 (incl mutations, transmission and transmissibility, strains) x x x MAFF (DAHP (NaVRI)) USAID
WCS Funding
Established ‐ NAVRI provides molecular detection of influenza (during outbreak EU LACANET Gap within RGC Serologic and molecular diagnostic capacity for prioritized zoonotic diseases in animals and investigations). IPC provides the confirmation and duplicate testing as well as contact AFRIMS TA
x x x MAFF (DAHP (NAVRI)) IPC capacity for other 4 humans has been developed at the sub-national and national level tracing investigation for H5N1 cases. Testing capacity for all priority zoonoses at all NAMRU2 FundingFAO diseases (ie not H5N1)
international partner laboratories (IPC, AFRIMS, NAMRU2)
Serological diagnostics capacity has been piloted for at least one of the prioritized zoonotic diseases for humans and livestock in target regional laboratories
A national surveillance database to record, monitor, and report zoonotic outbreaks to Exists for H5N1 Gapstakeholders has been established
Zoonotic surveillance systems in place for five or more zoonotic diseases/ 4pathogens of greatest public health concern
Zoonotic surveillance has been expanded to include additional sites
DOD CTR‐CBEP (Cooperative Discovery research on small mammals and bats‐pathogens ‐ est disease baselines and Duke‐ NUS Biological Engagement TA
x x xidentify new and emerging diseases across country MAFF Program) Funding
NAMRUEU LACANET
Develop processes for wildlife diagnosis and establish mechanism for transfering capacity TAx x x MAFF. MoE IPC
to national government FundingWCS
Procedures to investigate and confirm suspected zoonotic outbreaks and other public health events have been developed Improve mechanisms for the timely sharing of information and coordination of risk USG JEE review
assessment, response and communication across sectors, including clarifying where ultimate decision‐making authority for zoonotic disease outbreaks lie
Establish lab network contingency for outbreak of unknown aetiology x x xMAFF (DAHP (NAVRI)), MOH (CDC, NIPH)
CDCDOD CTR‐CBEPUSAID
IPCWHOOIEFAODMDP
TA Funding
Plans to improve animal and human exposure surveillance, testing capacities, and appropriate risk assessments have been developed
Establish system for surveillance link to zoonosis events; consider livestock farming systems
and One Health risk assessment where wildlife may havepoultry and swine value chain study; evaluate existing x x x
MAFF (DAHP (NaVRI))MAFF (DAHP)MOH (CDC, PHD, OD, health facilities)
DOD CTR‐CBEPUSAID
IPCWHOWCSOIEFAOEU LACANETDMDP (Diagnostic Microbiology Development Program)AFD ECOMORE
TAFunding
Linkages between animal-human disease surveillance and reporting mechanisms has been enhanced in a subset of regions Zoonosis TWG responsible for these linkages. x x x x x Zooonosis TWG Coordination
5Zoonotic surveillance systems in place for five or more zoonotic diseases/ pathogens of greatest public health concern with system in place for continuous improvement
A monitoring and evaluation assessment of diagnostics and surveillance report submission has been completed from core human and animal health facilities to district and national levels
Measurable success criteria to document progress of zoonotic surveillance have been defined
Partnerships with Ministries of Health and Agriculture, FAO, OIE and other stakeholders to combat zoonotic spill-overs and outbreaks have been established
Strengthen One Health data sharing and communications monthly Zoonotic‐ Technical Working Group
through coordination of x x x x x
MOH CDCMAFF (DAHP MAFF (FA)
(NAVRI))USAIDCDCDOD DTRA CBEP
FAOUC Davis‐led consortiumIPCEU
TAFunding
A preparedness and response plan has been prepared to coordinate animal and health agencies, sectors, and other stakeholders to effectively respond to priority zoonotic outbreaks
Indicator 2
P.4.2 Veterinary or Animal Health Workforce
3Animal system
health workforce and less than half
capacity within of sub‐national
the national levels.
public health
Training workshops for relevant career tracks have been developed
FETP trainee recruitment has continued
4Animal system
health workforce capacity within the national and more than half of sub‐national levels.
public health
A plan between the MoH and MoA has been developed to strengthen animal health workforce programs (due to the strong focus on this area we have added in multiple
Support for One Health workforce national training plan x x xMOH CDCMAFFMoE
KOICA TBCProposal under consideration
Ensure private sector veterinarians/ village animal health workers workforce development and promote private sector veterinarians in zoonotic disease surveillance
are included in and paraprofessionals USG JEE review
Provide diagnostic and biosafety training in the animal health sector x x xNIPHMOH CDC
DOD CTR‐CBEPTAFunding
Train Rapid responsible
Response Teams (human health), Task authorities in coordinated response
force (animal health) and wildlife‐x x x x x
MAFF (DAHP MOH (CDC, NIPH)
(NAVRI)), DOD CTR‐CBEPUSAID
IPCWHOOIEFAO
TAFunding
Build capacity of One Health unit and vet students and lecturers, est parasitology animal lab, build capacity of lab technicians, training workshops on epidemiology and biosecurity with focus on zoonosis, zoonotic parasites, solid and liquid waste mgt from poultry in farms, support final year students' research.
x x x x xKampong School of (KCNSA)
Cham National Agriculture
DOD CTR‐CBEP (Cooperative Biological Engagement Program)
TAFunding
milestones into the Summary Roadmap highlighting the ongoing nature of this capacity building work) Provide a framework through a collaborative research project for One Health experts
respond to newly emerging infectious diseasesto
x x xNIPHMOH CDC
DOD CTR‐CBEPTAFunding
Support implementation of national veterinary law x x x x xMAFF (DAHP) (EU Livestock Project)
USAID FAOTAFunding
AET and CAVET covered under Detect4 Workforce Development
Inservice training for wildlife and forestry government officers in lab and surveillance x x MAFF (DAHP (NaVRI)) USAIDWCSIPCEU LACANET
TAFunding
5Animal health workforce capacity and at all sub‐national levels. This workforce continuing education
within the includes a
national public plan for animal
health health
system
A database of trainees and SMEs has been developed
Train-the-Trainers workshops have been conducted for the One Health System Mapping and Analysis Resource Tool
Training workshops for relevant career tracks have been developed
Indicator 3P.4.3 Mechanisms for responding to infectious zoonoses and potential zoonoses are established and functional
3A mechanism for coordinated response to outbreaks by human, animal and wildlife sectors is established
of zoonotic diseases
Enhance linkages among designated reporting facilities, decision-making sectors, and communities to strengthen diseases surveillance capacity
Community of practice established focused on One Health and Ecohealth best practices x x x x EU ComAcross Regional Laos and
project Camb
for TA Funding
One Health Communications Network established x x x MAFF (DAHP (NaVRI)) EU LACANETRegional Laos and
project Camb
for
Support outbreak investigations in animal populations (Avian Influenza) x x x x x MAFF (DAHP (NaVRI)) USAID
FAOConsortium DavisIPC
led by UC TA Funding
Procedures and plans have been developed to investigate and confirm suspected zoonotic outbreaks and other public health events
Prepare/improve a preparedness and response plan to coordinate animal and health agencies, sectors, and other stakeholders to effectively respond to priority zoonotic outbreaks Consider developing policies for compensation for culling of animals
Zooonosis TWG USAID EPT2 FAO USG JEE reviewTA Funding
Technical response guidelines have been established for district rapid response team to zoonotic outbreaks
Publish guidelines for coordination of outbreak response at national level incl agreed trigger points for joint response to zoonoses incidents and SOPs for coordinated field level mgt of outbreaks, incl incorporating wildlife component when appropriate
x x x x xMAFF (DAHP (NaVRI))MOH (CDC, PHD, OD, NIPH)
USAID
IPCWHOWCSOIEFAODMDP
TA Funding
Training exercises to test capacity of emergency deployment capacities to detect and respond to zoonotic diseases have been developed
4Timely and systematic information exchange between animal/wildlife surveillance units, human health surveillance units and other relevant sectors in response to potential zoonotic risks and urgent zoonotic events
National plans for surveillance of pathogens of concern have been evaluated
Plans for sustainable functioning of One Health capacity have been developed
5 Timely (as defined zoonotic events of
by national standards) potential national and
response to more than international concern
80% of
workforce programs (due to the strong focus on this area we have added in multiple
A monitoring and evaluation assessment of public health action in response to zoonotic outbreaks has been conducted
Collaborations with WHO, OIE, and other international stakeholders focused on the development of integrated, laboratory-based surveillance capacity have been encouraged
JEE self Key assessment level
JEE external assessment level
Prevent 3: Biosafety and Biosecurity‐ Implementation of a comprehensive, sustainable and legally embedded National oversight program for biosafety and biosecurity, including the safe and secure use, storage, disposal, and containment of pathogens found in laboratories and a minimal number of holdings across the country, including research, diagnostic and biotechnology facilities. A cadre of biological risk management experts possesses the skillset to train others within their respective institutions. Strengthened, sustainable biological risk management best practices are in place using common educational materials. Rapid and culture‐free diagnostics are promoted as a facet of biological risk management. The transport of infectious substances will also be taken into account.
Target: A whole‐of‐government national biosafety and biosecurity system is in place, ensuring that especially dangerous pathogens are identified, held, secured and monitored in a minimal number of facilities according to best practices; biological risk management training and educational outreach are conducted to promote a shared culture of responsibility, reduce dual use risks, mitigate biological proliferation and deliberate use threats, and ensure safe transfer of biological agents; and country‐ specific biosafety and biosecurity legislation, laboratory licensing, and pathogen control measures are in place as appropriate.
Standardised Milestones Activity
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5 RGC USG
Other donors/
stakeholders Comment
Funding/ Type of Support
Indicator 1
P.6.1 Whole‐of‐government biosafety and biosecurity system is in place for human, animal, and agriculture facilities
1No elements place
of a comprehensive national biosafety and biosecurity system are in
Laboratory Safety and Security Professionals in the Ministries of Health, Africulture and Defense responsible for inspection/certification of laboratories for compliance with biosecurity and biosafety requirements are identified
Bimonthly meetings of Biosafety Committee and management and sustainable biosafety program
annual training workshop on biorisk x x x x x
BMLSDHSNIPHMOH CDCMAFF (DAHP (NAVRI))
CDCUSAID (EPT2)
WHOFAO
Additional coordination
needed
Inventory of dangerous pathogens conducted USG JEE review
Human health and animal facilities storing/maintaining especially dangerous pathogens and toxins are identified
First step towards development of a national BS&S framework to secure and consolidate dangerous pathogens and their associated research at a minimum of secure facilities
number x
BMLSNIPHMOHDHS
DTRADOD‐CTR‐CBEP CDC
Provide SME on consolidate principles and mechanisms
TA
National legislation, regulations and licenses for biosafety, biosecurity and biorisk management (BRM) are identified and reviewed for alignment with internationally accepted best practices, guidelines, and minimum standards set by countries with established BS&S programs
Provide SME on biosafety and for a national BS&S program
biosecurity legislation as support for national legislation x
BMLSNIPHMOH
DTRADOD‐CTR‐CBEP CDC
TA Funding
External quality assurance and quality guidelines established
audit system for compliance with national biosafety and x x x
BMLSMOH
ADB Part of upcoming GMS health security project. Details TBC
TA Funding
Engagement meeting with Ministries of Health, Agriculture and Defense, and other appropriate government entities and stakeholders to determine laboratory capacities and gaps, and develop next steps aimed at strengthening BS&S compliance with internationally recognized standards is conducted
BMLS coordinates activities in the sector x x x x x BMLS
BMLS might benefit from further support in its coordination role. No partner activities planned.
Assessments of current biosafety and biosecurity practices, and research and teaching methods at human and animal health institutes is conducted
Baseline assessments at central and provincial level labs x xBMLSNIPH
DOD CDC
CTR‐CBEP
WHOSandiaDMDPMahidol Oxford Research Unit
Sandia completed baseline assessment. Follow up? 16 diagnostic facilities over two years
TA Funding
Biorisk assessment conducted annually x x x x xBMLSNIPH
TAFunding
2
Some, but not all, elements of a comprehensive biosafety and biosecurity system are in place; country is: Starting the process to monitor and develop an updated record and inventory of pathogens within facilities that store or process dangerous pathogens and toxins and what they house. Developing, but has not finalized, comprehensive national biosafety and biosecurity legislation. Developing laboratory licensing. Developing pathogen contol measures, including standards for physical containment and operational handling and faiure reporting systems. Not consolidating dangerous pathogens and toxins into a minimum number of facilities. Not employing diagnostics that preclude culturing dangerous pathogens. Not implementing oversight monitoring and enforcement mechanisms.
Comprehensive national legislation for biosafety and biosecurity is developed and in draft formProvide SME on biosafety and biosecurity legislation as support for national legislation for a national BS&S program; national BS&S plan that categorizes risks among endemic agents and provides guidance on best practice is approved and disseminated
x x
BMLSNIPHMOHDHS
DOD CDC
CTR‐CBEPADB
TA Funding
Recordkeeping that ensures information security for all sensitive documentation is initiated in facilities where especially dangerous pathogens and toxins are stored Ongoing support as part of quality management work x x x x x
BMLSNIPHProvincial labs
DOD CDC
CTR‐CBEPDMDP
In SLMTA and DMPD‐supported labs. Others?
TAFunding
A biosafety and biosecurity framework to improve security and consolidation of dangerous pathogens and toxins at a minimum number of facilities is drafted
Provision of SME on biosafety and security legislation, mechanisms, BS&S assessments and training
consolidation principles and x
BMLSNIPHMOHDHS
DOD CDC
CTR‐CBEP
Updates and revisions to biosafety and biosecurity regulations, guidelines and licenses with Ministries of Health, Agriculture and Defense, other appropriate government entities, and stakeholders are aligned with standardized classification and accreditation standards that cover pathagen control and personnel reliability program requirements are provided
Laboratories are upgraded to align with biosafety and biosecurity best practices and comply with oversight and enforcement mechanisms outlined in the national legislation and guidelines BS&S capacities in animal labs meet WHO/IHR standards x
BMLSMOH
DoD‐CTR‐CBEPDMDPWHO
DMDP providing safety supplies to labs
6 TAFunding
Adequate physical security measures commensurate with international best practices are ensured
Procedures and guidelines to consolidate especially dangerous pathogens and toxins into a minimal number of facilities are in draft form
IPC shared SOPsmicrobiology.
for suspected ebola case, H5N1 and MERS. DMDP supported SOPs for
SOPs lacking in virology, biohazardous waste, destruction, haemotology, biochem, serology, blood bank
TA
3
Comprehensive national biosafety and biosecurity system is being developed; country is: Finalizing the process to support the active monitoring and maintaining of up‐to‐date records and pathogen inventories within facilities that store or process dangerous pathogens and toxins; finalizing the development and implementation of comprehensive national biosafety and biosecurity legislation; finalizing the development and implementation of pathogen control measures, including standards for physical containment and operational handling , and containment failure reporting systems; starting the consolidation of dangerous pathogens and toxins into a minimum number of facilities.
Site-specific biorisk management programs and supporting documents are disseminated to include biosafety, biosecurity, incident response and emergency plans (e.g. in case of explosion, fire, flood, worker exposure, accident or illness, major spillage and waste management)
Biosafety and biosecurity framework to improve pathogen control measures, including consolidation, physical containment, are present, in use, and operated properly within a minimum number of facilities
SME and TA provided for identifying dangerous pathogens and consolidation at central lab. Repository lab operates in compliance with WHO BS&S guidelines.
a x
BMLSNIPHMOH
DoD‐CTR‐CBEPTA Funding
A system for incident reporting is developed that includes identifying incidents, reporting according to regulations, and addressing action items that improve safety and security
4
5
1
Procedures for biosecurity oversight for handling of pathogen/biological materials are developed
Documents for dual use research and responsible code of conduct for scientists and staff are developed
Procedures for pathogen processing and storage are improved
Outside, unbiased monitoring and oversight of biosafety and biosecurity practices are established
Procedures for pathogen processing, transfer, and storage have been approved
Biosafety and biosecurity system is developed, but not sustainable; country is: Actively monitoring and maintaining an updated record and inventory of pathogens within facilities that store or process dangerous pathogens and toxins; Implementing enacted comprehensive national biosafety and biosecurity legislation; Implementing laboratory licensing; Implementing pathogen control measures, including standards for physical containment and operational handling and containment failure reporting systems; Completed consolidating dangerous pathogens and toxins into a minimum number of facilities; Employing diagnostics that preclude culturing dangerous pathogens Implementing oversight monitoring and enforcement activities
Comprehensive national biosafety and biosecurity legislation implemented in full
Diagnostics that can eliminate the need for culturing especially dangerous pathogens are upgraded
Equipment operation and maintenance plans are developed and implemented at laboratories storing pathogens of security concern
Ensure annual decontamination spare parts for BSC
of certified equipment, calibrate BSC, ensure sufficient x x x x x
BMLS MAFF (DAHP CENATNIPHDHS
(NaVRI) NAMRU‐2CDC CambodiaCDCThailand
FAO WHO
TA, funding
Provide incinerators (up to 13) and relevant trainingCDCDOD CTR‐CBEPPACOM TBC
TBD
Biosafety and biosecurity compliance for pathogen storage, processing and transfer is monitored and evaluated
Sustainable biosafety and biosecurity system is in place; country is: Compliant with numbers one through six under “Demonstrated Capacity” plus: Ministries have made available adequate funding and political support for the comprehensive national biosafety and biosecurity system, including maintenance of facilities and equipment
National standard of specimen collection, handling, preservation, protection, transportation, disposal, packaging and import/export procedures are improved
National plans for biosafety and biosecurity functioning and compliance are strengthened
Sustainable funding and an oversight and enforcement mechanism is in place to support biosafety and biosecurity programs/initiatives from the ministry level Seeking funding from Canada GPP for biosecurity support x NIPH CDC GPP TA
Indicator 2
P.6.2 Biosafety and biosecurity training and practices
No biological biosafety and biosecurity training or plans are in place
Biosafety and biosecurity training curriculum, which aligns with international best practices, is developed using country-specific content (e.g.,regulations/authorities, agency roles/responsibilities, andcase studies)
Develop national biosafety curriculum x x xBMLSDHSNIPH
DOD DOD
AFRIMSCTR‐CBEP
WHOSandiaMahidol Oxford Research Unit
Government ownership/ plan for institutionalisation
2
Country has conducted a training needs assessment and identified gaps in biosafety and biosecurity training but has not yet implemented comprehensive training or a common training curriculum. General lack of awareness among the laboratory workforce of international biosafety and biosecurity best practices for safe, secure and responsible conduct. Country does not yet have sustained academic training in institutions that train those who maintain or work with dangerous pathogens and toxins.
Training programs and oversight to ensure personnel reliability and compliance to Biosafety and Biosecurity rules and regulations are established
Train biosafety officers and all relevant staff in use of BSC (Biosafety Cabinet) x x x x x
BMLSDHSNIPHHospitalsProvincial MoD
labs
NAMRU‐2DOD CTR‐CBEPCDCDOD AFRIMS
TA through SLMTA for 13 prov labsDuring research studies by AFRIMS
TAFunding
Provide diagnostic and biosafety training in the animal health sector x x xNIPHMOH CDC
DOD CTR‐CBEPTAFunding
Onsite training at 6 government microbiology labs x x x x xBMLSProvincial labs
and national DOD CTR‐CBEP
DMDPSandiaMahidol Oxford Research Unit
Onsite training at labs. Other govt labs invited to attend
6 TAFunding
National biosafety and biosecurity training‐ established professional training with preexisting and new BS&S curriculums (i.e. laboratory technicians, physicians, veterinarians, hazardous waste disposal technicians etc) in compliance with WHO, international atomic energy agency and OIE standards
xBMLSProvincial labs
and national DOD CTR‐CBEPTAFunding
Training on biosafety to viral isolation NPHL lab x NIPH CDCTAFunding
Biosafety trainings for animal health x MAFF (DAHP (NaVRI)) USAIDFAOIPC
TAFunding
Biosafety specimen
and biosecurity training at influenza sampling, packaging and transport
surveillance sentinel sites (14) incl x
NIPHMOH CDC
CDCTAFunding
Biosecurity training for wildlife sampling and surveillance by field workers xMAFF FA
(DAHP (NaVRI))USAID
WCSFAO
TAFunding
Training curriculum, SOPs, tool-kits, best-practices, and procedures to ensure compliance with biosafety and biosecurity rules and regulations aligned with international best practices are disseminated
Biosafety SOPs developed x x x x
BMLSNIPHProvincial labsMAFF (DAHP (NAVRI))
CDC‐SLMTAUSAID (EPT2)DOD CTR‐K67CBEP
WHODMDPFAPI‐TECHIPCSandiaMahidol Oxford University Research Centre
SOPs lacking in virology, biohazardous waste, haemotology, biochem, serology, blood bank. IPC shared SOPs for suspected ebola case, H5N1 and MERS. DMDP supported SOPs for microbiology. I‐Tech and SLMTA provide partial
Continuing education and training programs for biosafety and biosecurity aligned with international best practices are developed
Engagement meeting to develop sustained training curriculum at academic institutions is completed
Country has a training program in place with common curriculum; has begun implementation: Country has a training program in place at most facilities housing or working with dangerous pathogens and toxins; Country is developing
3 sustained academic training for those who maintain or work with dangerous pathogens and toxins. Country is developing, or has not yet implemented, a train‐the‐trainers program for biosafety. Country is developing sustained academic training for those who maintain or work with dangerous pathogens and toxins.
Training programs and oversight to ensure personal reliability and compliance to Biosafety and Biosecurity rules and regulations aligned with international best practices are implemented
Sustained academic training in institutions that train those who maintain or work with especially dangerous pathogens and toxins aligned with international best practices is implemented
Country has a training program in place with common curriculum and a train‐the‐trainers program: Country has a training program in place at all facilities housing or working with dangerous pathogens and toxins; Training on biosafety and
4biosecurity has been provided to staffat all facilities that maintain or work with dangerous pathogens and toxins; Country has limited ability to self‐sustain all of the above.
Sustainable training curriculum in biosafety and biosecurity aligned with international best practices implemented
NAMRU2 trains lab technicians as ToT Sustainable train-the-trainer program for biosafety and biosecurity aligned with international best Trained biosafety/biosecurity officers provide further training to relevant staff and BMLS
x x x x x WHO who return to lab practices implemented physicians NIPHwith NAMRU mentor
Country has a sustainable training program, train‐the‐trainers program, and common curriculum. Staff are tested at least annually and exercises are conducted on biological risk protocols: Country is compliant with numbers one
5 through five under “Demonstrated Capacity” and has funding and capacity to sustain all of the above. Review of training needs assessment is conducted annually and refresher training on need areas conducted annually Training on emergency response procedures provided annually.
Adequate availability of funding mechanisms are in place to support training programs from the national government
Key JEE self assessment level
JEE external assessment level
Prevent 4: Immunization‐ Effective protection through achievement and maintenance of immunization against measles and other epidemic‐prone vaccine preventable diseases (VPDs). Measles immunization is emphasized because it is widely recognized as a proxy indicator for overall immunization against VPDs. Countries will also identify and target immunization to populations at risk of other epidemic‐prone VPDs of national importance (e.g., cholera, Japanese encephalitis, meningococcal disease, typhoid, and yellow fever). In the case of some diseases that are transferable
from cattle to humans, such as anthrax and rabies, animal immunization should also be taken into account.
Target: A functioning national vaccine delivery system—with nationwide reach, effective distributions, access for marginalized populations, adequate cold chain, and ongoing quality control—that is able to respond to new disease threats.
Indicator 1
P.7.1 Vaccine coverage
Standardised Milestones
(measles) as part of national program
Activity Yr 1 Yr 2Yr 3
Yr 4 Yr 5 RGC USG
Other donors/ stakeholders Comment
Funding/ Type of Support
490% of the country’s 12‐month‐old population has received at least one dose of measles containing vaccine, as demonstrated by coverage surveys or administrative data. 80% of all sub‐national (districts/provinces) units covered.
Collaborations with WHO, and programs are established
other international stakeholders focused on development to invest in immunization Strengthen routine immunization system partnerships (outreach to disadvantaged locations)
and maintain coverage through international populations; improve access in hard to reach
x x x x x NIP
WHOGAVI ‐ via Health Sector Support Program2
TAFunding
Coordination with sectors and status checking)
stakeholders to implement vaccination controls at PoE is established (vaccination Prakas in place for enabling health measures at POE. Have checked disease status disease outbreaks, but not specifically vaccine statusMOH may include checking of vaccine status for certain diseases when applicable
during
MOH CDC
Measurable success criteria to document progress of immunization programs is determined Already in place (DHS), NIP conducts reviews and EPI coverage survey
x x x x x NIP
WHOGAVI ‐ via Health Sector Support Program2
TAFunding
5
95% of the country’s 12‐month‐old population has received at least one dose of measles containing vaccine, as demonstrated by coverage surveys or administrative data; or 90% of the country’s 12‐month‐old population has received at least one dose of measles containing vaccine and the trajectory of progress, plans and capacities are in place to achieve 95% coverage by 2020.More than 80% of all sub‐national (districts/provinces) units are covered.
Sustainable plan for vaccine programs is developed and implemented Already in place (comprehensive multi‐year plan)
NIP
WHOGAVI ‐ via Health Sector Support Program2
TAFunding
National plan is strengthened for better integration of financial management immunization priorities
for healthcare planning and Immunisation Immunisation Plan)
included program
in National included in
Health Strategic Plan Minimum Package Activity (part of National Health
USAID URC
Indicator 2
P.7.2 National vaccine access and delivery
4
Vaccine delivery (maintaining cold chain) is available in 60‐79% of districts within country OR Vaccine delivery (maintaining cold chain) is available in 60‐79% of the target population in the country; functional vaccine procurement and forecasting to no stock outs at the central level and rare stock outs at the district level
the
lead
Information, education, and disseminated
communication materials on vaccine delivery and cold‐chain management are developed IEC materials are periodically developed and disseminated
x x x x NIP USAID
WHOGAVIUNICEFKOICA TBD
KOICA proposal for TA, funding, equipment under consideration
TAFunding
Steps to strengthen are developed
cold‐chain quality assurance and safety measures within vaccine storage and delivery systems Support for cold chain monitoring, incl recruit maintenance, purchase new equipment
more staff, SOPs for equipment
x x x x NIP USAID
WHOGAVIUNICEFKOICA TBD
KOICA proposal for TA, funding, equipment under consideration
TAFunding
Trainings and exercises for event other agencies are developed
or hazard‐specific response and management plans with sectors, stakeholders, and Management plans (EBM improvement plan) in placeTraining conducted periodicallyTraining surveillance staff on surveillance and outbreak investigation and response
x x xNIPMOH CDC
WHOGAVIUNICEF
TAFunding
5
Vaccine delivery (maintaining cold chain) is available in greater than 80% of districts within the country OR Vaccine delivery (maintaining cold chain) is available to more than 80% of the national target population; systems to reach marginalized populations using culturally appropriate practices are in place; vaccine delivery has been tested through a nationwide vaccine campaign or functional exercise; functional procurement and vaccine forecasting results in no stock‐outs
Training capacity for NIP staff WHOGAVI
TAFunding
Sustainable plan to ensure vaccine delivery and cold-chain management is developed and implemented x x NIP UNICEF
Building partnership and better coordination at sub‐national levelsNIP
WHOGAVI
TAFunding
x x x x x MOH CDC UNICEF
Strategic framework to nationally prioritize resources and investments in immunization is developedNIP WHO
Key JEE self assessment level
JEE external assessment level
Detect 1: National Laboratory System‐ Effective use of a nationwide laboratory system capable of safely and accurately detecting and characterizing pathogens causing epidemic diseases, including both known and novel threats, from all parts of the country. Laboratory capacity should have the ability for expanded deployment, utilization, and sustainment of modern, safe, secure, affordable and appropriate diagnostic tests or devices.
Target: Real‐time biosurveillance with a national laboratory system and effective modern point‐of‐care and laboratory‐based diagnostics.
Yr Other donors/ Funding/ Type of Standardised Milestones Activity Yr 1 Yr 2 Yr 3 Yr 4 5 RGC USG stakeholders Comment Support
D.1.1 Laboratory testing for detection of priority diseases
1 National laboratory system is not capable of conducting any core tests.
MOH CDCCDC
MAFF (DAHP WHODOD CTR‐CBEP
National list of priority diseases endorsed x (NaVRI)) FAO TAUSAID
Engagement meeting with MoH, MoA, stakeholders and partners to determine national laboratory BMLS DMDP
priorities that will be adopted and disseminated for priority diseases are conducted NIPH
Mentor AET graduate within BMLS to develop lab surveillance system that includes a notifiable x x x BMLS CDC TA
pathogen list
BMLS WHOAnnual data collection on national lab diagnostic and confirmatory lab capacity x x x x x MOH CDC CDC DMDP TA
NIPH FAO
TASupport for Kantha Bopha hospital lab ‐ equipment and training x IPC
FundingTA
Refurbish RCAF lab in Prey Veng x x RCAF DOD CTR‐CBEPFunding
Train and provide mentorship to six laboratories in diagnostic microbiology media production, and MOHTA
establish, through the Diagnostic Microbiology Development Program (DMDP), a small scale Central x x NIPH DOD CTR‐CBEP DMDPFunding
Media Making Laboratory (CMML). Provincial labs
Preservice training for TB diagnostics; intensified case finding of TB HIV/AIDS (isonizid therapy and TB CDC TA
infection control); provision of TB culture and DST; training to 33 labs on maintenance of GeneXpert; x x x x CENAT FHI360USAID Funding
coaching for smear microscopy for 26 operational districts
MoH (NIPH, CNM), Microbiology laboratory training and in‐country research capacity: Limited capacity for training of
MoND, MoH and MoND staff as per Biosafety and Biosecurity section, in addition to ongoing internal staff
MoEducation, GEIS/NAMRU2 professional development. Potential for further engagement, contingent on evolution of national
MoFinance, plan and funding sources.
?MoAgriculture
NAMRU2 approach is conduct 2 trainings
CNMCDC p.a with district TA
Inservice training for malaria diagnostics and treatment, parasitology, wet work and microbiology x x x x x RCAFDOD AFRIMS personnel as ToT and Funding
HCFsNAMRU mentors those trainees at site
Plans are completed to target human and animal health laboratories for capacity‐building and essential functioning to meet diagnostic and confirmatory requirements for priority diseases Provide limited laboratory capacity building within the Cambodia laboratory network in partnership DOD CTR‐CBEP TA
xwith the U.S. Naval Medical Research Unit 2 (NAMRU‐2) as allowed by funding and mission. (GEIS/NAMRU2) Funding
MAFF (DAHP UC DavisTA
Inservice training for lab diagnostics x x (NaVRI)) USAID FAOFunding
NIPH IPC
NIPHMAFF (NAHP (NaVRI)) FAO
Novel viral family screening tools implemented in local labs with training of animal and human health x x MAFF USAID IPC
lab staff RUA UC DavisMOH CDCUHS
MOH CDCDHS
Basic lab equipment and supplies x x x ADB Provincial and Part of upcoming
district hospitals GMS health security project. Details TBC TA and funding
MOH CDCDHS ADB Provincial and Part of upcoming district hospitals GMS health security
Staff training for provincial and district hospitals for internal quality improvement x x x project. Details TBC TA and funding
DOD CTR‐CBEP
Provide support for WHO Cambodia laboratory lead x WHO TA and fundingFAOMAFF (DAHP USAID TA
Support for quality performance testing of wildlife samples, diagnosis of major EIDs and TADs x x x IPC(NaVRI)) DOD CTR‐CBEP FundingEU
MOHWHO
NIPHEUPlans are completed for proficiency in classical diagnostic techniques including bacteriology, serology and Support for testing for viral influenza, other viruses and bacteria identified through surveillance MAFF (DAHP DOD DTRA CBEP TA
x IPCPCR to improve quality services in public health laboratories compliant with national standards system and outbreak events (NaVRI)) CDC Funding
FHI360NPHL
FAOBMLS
MAFF (DAHP WHOPlans are completed to update diagnostic capabilities to detect new and emerging pathogens that will be Build capacity of lab staff for quality control and performance testing for emerging infectious (NaVRI)) USAID FAO TA
x x xadopted into the national laboratory program diseases MOH CDC CDC IPC Funding
NIPH EU
Engagement meeting with MoH, MoA and stakeholders to review the national laboratory policy to update minimum standards and licensing and registration are conducted
2 National laboratory system is capable of conducting 1‐2 core tests
National Plan of Action for diagnostic and confirmatory laboratory requirements for priority diseases implemented and operationalized
BMLS CDCDHS DOD CTR‐CBEP Limited to human TA
Implement EQA program for microbiology, biochemistry, hematology, HIV x x x x x DMDPNIPH USAID health lab Funding
External Quality Assessment (EQA) in designated human and animal laboratories implement EQA MOH CDCAssessment schemes for major public health disciplines for diagnostic laboratories
Implement EQA program for TB lab x CENAT USAID FHI360 TA and funding
Training curriculum is developed for all staff which includes annual task‐based training, refresher training or mentoring in their appropriate technical and administrative areas
BMLSStandard list of lab equipment finalized x x x x x CDC WHO TA
DHS
Diagnostic equipment and supplies are updated with relevant diagnostic capacities to perform core tests MAFF (DAHP Procurement of essential diagnostic reagents and materials x x USAID FAO Funding/ TA of priority diseases (NaVRI))
Equipment and maintenance of biochemistry hematology in 5 provinces x NCHADS CDC TA and funding
MOHPart of upcoming SOPs for laboratory services for internal quality improvement x x x Provincial and ADB TA and fundingGMS health security district hospitalsNational training curriculum, SOPs, tool‐kits, best‐practices, and procedures are disseminated to project. Details TBC
laboratory staff to ensure best practices according to IHR standardsCENAT USAID
FHI360 Not all labs nationally Guidelines and SOPs at US‐supported labs x NIPH CDC
WHO coveredNCHADS DOD CTR‐CBEP
3 National laboratory system is capable of conducting 3‐4 core tests
Interconnected coordination of AMR, immunization and zoonotic specimen diagnostics, processing and reporting is implemented
Access to networks of international laboratories established to meet diagnostic and confirmatory laboratory requirements and support outbreak investigations for events specified in Annex 2 of IHR (2005)
4National laboratory core tests
system is capable of conducting five or more of the ten
Monitoring and evaluation assessment incorporate recommendations into the
to document diagnostics, data quality and staff national laboratory strategic plan is completed
performance, and Ongoing‐ coordination by subTWG Annual lab network meeting
on blood safety and labs in placex x x x x
NIPH (chair TWG)BMLSDHS
of sub
DOD CTR‐CBEPDMDPWHO
Procedures are in place for rapid virological assessment of cluster of cases with severe acute respiratory illness of unknown cause, acute febrile diseases of unknown cause or individual cases when epidemiologic risk is high
5In addition system for
to achieving “demonstrated capacity”, procurement and quality assurance
country has national
Collaborations with WHO, OIE, and other international stakeholders are focused on the integrated laboratory capacity to develop a sustainable plan for laboratory functioning
development of
Sustainable funding for integrated laboratory capacity support is obtained
Indicator 2
D.1.2 Specimen referral and transport system
2System is than 50%
in of place to transport specimens to national laboratories from less intermediate level/districts in country for advanced diagnostics
Functional system for specimen collection is operationalized
referral to reference laboratories within the appropriate time‐frame of
Sample transport mapping tool developed x x DOD CTR‐CBEP SANDIA TA and funding
Based on results of transport mapping, design efficient specimen transport system DOD CTR‐CBEP USG JEE review
Develop national regulation for packaging and transport of clinical specimens x x x xBMLSMOH CDCNIPH
DOD CTR‐CBEPWHOSANDIA
TA and funding
Training on gathering specimen samples from patients and safe transport x x x x xHealth RCAF
centersDOD CTR‐CBEP WHO TA and funding
Sample collection and transportation kits prepositioned at appropriate levels for trained and certified personnel for specimen collection, packaging, labelling, referral & shipment, according to safety procedures
Training and supervision for use of malaria rapid diagnostic kits and microscopy , TB cell culture, HIVCNM NCHADSCENAT
USAIDCDC
URCCAP‐M
TA and funding
3System is in place to 80% of intermediate diagnostics
transport specimens level/districts within
to national laboratories from the country for advanced
50‐
Clinical specimens from appropriate national or collection
investigation international
of urgent reference
public health events are delivered for testing to laboratories within the appropriate time‐frame of
Staff at the national level for the safe standards (ICAO/IATA) are trained
shipment of infectious substances according to international Develop national standards for stndards and disseminate to all
packaging and transport of clinical public health and lab networks
specimens based on ICAO/IATA x x x x x
BMLSNIPHMOH CDC
DOD CTR‐CBEPWHODMDP
TA and funding
Processes for shipment of infectious substances consistently meet IATA/ICAO standards
when investigating an urgent public health event
4System is in place to transport specimens to national laboratories from at least 80% of intermediate level/districts within the country for advanced diagnostics
Monitoring and evaluation assessmentthe national laboratory strategic plan
of specimen referral systems are completed, and used to update
Investigations or training exercises are conducted to confirm functionality of specimen referral systems
Demonstrated capability plus, transport specimens to/from other labs in the 5region; specimen transport is funded from host country budget
Sustainable funding of the national standard of specimen collection, handling, preservation, protection, transportation, disposal, packaging and import/export procedures is obtained
Indicator 3
D.1.3 Effective modern point of care and laboratory based diagnostics
Minimal, laboratory diagnostic capability exists within the country, but no 2 tier specific diagnostic testing strategies are documented. point of care diagnostics being used for country priority diseases
Update tier‐specific testing strategies taking into account specimen transport system and to highlight USG JEE review
division of responsibilities among different tier laboratories
Support to TB labs in Phnom Penh (culture, drug susceptibility testing, Xpert) x x x x CENAT CDC TA and funding
Tier‐specific testing strategies for priority diseases at designated laboratories are implemented
Support for tier‐specific testing beyond malaria, influenza, TB USG JEE review
RCAFField test point of care diagnostic tests for malaria and influenza x AFRIMS TA and funding
CNM
In‐service training plans are developed for all staff which includes annual task‐based training, refresher See indicator 1 above
training or mentoring in their appropriate technical and administrative areas
Tier specific diagnostic testing strategies are documented, but not fully implemented. Country is proficient in classical diagnostic techniques including
3 bacteriology, serology and PCR in select labs but has limited referral and confirmatory processes. Country is using point of care diagnostics for country priority diseases, and at least one other priority diseasePlans for interconnected coordination of AMR, specimen processing and reporting into tier‐specific WHOdiagnostic testing at designated laboratories are developed KOICA proposal
Strengthen lab information systems (CamLIS) and integrate into PMRS, incl upgrade to a web‐based I‐TECHx x x x x BMLS USAID undergoing TA and funding
system URCconsideration
KOICA TBD
Reliable diagnostic capacity is improved for core pathogen tests according to a standard process
Connectivity of analytical phases of multiple testing methodologies are implemented for specimen testing and processing into a common workflow for data capture Country has tier specific diagnostic testing strategies documented and fully implemented, a national system of sample referral and confirmatory diagnostics culminating in performance of modern molecular or Country is
4using point of care diagnostics according to tier specific diagnostic testing strategies for diagnosis of country priority diseases serological techniques at national and/or regional laboratories.Monitoring and evaluation assessment to document diagnostics, data quality and staff performance, and incorporate recommendations into the national laboratory strategic plan is completed
Regulatory authorities are designated to validate or regulate specific diagnostic testing strategies and point of care diagnosticsCountry has sustainable capability for performing modern molecular and serological techniques as part of a national system of sample referral and confirmatory diagnostics. Country is using rapid and accurate point of care diagnostics as defined by tier specific diagnostic testing strategies. Country is
5 also engaging formally other reference laboratories for testing capacity not available in country where needed to supplement the national diagnostic testing strategies for seven or more of ten lab tests required for priority diseases Country is able to sustain this capability on its own (no more than 20% dependence on donor funding).Strategic framework is developed to nationally prioritize resources and investments in laboratory development
Indicator 4D.1.4 Laboratory Quality System
1 There are no national laboratory quality standards
Plan is developed with MoH and stakeholders to update policies for QMS for national and reference laboratories
Site‐specific QMS is developed for designated laboratories and disseminate supporting documents to include biosafety, biosecurity, incident response and emergency plans (e.g. in case of explosion, fire, flood, worker exposure, accident or illness, major spillage)
Support the International Technology and Education Center for Health (I‐TECH) for Quality Management Systems (LQMS) development in 6 laboratories in Cambodia
Laboratory x
NIPHDHS
DOD CTR‐CBEP I‐TECH TA and funding
Lab capacity, diagnosis and management strengthened through facilities thorugh regular monitoring and supervision (SLMTA)
LQMS and data analysis at health x x x x x
DHSNIPH
DOD CTR‐CBEP WHO TA and funding
2National quality standards have been for verifying their implementation
developed but there is no system
QMS into subnational and national public health laboratories is implemented and regulated
LQMS mentoring program in 25 labs ‐ focus on harmonising WHO and SLMTA LQMS programs
NIPHNPHLMOH CDCMAFF (DAHP (NaVRI))Provincial labs
DOD CTR‐CBEPITECHWHO
TA and funding
Standardized laboratories
reporting system and network introduced, with support for reporting at CPA1 and CPA2 USG JEE review
Support the International Technology and Education Center for Quality Management Systems (LQMS) development in up to 15
Health (I‐TECH) for Laboratory laboratories in Cambodia
xNIPHDHS
DOD CTR‐CBEP I‐TECH TA and funding
3A system of licensing of health laboratories that includes conformity to a national quality standard exists but it is voluntary or is not a require‐ ment all laboratories.
for
Individuals from laboratories laboratory program activities
are designated and policies
to perform QMS data analysis and utilization to inform
Required conformity to QMS validation and regulation
are established and implemented with designated regulatory authorities for
4Mandatory licensing of all health laboratories national quality standard is required
is in place and conformity to a
National EQA program across microbiology, virology, serology, and parasitology is implemented
Support for ISO accreditation x x
NIPHNPHLCENATNCHADS
CDCUSAID
FHI360Support for CENAT contingent on govt approval
TA and funding
Support for blood banks' regional accreditation x NBTC CDCAustralian Red KOICA TBD
CrossTA and funding
All national reference laboratories are adapted from international standards
accredited to international standards, or to national standards Support to NIPH to achieve National Influenza Centre status and National Pipette Calibration Centre x
NIPHNPHL
CDC TA
5Mandatory licensing international quality
of all health laboratories standard is required.
is in place and conformity to an
National plan for QMS compliance is strengthened at the subnational and national level
Strategic framework is developed to nationally prioritize resources and investments in QMS
Key JEE self assessment levelJEE external assessment level
Detect 2/3 : Real Time Surveillance ‐ A functioning public health surveillance system capable of identifying potential events of concern for public health and health security, and country and regional capacity to analyze and link data from and between strengthened real‐time surveillance systems, including interoperable, interconnected electronic reporting systems. Countries will support the use of interoperable, interconnected systems capable of linking and integrating mulit‐sectorial surveillance data and using resulting information to enhance the capacity to quickly detect and respond to developing biological threats. Foundational capacity is necessary for both indicator‐based (including syndromic) surveillance and event‐based surveillance, in order to support prevention and control activities and intervention targeting for both established infectious diseases and new and emerging public health threats. Strong surveillance will support the timely recognition of the emergence of relatively rare or previously undescribed pathogens in specific countries.
Target: Strengthened foundational indicator‐ and event‐based surveillance systems that are able to detect events of significance for public health, animal health and health security; improved communication and collaboration across sectors and between sub‐national (local and intermediate), national and international levels of authority regarding surveillance of events of public health significance; improved country and intermediate level/regional capacity to analyze and link data from and between strengthened, real‐time surveillance systems, including interoperable, interconnected electronic reporting systems. This can include epidemiologic, clinical, laboratory, environmental testing, product safety and quality, and bioinformatics data; and advancement in fulfilling the core capacity requirements for surveillance in accordance with the IHR and the OIE standards.
JEE self assessm Standardised Milestones Activity Yr ent of
1 Yr 2 Yr 3 Yr 4 Yr 5Other donors/ Funding/ Type
RGC USG stakeholders Comment Supportof
core capacity Indicator 1
D.2.1 Indicator and event‐based systems in place
Indicator and event‐based surveillance system(s) in 4
place to detect public health threats
currently focused on MOH CDC CDC WHO MOH CDC but could
Develop inventory of SOPs for different diseases, use/implementation interdigitate
Strengthen disease surveillance through following sub‐activities:
of SOPs, x x
broaden.TA
‐Cambodia Early Warning Response Network (CamEWARN)‐review and revise training materials‐evaluate surveillance and response training‐disseminate surveillance manual MOH CDC CDC WHO‐formalizing monitoring of media/internet sources‐promoting active public reporting using new technologies (e.g. smartphones, social media) ‐fostering reports from new partners, including healthcare workers in private facilities x x
JEE
TA
recommendation
and funding
incorporate private
Develop curriculum
sector
and
into s
training
urv
for
eillance system
supervision and coaching of disease MOH CDCsurveillance
Guidelines implemented for event confirmation, verification, Ongoing capacity building to provincial assessment and notification equipment/ operational budget
RRT, incl video training and car/ x
x
x
x
x
x
x
x
xMOH
MOH
WHOCDC
ADB
CDC WHO
Fu
TA
nding
and
funding
Training on event based surveillance to clinicians x x x xFAO
TA and funding
Training support surveillance and
to community health outbreak response
workers and health officers on x x x
MAFF (DAHP) USAID ADBIPCWHO
TA and funding
MOH InSTEDD
CDC CDCSkoll
iLab
Review hotline system x Google
IPC
TA
Covers 6 regional priority
and funding
Capacity building for disease surveillance at market disease hotspots ‐ strengthen NaVRI Outbreak Mobile Response Unit x
Improve the quality of indicator‐based surveillance data by providing ongoing training to reporters on the use of syndromic case definitions and rigorous,
x x x x
MAFF
MOH TBC
(DAHP
CDC
(
and
pathogens: rabies, NaVRI)) WCS leptospirosis, antrhax, JEV, EU LACANET scrub typhus, trichinella
TA
others ADB Part of upcoming GMS
health security project.
and funding
systematic assessments of data capture at the local level x x x Details TBC TA URC
and funding
Technical collection
assistance to ensure quality routine malaria surveillance and data x
CNM USAID PSIMalaria Care TA
Enhanced understanding of the surveillance requirements for key diseases of security concern
Surveillance of melioidosis x x x
Provincial NIPH
health DOD CTR‐CBEP
TA and funding
Conduct integrated longitudinal surveillance A positive samples in poultry and swine) and
of influenza EIDs
(incl subtyping of Flu x x x
MAFF (DAHP (NaVRI)) USAIDFAOIPC
Maintain influenza sentinel surveillance system ‐ ILI and SARI. x x x x x
Sentinel NIPH
sites MOHCDC WHO
TA and funding
Implement blood safety program for blood‐borne pathogens
incl emphasis on lab safety and surveillance x x x
U.S. PACOM
Policies, regulations, and communication procedures established at designated PoE as required by the IHR in Annex 1
Finalize and disseminate multisectoral Public Health Emergency Contingency Plan for Sihanouk seaport and Pochentong airport, incl case management guidelines x x
MAFF, Mo Env, Mo Industry, Mo Interior, Mo Finance, Immigration Police, Mo Commerce,
Mo Defense, Mo of Public Works and Transport,
Port and Airport authorities, PHD, health centres and hospitals, private sector (shipping,
ADB (for WHO
seaport)
ADB support TBC
Develop protocols for surveillance and vector control in provide training for quarantine officers, designated POE agencies on the protocols.
and near the POE and authorities and expert
x ADB support TBC
5
In addition to surveillance systems in country, using expertise to support other countries in developing surveillance systems and provide well‐standardized data to WHO and OIE for the past five years without significant external support
Sharing of surveillance activities is coordinated and supported through government commitment, stakeholders and partnerships, including neighboring countries
Regional, cross‐border and of outbreak control among
intersectoral information regional neighbours
sharing and coordination x x x x TBC ADB
Part of upcoming GMS health security project. Details TBC TA and funding
Support for the Research Coordinated Network x x x U.S. PACOM TA and funding
Indicator 2
D.2.2 Surveillance is an interoperable, interconnected, electric real‐time reporting system
3
Country has in place an interoperable, interconnected, electronic real‐time reporting system, for either public health or veterinary surveillance systems. The system is not yet able share data in real‐time.
to
Interoperable information systems for laboratory services within laboratories and through data exchange and integration across local and national laboratories and health services supporting public health threat detection and response activities based on the national surveillance strategy are operationalized Strengthen linkages between NAVRI epidemiology and lab info systems x x
BMLSMOH CDCNIPHMAFF (DAHP (NAVRI))
USAID DOD CTR‐CBEP
FAOWHODMDPADB
TAFunding
Strengthen linkages between surveillance system and lab info systemsADB USG JEE review
Platform and capacity for data integration, analysis and use across all levels and domains of the national health surveillance system promoting national and international data use and exchange for early detection and rapid response for public health threat are operationalized
Strengthen maintain effollow up,
routine information sharing within and between govt agencies; fective surveillance systems through field and lab reporting, rumor monitoring unidentified disease events x
MOH CDCNIPHDHSMAFF (DAHP (NaVRI))
CDCUSAID
WHOFAOIPC TA
Funding
Create a surveillance data validation system (CamEWARN/ILI/SARI) xMOH CDC
WHOADB
Promote use of CamLIS data‐ upload reports x x x x xMOH CDC CDC WHO
p
Strengthen HIV information systems for surveillance incl linking HIV databases to better monitor individuals across cascade, improve data security, unique health identifier, and improve interoperability with other health systems x x x x
NCHADSPHDs
CDCUSAID TA
Funding
TA to emerging diseases technology hubUSAID IPC
TA
Plans implemented to establish case management system that is integrated into interoperable, interconnected, electronic real-time reporting system
Develop national patient registration system with update national HMIS system for case reporting
national unique identifier; x x x x
NCHADSMOH
CDCUSAID
URCWHO TA
Funding
4
Country has in place an interoperable, interconnected, electronic real‐time reporting system, for either public health, health or veterinary surveillance systems. The system is not yet fully sustained by host government
Plans developed with country commitment to a sustainable funding plan for interoperable, interconnected, electronic real-time reporting system
5
Country has in place an interoperable, interconnected, electronic real‐time reporting system, including both the public health health or veterinary surveillance systems which is sustained by the government and capable of sharing data with relevant stakeholders according to country policies and international obligationsSharing of surveillance activities is coordinated and supported through government commitment, stakeholders and partnerships, including neighboring countriesIndicator 3
D.2.3 Analysis of surveillance data for priority disease/syndrome is analyzed, interpreted, and disseminated
4Annually or monthly reporting; attributed functions to experts for analyzing, assessing and reporting data
Data is compiled, analyzed for trends, summarized for decision-making, and shared with stakeholders
Support outbreak response forum incl recommendations for timely response
weekly review of surveillance data and x x x x
NCHADSMOH
CDCPEPFAR
WHO
Set up multistakeholder working group for ILI/SARI xMOH CDC CDC
WHOIPC
Sharing of surveillance plans and results at zoonotic TWG x x x x
MOH FA
(DAHP (NaVRI)) USAID FAOIPC
CamEWARN data analysed and reports created; MOH CDC weekly reports x x x x xMOH CDC
Distribute surveillance data to public health officials as widely as possible to facilitate timely and accurate epidemiological determination of geographic distribution of risk for disease. x
MOH RCAFPHD
CDCDOD AFRIMS
Expand the capacity for, and routine practice of, EBS and IBS surveillance analysis and risk assessment at the provincial level and, where feasible, operational districts, as well as through support for IBBS special studies
data
x x
NCHADS MoH CDC
CDC
5 Systematic reporting; dedicated team in place data analysis, risk assessment and reporting
for
Data is compiled, analyzed for trends, summarized for decision-making, and shared with stakeholders
Indicator 4
D.2.4 Syndromic surveillance system in place
4Syndromic system(s) in place to detect three more syndromes indicative of public health
or
emergenciesRegular feedback of syndromic surveillance results to all levels and other relevant stakeholders is disseminated
Syndromic Cambodia
and indicator‐based surveillance activities are synonymous in
In addition to surveillance systems in country, using 5 expertise to support other countries in developing surveillance systems
Sharing of surveillance activities is coordinated and supported through government commitment, stakeholders and partnerships, including neighboring countries
Key JEE self assessment levelJEE external assessment level
Detect 4: Workforce Development‐ Prevention, detection, and response activities conducted effectively and sustainably by a fully competent, coordinated, evaluated and occupationally diverse multi‐sectorial workforce.
Target: State parties should have skilled and competent health personnel for sustainable and functional public health surveillance and response at all levels of the health system and the effective implementation of the IHR (2005). A workforce includes physicians, animal health or veterinarians, biostatisticians, laboratory scientists, farming/ livestock professionals, with an optimal target of one trained field epidemiologist (or equivalent) per 200,000 population, who can systematically cooperate to meet relevant IHR and PVS core competencies.
JEE self assessment of core capacity
Standardised Milestones ActivityYr 1
Yr 2
Yr 3
Yr 4
Yr 5 RGC USG
Other donors/ stakeholders Comment Funding/ Type of Support
Indicator 1
co
2Country has multidisciplinary HR capacity (epidemiologists, veterinarians, clinicians and laboratory specialists or technicians) at national level
Database of in‐country multi‐disciplinary SMEs is developed Human resource database strengthened to manage multidisciplinary workforce xMOH, CDC Department Personnel
of
National, multi‐sectoral strategic plan is developed to enhance the multidisciplinary workforce with final approval from Ministry of Health or equivalent
National workforce development plan 2016‐2020 reviewed to include epidemiologists ("One Health" workforce plan and training national framework approved) and to incorporate RCAF requirements for epidemiologists
x
MOH, CDC MAFFDepartment Personnel
of USAIDCDC
WHOSEAOHUN KOICA TBC
Proposal for TA and to be considered
funding
Relevant public health multidisciplinary workshops and curriculum are conducted with universities and partners, including human resource requirements for IHR
Curriculum development and provision of masters degrees for agriculture x x x x xRoyal University AgricultureMAFF
of FAO FAO TCP TBD
Pre‐service training on One Health approach in animal and human health sectors. Faculty to attend regional masters program. Faculty, vet and med students join surveillance activities.
x x x x
UHS Royal University AgricultureMAFFMAFF (DAHP (NaFAMOH CDC
of
VRI))
USAIDCDC (TBD)
SEAOHUN TBCKOICA TBCIPCUC DavisADBOIEFAO
Proposal for TA and to be consideredCollaboration in coordination with F
funding
AO‐TCP
Include IPC module in medical and health sciences training curriculum x xMOH DHSIPC ProfessionalUHS
WHODevelopment partners
Blood safety training x xProvincial staffNBTC
blood center CDC KOICA TBC
Proposal for TA and to be considered
funding
Laboratory epidemiology training introduced
x x x
MOH CDC CDC WHOKOICA TBD
Proposal for TA and to be considered
funding
Inservice curriculum (blood component) for midwives and doctors xUHS NTBC
CDC Red Cross Australia TA and funding
3 Multidisciplinary HR capacity is available at national and intermediate level
Recruitment program to enhance the multidisciplinary public health workforce developed with stakeholders
is Rapid response teams strengthened at provincial and central levels MOH CDC WHO TA and funding
Train‐the‐trainer programs in relevant public health disciplines are developed
TOT for epidemiology and laboratory staff to strengthen analysis and of lab functions to surveillance, outbreak detection and response
integration x x x
MOHMAFF (DAHP (NaVRI)
CDC TBCDOD CTR‐CBEP
KOICA WHODMDPFAO
TBDProposal for TA and to be considered
funding
Leadership and management training program to increase management capacity of health program coordinators to assess necessity, quality and impact of programs
x x x MOH CDC TBC KOICA TBDProposal for TA and to be considered
funding
EU ComAcrossCIRAD
Regional project focused on Regional masters program with One Health focus developed x x x x Toulouse Vet Uni TA and funding
Cambodia and LaosPartnerships with international organizations are established to enhance university FMVcurriculum for public health disciplines Katsesart Uni
International organisations support masters degree in agriculture and ongoing support for UHS program
Multidisciplinary HR capacity is available as required at relevant levels of public health 4 system (e.g. epidemiologist at national level and intermediate level and assistance
epidemiologist (or short course trained epidemiologist) at local level available)
Collaborations are encouraged with WHO, FAO, World Bank, OIE, and other international stakeholders focused on the development of workforce capacity
Train‐the‐trainer capacity is established for multi‐disciplines
Country has capacity to send and receive multidisciplinary personnel within country 5 (shifting resources) and internationally
Sustainable plan is developed and implemented for multidisciplinary workforce development
National plans for workforce development are routinely updated
Indicator 2
D.4.2 Applied epidemiology training program in place such as FETP
No FETP or applied epidemiology training program is established within the country, 2 but staff participate in a program hosted in another country through an existing
agreement (at Basic, Intermediate and/or Advanced level)
Program staffing, with roles and responsibilities, are outlined
Leadership roles and responsibilities, and management of FETP program to supervise staff and trainees are outlined
Plan outlining technical leadership of the FETP program to facilitate and develop course curriculum, maintain scientific excellence of the training, monitor and evaluate trainees and consult on epidemiological methods is developed
Field supervisors and mentors are designated for the FETP program
FETP training materials, protocols, SOPs and tool‐kits are disseminated
One level of FETP (Basic, Intermediate, or Advanced) FETP or comparable applied 3 epidemiology training program in place in the country or in another country through an
existing agreement
WHOCDC
MOH CDC FAO Proposal for TA and funding USAID (EPT2)
MAFF (DAHP(NAVRI)) Safetynet to be consideredDOD CTR‐CBEP
KOICA TBDBasic AET and CAVET courses continue x x x x x
MAFF (DAHP) USAID FAOFETP program is implemented at either the basic, intermediate or advanced level at designated sites (AET and CAVET 3 programs)
Field Epidemiology Training Programme for Veterinary (FETPV Thailand) x x x x x Funding
DOD CTR‐CBEPStrategic plan for applied epidemiology training (AET) finalized MOH CDC CDC WHO TA and funding
xDOD AFRIMS
Twelve‐month full time AET course replaces foundation course MOH CDC CDC DOD CTR‐CBEP
WHOKOICA TBD
Proposal for TA and to be considered
funding
x x x
Trained FETP staff are integrated into core public health surveillance, epidemiology, biostatistics, laboratory and
competencies (Frontline biosafety, communication)
Collaboration strengthened process conducted
between AET and CAVET programs ‐ joint selection MAFF MOH
(DAHP (NAVRI))DOD CTR‐CBEP
WHOFAO
Proposal for TA and to be considered
funding
4
x x x
Field supervision and mentoring are of projects, barriers to training, etc.
designated to monitor trainee activity, development Mentored, in‐service training conducted
x x
MAFF (DAHP MOH CDC
(NAVRI))DOD CTR‐CBEP WHO TA and funding
Two levels of FETP (Basic, Intermediate and/or Advanced) or comparable applied epidemiology training program(s) in place in the country or in another country through an existing agreement
Two levels of FETP program are implemented at either the basic, intermediate or advanced level at designated sites
Staff are trained in procedures and tools to analyze data by time, place and person
Monitoring and evaluation assessment healthcare systems is conducted
of the performance of FETP workforce within the
M&E as envisaged in AET strategic plan x x x x
MOH CDC MAFF (DAHP)
CDC WHOFAO
TA
WHO
5
Network of FETP graduates is operational to facilitate professional developmentEnhanced information sharing and professional support through national and international field epidemiological networks (AET/CAVET), including alumni meetings and TEPHINET conference. Quarterly workshops for AET graduates. CAVET workshops are planned x x x x x
MOH CDC MAFF (DAHP)
CDC DOD CTR‐CBEP
FAOSafetynetKOICA TBD
TA and funding
Three levels of FETP (Basic, Intermediate and Advanced) epidemiology training program(s) in place in the country
or or comparable applied in another country through an
existing agreement, with sustainable national funding
Training workshops are conducted for relevant career tracks
Relevant workforce is trained in IHR competency and One‐Health approach Conduct One Health Training between AET and CAVETMOH CDCMAFF (DAHP)
CDCDOD USAID
CTR‐CBEP (EPT2)
WHOFAO
TA and funding
x x x x
FETP workforce capacity is expanded into additional jurisdictions
Sustained funding is established for FETP career tracks
Train‐the‐trainer capacity is established
ToT for veterinary staff conducted in Thailand
MAFF (DAHP)Royal University Agriculture
of DOD CTR‐CBEPUSAID (EPT2)
Thailand:FAO TA and funding
Indicator 3
3
D.4.3 Workforce strategyA public health workforce strategy exists, but is not regularly reviewed, updated, or implemented consistently
Public‐approved healthcare workforce strategic plan is completed
National workforce development plan 2016‐2020 reviewed to include epidemiologists; support university partners to work with governmetn to analyse One Health workforce competencies and develop a corresponding
xMOH, CDC Department of Personnel
WHOProposal for TA and to be considered
funding
A public health workforce strategy has been drafted and implemented consistently;
workforce plan and training framework
5
strategy is reviewed, tracked and reported on annually
The implementation of the national health workforce strategy is monitored and evaluated to track progress and barriers
“Demonstrated Capacity” has been achieved, public health workforce retention is tracked and plans are in place to provide continuous education, retain and pro‐ mote qualified
Human resource database strengthened to manage multidisciplinary workforce xMOH, CDC Department of Personnel
Proposal for TA and to be considered
funding
workforce within the national system
Strategic framework is developed to nationally prioritize resources and investments in healthcare workforce development
4
Key JEE self assessment levelJEE external assessment level
Respond 1: Emergency Response Operations‐ Effective coordination and improved control of outbreaks as evidenced by shorter times from detection to response and smaller numbers of cases and deaths.
Target: Countries will have a public health emergency operation centre (EOC) functioning according to minimum common standards; maintaining trained, functioning, multi‐sectoral rapid response teams and “real‐time” biosurveillance laboratory networks and information systems; and trained EOC staff capable of activating a coordinated emergency response within 120 minutes of the identification of a public health emergency.
Yr Yr Yr Yr Yr Other Funding/ Standardised Milestones Activity 1 2 3 4 5 RGC USG donors/ Comment Type of
R.2.1 Capacity to Activate Emergency Operations
2 EOC point of contact is available 24/7 to guide response
IMS (Incident Management System) structure including the succession plan for Finalize draft SOPs for EOC x MOH CDC WHO TA
the national PHEOC and TOR for each IMS structure are developed
SOPs finalized for EOC Finalize draft SOPs for EOC x MOH CDC WHO TA
Software and ICT support provided for regional environnmental TATechnologically supported Emergency Operations Center USAID WFP TBC Mechanism TBDoperations centers Funding
Develop SOPs to increase surge capacity and relocate resources from MOH CDC
national and subnational levels to support action at community/primary Core public health emergency management (PHEM) staff needs are identified x Department of
response level as a part of multihazard public health emergency planning, finance
response (PHEPR) plan
EOC staff team is trained in emergency management and 3 PHEOC standard operating procedures and is available for
response when necessary
Appropriate candidates to serve as permanent EOC Manager are identified Completed
Commitment of the MoH and approval of the CDC Country Office for EOC management training are secured Provide training and simulation exercise for staff at national and
x x x x x MOH CDC ADB Fundingprovincial level on public health emergency and use of SOPs
Training with MoH in developing EOC staff training plans is developed 10 provinces
CNMImprove Rapid Response Teams' malaria response through training on URC IM TBD. National TA
Training for malaria response x x x x Provincial health USAIDreactive case detection and IRS PMI and 10 ODs Funding
department
TBC TATrain field rapid response team for RCAF x x RCAF
Nationwide Funding
Joint multisectoral response is developed WHOOne Health training with AET and CAVET; AET and CAVET graduates IPC Does not involve all
MOH CDC CDC TAengaged in outrbreak investigation and response; revised SOP for joint x x x x x WCS sectors ‐ One Health
MAFF (DAHP) USAID Fundingoutbreak investigation FAO focus
OIE
Foundational‐level IMS training for core and surge staff are completed
In addition to activities for “developed capacity”, there is 4 dedicated EOC staff that has received training and can
activate a response within two hours
Routine national
communication connectivity with international, public health focal points is established
national, and sub‐As part of table top simulation exercises referred to at R2.3 below
Authorities for activation and deactivation of the national PHEOC are identified Include in draft SOPs for EOC referred to above
PHEOC facility location and funding mechanisms for PHEOC are identified Completed
Technical assistance with the receipt, inventory, PHEOC equipment systems are provided
installation and testing of EOC's logistics personnel etc)
(telecommunication determined
equipment, food, transport, support x MOH CDC CDC WHO
WHO can apply some outbreak response funds
Funding
Database of PHEOC SMEs for preparedness and response are developedDevelop comprehensive list of experts for multihazards under the National Action Plan by compiling sector specific lists developed by response national authorities
x NCDM
5In addition to activities for “demonstrated capacity”, exercises are conducted two or more times per year to test EOC activation
Discussion and operations‐based exercises conducted jointly with MoH
Implement or test the simulation exercise
multihazard PHEPR in an actual emergency or x
MOH CDCOther agencies
WHOWHO can apply some outbreak
response funds and test in real life
scenario
TA Funding
Exercise (PPP)
to test the updated Pandemic Preparedness and Response Plan x
MOH CDCOther agencies
WHOTA Funding
R.2.2 Emergency Operations Centre Operating Procedures and Plans
1No EOC plans/procedures for Incident Structure (or equivalent) are in place
Management
National baseline assessment of public health emergency management (PHEM) capacities, including PHEOC infrastructure, PHEM workforce, and PHEM systems is completed
Legal authorities for the Ministry responses are confirmed
of Health PHEOC to manage public health
5‐year strategic plan for PHEM capacity enhancement is developed with MoH
Multi‐year annual budget to sustain its PHEM capacities is developed with MoH
National policies that enable processes for public health management activities are collected and analyzed
emergency
2
EOC plans/procedures describing incident management structure (IMS) or equivalent structure are in place; plan describes key structural and operational elements for basic roles (including Incident management or command, Operations, Planning, Logistics and Finance)
Country's priority public health assessment is completed
threats and hazards are documented and risk
Profile risks (identify types of hazards Cambodia is likely to experience in coming years) and map national resources for IHR relevant hazards and priority risks ‐ conduct a National Threat and Hazard Identification and Risk Assessment (THIRA)
xNCDMMOH CDC
Cambodia ADBWHO
Red Cross CoordinationTAFunding
Conduct risk assessment for each public health event at national level MOH CDC WHO TA
Create an annual summary the risk assessment results
report of the public health events based on x x x x MOH CDC WHO TA
Conduct risk assessment for each public health event at subnational level x x x x xMOH CDCMAFF
WHOFAOOIE
TA
3
Develop epidemiological risk modeling capacity x x x MAFF (DAHP and FA) USAID IPCTA Funding
Missions, mandates, capabilities, and capacities PHEOC functioning and response are developedKey PHEOC planning documents are developed
of participating agencies for
Expand National Contingency Plan for Responding to Flood Disaster 2015 to develop a multihazard Public Health Emergency Preparedness and Response (PHEPR) Plan and SOPs incl emerging infectious diseases, food safety, chemical and radiation emergencies
xNCDMOther agencies
USAIDCDC
WHOADB TBC
National level collaboration with WHO/US CDC to develop SOPs for different diseases
TA Funding
Engage the interministerial technical working group public health response plan that reflects a whole of responding to priority public healt threats
to develop a nationalgovt approach to
JEE recommendation
Review and update the Pandemic Preparedness and as integrated part of public health emergency plan
response Plan (PPP) x
NCDMOther agencies
WHOTA Funding
Conduct Pacific Angel 16, which includes a Subject Matter Expert Exchange on public health emergencies, including preparedness
xRoyal Cambodian Armed Forces
U.S. PACOM, Pacific Air ForcesDOD U.S. Pacific Fleet
Develop EOC Plan (handbook), and position specific duties
incl EOC activation SOP, train staff in IMS JEE recommendation
SOPs for outbreak investigation administrative and logistic SOP,
and response finalized report protocol
incl x MOH CDC CDC WHO
Currently MOH CDC focused, but could broaden
TAFunding
In addition to meeting requirements of “limited capacity”, EOC plans are in place for functions including public health science (epidemiology, medical and other subject matter expertise), public communications, partner liaison
Logistical plans to link laboratory and surveillance management center at PHEOC are developed
capabilities to the incident Consider in context of SOPs for coordination with CBRN Taskforce and NCDM for coordination between IHR NFP and relevant ministries and national authorities
x xMOH CDCCBRN TaskforceNCDM
WHO
National CONOPS (concept of operations) that define the relationship between the national disaster management organization and the national PHEOC are identified
Consider in context of SOPs for coordination with CBRN Taskforce and NCDM for coordination between IHR NFP and relevant ministries and national authorities
x xMOH CDCCBRN TaskforceNCDM
WHO
In addition to meeting “developed capacity”, the following EOC plans are in place: concept of operations; Forms and templates for data collection, reporting, briefing; Role descriptions and job aids for EOC functional positions
EOC roles and responsibilities plans to key stakeholders are disseminated Finalize contact disseminate via
list of concerned CDC website
ministries and authorities and x MOH CDC
Establish Risk Communication Committee‐ responsibilities, meet twice per year
draft roles and x x x x
MOH CBRN
CDCTask Force
UNICEF
4
5
1
2
Risk communications strategy and/or operational plan are disseminatedConduct AI Risk Communication school forum x
MAFF (DAHP) MOH CDCProvincial department of education
USAID FAO 5 provinces
Consultative workshop to with Risk Communication
develop strategy Committee
and specific response plan x MOH CDC
WHOUNICEF
In addition to meeting “demonstrated capacity”, response plans are in place that describe scaled levels of response with resource requirements for each level and procedures for acquiring additional resources
National legislation or directives for PHEOC and otherhealth emergencies are developed and/or improved
entities to manage public Develop sectors
policy/ SOPs for coordination between IHR NFP and relevant x
MOH CBRN
CDCTaskforce
WHO TA
National public are identified
health response fund and the policies for utilization of this fund EOC logistics and outbreak response fund established
Current legislation, regulation and emergency management activities
other national are assessed
policies that authorize
Draft CDC Law formally endorsed for implementation x xMOH CDC ‐ legislation department
WHO
Develop MoUs between public health and other concerned ministries x xMOH CDC ‐ legislation department
Develop subdecree / Prakas on suspected emerging or specific
isolation and quarantine infectious diseases
of people with x x
MOH CDC ‐ legislation department
Measurable identified
success criteria to document progress of PHEOC capacity are
Annual outbreak investigation and framework for measuring capacity
response exercise development
provides MOH CDC CDC WHO
Hold regular meetings IHR NFP functions and
(2‐4x SOPs
per year) with relevant for improvement
ministries to review x x x x x
MOH CDCCBRN TaskforceNCDM
WHO
R.2.3 Emergency Operations ProgramNo exercises have been completed
Discussion and operations‐based exercises conducted jointly with MoH.
Conduct sectors
joint risk assessment exercise between MOH and other relevant x x x x x MOH CDC CDC WHO
Develop comprehensive, multi‐year public health management training and exercise program
emergency JEE recommendation
Table top exercise decision making
has been completed to test systems and
Table‐top trainings management plans participated in
and exercises with sectors,
for event or hazard‐specific response stakeholders, and other agencies are
and
Table top exercises and national, regional, local
simulations participants
between , involve
Vietnam and Cambodia incl AET and CAVET graduates
MAFFUSAIDDOD CTR‐CBEP
Focus on VN/Camb border. Dicsussing DTRA support.
TAFunding
Table top exercise on outbreak investigation and response xMOH CDC MAFF (DAHP)
CDCUSAID
WHOFAOADB
Conduct Exercise CARAT Health Engagement disease control and force health protection
to address HADR‐related x
Royal Navy
Cambodian DOD Navy Environmental and Preventative Medicine Unit 6
Conduct an exercise to test between EOC and NDMC
the effectiveness of SOPs defining CONOPS x x
MOH CBRN NCDM
CDCTaskforce WHO
Functional exercise has been completed to test operations capabilities but EOC has not yet been activated for a
3 response. System is not yet capable of activating a coordinated emergency response within 120 minutes of the identification of a public health emergencyOperations‐based functional exercises to test coordinated response in a public WHO
Test risk communication strategy and response plan during simulation x MOH CDChealth emergency are conducted UNICEFEOC activated a coordinated emergency response or exercise within 120 minutes of the identification of a
4public health emergency; response utilized operations, logistic and planning functionsEOC activates a coordinated emergency response or exercise within 120 minutes of the identification of a public health emergency; response utilized operations, logistic and planning functions
In addition to achieving demonstrated capacity, a follow 5 up evaluation was conducted and corrective action plan was developed and implementedAfter Action reviews (AAR) and improvements for routine trainings and exercises incorporated into national response plans
R.2.4 Case management procedures are implemented for IHR relevant hazards
No case management guidelines are available for priority 1epidemic‐prone diseasesPlease see Surveillance/informatics milestones to meet this capacity
Case management guidelines are available for priority 2epidemic‐prone diseasesPlease see Surveillance/informatics milestones to meet this capacityCase management guidelines for other IHR relevant hazards are available at relevant health system levels and
3 SOPs are available for the management and transport of potentially infectious patients in the community and at PoEPlease see Surveillance/informatics milestones to meet this capacityCase management, patient referral and transportation, and management and transport of potentially infectious
4patients are implemented according to guidelines and/or SOPsPlease see Surveillance/informatics milestones to meet this capacityIn addition to demonstrated capacity, appropriate staff
5 and resources (as defined by the country) is in place in management of relevant IHR‐related emergenciesPlease see Surveillance/informatics milestones to meet this capacity
Key JEE self assessment level
JEE external assessment level
Respond 2: Linking Public Health and Law Enforcement‐ Development and implementation of a memorandum of understanding (MOU) or other similar framework outlining the roles, responsibilities, and best practices for sharing relevant information between and among appropriate human and animal health, law enforcement, and defense personnel. Ensure validation of the MOU through periodic exercises and simulations to test rapid, multi‐sectorial response to potential public threat incidents. In collaboration with FAO, International Criminal Police Organization (INTERPOL), OIE, WHO, individual Biological and Toxin Weapons Convention State Parties, the United Nations Secretary‐General's Mechanism for Investigation of Alleged Use of Chemical and Biological Weapons (UNSGM), and other relevant regional and international organizations as appropriate, countries will develop and implement model systems to conduct and support joint criminal and epidemiological investigations to identify and
respond to suspected biological incidents of deliberate origin.
Target: In the event of a biological event of suspected or confirmed deliberate origin, a country will be able to conduct a rapid, multisectoral response, including the capacity to link public health and law enforcement, and to provide and/or request effective and timely international assistance, including to investigate alleged use events.
Yr Yr Yr Other donors/ Funding/ Type of Standardised Milestones Activity Yr 1 Yr 2 3 4 5 RGC USG stakeholders Comment Support
Indicator 1R.3.1 Public Health and Security Authorities, (e.g. Law Enforcement, Border Control, Customs) are linked during a suspected or confirmed biological event
Points‐of‐contact and triggers for notification and information 2 sharing have been identified and shared between public health,
animal health and security authorities
NACW (National An International Joint Investigations Workshop has been conducted to improve understanding Linkages established with identified international networks‐ Authority for of baseline public health, animal health, and security/law enforcement capabilities by relevant x x x xre chemical and radiological emergencies Prohibition of CBRN
multi‐sectoral agency counterparts. Weapons)
NACW (National Amend Law on Prohibition of Chemical, Nuclear, Authority for
x xBiological and Radiological Weapons Prohibition of CBRN
Weapons)
MOH CDC legislation WHOFormal endorsement of CDC law x xTriggers for sharing information on biological threats or other incidents of concern (chemical, dept ADB TBC
radiological) with relevant multi‐sectoral agencies have been developed.NACW (National Develop SOPs for specific emergencies (chemical, Authority for ODCbiological, radiological) and organise training on SOPs xProhibition of CBRN PACOM
through table top and field training exercises Weapons)
Develop nuclear emergency laws x x Ministry of Industry
An informal communications process to share information related to biological threats or other Completed
incidents of concern (chemical, radiological) has been developed.
Identify and designate health facilities for chemical and MOH CDC WHOx
radiological emergency response, provide training Hospitals ADB TBC
Logistical plans to include multi‐sectoral agencies in the Public Health Emergency Operations Center (PHEOC) have been developed. Develop list of in‐country chemical and radiation experts; Ministry of Mines
provide training x x and EnergyMoE
The sample collection, transport, storage and testing requirements among the sectors (public health, law enforcement, agriculture) for biological threats and other incidents of concern (chemical, radiological) have been determined.
Develop SOPs for transport of contaminated materials x x
Ministry of and EnergyMAFFMOH CDCMoE
Mines
WHOADB TBC
3Memorandum of Understanding (MOU) or other agreement (i.e., protocol) exists between public health and security authorities within the country and has been formally accepted
Activities (notifications, assessments, investigation, written protocol or MOU have been identified.
laboratory testing) to be covered by a
Develop multi‐hazard public health emergency response planDevelop MoUs between public health and other concerned ministries. x x
MOH CDC as coordinator with concerned ministriesNACW
ODCPACOM
ADB TBCA draft written protocol or MOU has been developed that formalizes and interactions between public health, animal health, and security authorities.
institutionalizes
A written protocol or MOU has been finalized that formalizes and between public health, animal health, and security authorities.
institutionalizes interactions
4At least 1 public health emergency response or exercise within the previous year that included information sharing with Security Authorities using the formal MOU or other agreement (i.e., protocol)
Measurable response to
success criteria have been biological threats or other
developed to document progress of multi‐sectorial incidents of concern (chemical, radiological).
At least 1 public health emergency response or exercise has been conducted (within the previous year) that included information sharing with security authorities using the formal protocol or MOU.
5
Public health and security authorities exchange reports and information on events of joint concern at national, intermediate and local levels using the formal MOU or other agreement (i.e., protocol)public health and security authorities engage in a joint training program to orient, exercise, and institutionalize knowledge of MOU or other agreementsThe effectiveness of multi‐sectoral previously defined criteria.
response activities have been evaluated
using the
Training curriculum have been developed using country‐specific contentregulations/authorities, agency roles/responsibilities, and case studies).
(e.g.,
Country‐specific workshop other sector personnel.
have been delivered to public health, animal health, security, and
National response plans responding to biological
have been updated to identify multi‐sectoral approaches for threats and other incidents of concern (chemical, radiological).
Key JEE self assessment levelJEE external assessment level
espond 3: Medical Countermeasures and Personnel Deployment‐ Countries will have the necessary legal and regulatory processes and logistical plans to allow for the rapid cross‐border deployment and receipt of public health and medical personnel during emergencies. egional collaboration will assist countries in overcoming the legal, logistical and regulatory challenges to deployment of public health and medical personnel from one country to another.
Target: A national framework for transferring (sending and receiving) medical countermeasures and public health and medical personnel among international partners during public health emergencies.
Other donors/ Funding/ Type of Standardised Milestones Activity Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 RGC USG stakeholders Comment Support
Indicator 1
R.4.1 System is in place for sending and receiving medical countermeasures during a public health emergency
Plans have been drafted that outline system for sending 2 and receiving medical countermeasures during public
health emergenciesNational guidance documents on medical countermeasures stockpile and deployment are established/adapted
Documents the deployment
existing documents on medical countermeasures stockpile and Coordination
Training of early responders in appropriate use and management of non‐medical countermeasures is initiatedResources for countermeasures are mapped both within country and with partners
Standardized countermeasure requirements with protocols for storage, deployment, and logistical & administrative support are developed
Activities to be covered by a written protocol or Memorandum of Understanding (MOU) are determined
Logistics and operational plans for the optimized use of medical countermeasures are developed for all levels of response
Regulatory pathways to facilitate medical countermeasures during public health emergencies are established
Database of threat‐based approaches and potential medical countermeasures needed for response is created
Protocols, Standard Operating Procedures, technical guidelines, and toolkits adapted to ensure effective deployment of medical countermeasures
Medical countermeasure communications materials, trainings, and educational information to inform staff, the community and stakeholders are created
Risk‐mapping to identify strategies for medical countermeasure deployment is performed
Coordination of responses to observe appropriate authorizations, clearances, ethical norms, and permissions during investigations is ensured
National and regional plans to implement best practices for medical countermeasure deployment during public health emergencies are developed
Table‐top exercise(s) has been conducted to
3demonstrate decision making and protocols for sending or receiving health personnel from another country during a public health emergencyTrainings and exercises for event or hazard‐specific response and management plans with sectors, stakeholders, and other agencies are developed
RR
4At least one response OR a formal exercise within the previous year in which medical countermeasures were sent or received by
or simulation
the country
Capacity of emergency deployment of medical countermeasures response emerging infectious diseases is tested
to Conduct training and simulation for sending and receiving medical countermeasures
x
MOH CDCFORTCBRNTaskforce
5
Measurable success criteria to document progress of countermeasure response is determined
Country participates in a regional/international partnership or has formal agreement with another country or international organization that outlines criteria and procedures for sending and receiving medical countermeasures AND has participated in an exercise or response within the past year to practice deployment or receipt of medical countermeasuresInternational partnerships with medical product manufacturers supported and core services are supportedNational plans and policies for medical countermeasure stockpile/deployment measures are updated
Strategic framework to nationally prioritize resources and investments in medical countermeasures is developed
personnel during a public health emergency
Indicator 2
R.4.2 System is in place for sending and receiving health
1
2
No national personnel deployment plan has been drafted.
National response plans and legal & regulatory frameworkdeployment, including sector roles and responsibilities are
for personnel reviewed
Develop plan for sending and receiving international emergencies
Develop cross‐border SOPs for emergency response
personnel during public health x
x
x
x
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
Barriers to receiving health personnel during emergencies are identified
Points of Contact at relevant multi‐sectoral organizations are identified to assist with the implementation of the technical area/action package activities
Base camps or facilities for receiving health personnel are identified
Plans have been drafted that outline system and receiving health personnel during public emergencies
for sending health
Communication and coordination protocols for personnel during emergencies are developed
incoming international health
Develop plan emergencies
for sending and receiving international personnel during public health
x
x
x
x
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
CDC MOHFORTCBRN Taskforce
Safety and liability guidance documents medical emergencies is developed
for personnel deployment during
Communication established
network for health personnel during emergencies is
Standard Operating Procedures transportation, and distribution health personnel are developed
and training for the organization, of PPE, medications, and medical supplies to
Standardized plans for treatment centers for triage during emergency CDC MOH
incidents are developed FORTx CBRN Taskforce
National and regional plans to implement best practices for health personnel CDC MOHdeployment during public health emergencies are developed FORT
x CBRN Taskforce
Triggers for sharing information and emergency personnel deployment plans CDC MOHwith relevant multi‐sectoral agencies are identified FORT
x CBRN Taskforce
Tools for emergency health disaster education for the public for community CDC MOHacceptance of deployed health personnel are developed Develop plan for sending and receiving international personnel during public health FORT
emergencies x CBRN Taskforce
Table‐top exercise(s) has been conducted to demonstrate decision making and protocols for sending
3or receiving health personnel from another country during a public health emergency
CDC MOHProtocols, Standard Operating Procedures, technical guidelines, and toolkits FORTfor sending and receiving health personnel are adapted Conduct training and simulation for sending and receiving medical personnel x CBRN Taskforce
Trainings and exercises for hazard‐specific response and management plans Pilot Cross‐border Cambodia and Vietnam surveillance and management system: series CDC MOHwith relevant sectors, stakeholders, and other agencies are developedof meetings in both countries, discuss disease priorities and response, collect FORTinformation on epi zones x CBRN Taskforce
At least one response OR formal exercise or simulation within the previous year in which health personnel were sent or received by the country
Capacity of emergency deployment of medical countermeasures response to CDC MOHemerging infectious diseases is tested FORT
x CBRN TaskforceCDC MOH
Measurable success criteria to document progress of countermeasure FORTresponse are determined Conduct training and simulation for sending and receiving medical personnel x CBRN Taskforce
Country participates in a regional/international partnership or has formal agreement with another country or international organization that outlines
5 criteria and procedures for sending and receiving health personnel AND has participated in an exercise or response within the past year to practice deployment or receipt of health personnel
National plans and policies for personnel deployment are regularly updated
Engagement meeting(s) to build regional partnerships for personnel deployment is/are conducted
4