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HEALTH

programmeEMERGENCIES

WHO Health Emergency Programme (WHE) – The Way W(H)E Work

WHE

WHO Regional Office for Europe

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Extreme temperature

Civil unrest

Floods Storm

Volcanic activity terrorism

Earthquake + Tsunami

Wild fire

Epidemics &

pandemics

Foodborne outbreaks

Structural collapse

Power outage

Food contamination

Armed conflicts

Financial crisis

Emerging diseases

Insect infestation

Space weather

Industrial hazards

transportation

Air pollution

Explosions / Fire

Hazardous materials

in air

Biological Radio-nuclear chemical Trauma …Em

erg

ency

Res

po

nse

Fra

mew

ork

(E

RF

), W

HO

; 2

01

7CLASSIFICATION OF HAZARDS

1. Natural 2. Human-induced

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EU Regional public health hazards

• Infectious hazards + vaccine-preventable infections

• Zoonotic and vector-borne infections

• Food safety related events

• Natural disasters + extreme weather events

• Chemical, Biological, Radiological, Nuclear

• Conflicts & Terrorist acts

• Refugees and migrants

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Preparedness

Response

Recovery

Prevention

Emergencies are Everybody’s Business

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WHO Strategic Priorities & Outcomes – The WHO General Programme of Work (GPW13)

WHO’s vision for the next 5 years

2.1. Countries prepared for health emergencies

2.2. Epidemics & pandemics prevented

2.3. Health emergencies rapidly detected & responded to

Health Emergencies Priority Outcomes

1 billion more people

enjoying better health and well-being


better protected from health emergencies


benefitting from universal health

coverage

Promote health

Keep the world safe

Serve the vulnerable

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WHE WORKS ON TWO SIDES OF THE SAME COIN

Strengthening health systems (UHC)

Access to essential life saving health services & public health interventions

Robust health system with measures in place to provide a comprehensive and effective life saving operations in public health emergencies,

using the all hazards approach

Responsive health systems are an integral part of IHR

(2005) implementationStrengthening IHR capacities contribute to improving health systems’ resilience

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International Health Regulation (IHR) (2005)

• Globally agreed legal framework

• To prevent, protect against, control and provide a public health response to the international spread of disease

• Outlines core capacities to uphold global health security

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8 areas of work

Legislation and Policy

Coordination

Surveillance

Response

Preparedness

Risk Communications

Human Resources

Laboratories

Potential hazards

Infections

Zoonoses

Food safety

Chemical

Radio nuclear

Events at the Points of Entry

Ports

Airports

Ground crossings

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The “All Hazards Approach”

All-hazards is a concept acknowledging that whilehazards vary in source (natural, technological, societal),they often challenge health systems in similar ways

Thus:

• Risk reduction

• Emergency preparedness

• Response actions

• Community recovery activities

Usually implemented

along the same

model, regardless of

the cause

Emergency management cycle Vulnerabilities; Risk Specificity

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IHR Monitoring and Evaluation Framework

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Completed (14)✓ Albania, 2016✓ Armenia, 2016✓ Belgium, 2017✓ Finland, 2017✓ Kyrgyzstan, 2016✓ Latvia, 2017✓ Liechtenstein, 2017✓ Lithuania, 2018✓ North Macedonia, 2019✓ Republic of Moldova, 2018✓ Serbia, 2018✓ Slovenia, 2017✓ Switzerland, 2017✓ Turkmenistan, 2016

In the pipeline (5)• Bosnia & Herzegovina• Georgia• Montenegro• Tajikistan• Netherlands

35%, or 1 in 3, European countries conducting Joint External Evaluations

The JEE has 19 Technical Areas & 49 indicators

• Each indicator is allocated a score

• Priority recommendations for each technical area are formulated

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Simulation exercises

An exercise is a form of practice, training, monitoring or evaluation of capabilities, involving the description or simulation of an emergency, to which a described or simulated response is made

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After Action Review

AAR is a qualitative review of actions takento respond to an emergency as a means of identifying gaps, lessons and best practices involving stakeholders of the response

Principles• An assessment of the functionality of IHR

capacities• Not an external evaluation of performance• Can be combined with internal WHO

learning exercisesExamples of AARs supported• Measles in Kyrgyzstan (May 2019)

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Identified IHR capacities gaps

point to wider health system weaknesses

Concrete actions at the intersection between emergency management cycle and

health system strengthening

From gaps to action

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IHR CORE CAPACITIES, ESSENTIAL PUBLIC HEALTH AND HEALTH SYSTEM FUNCTIONS - LINKAGES

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→ Leading to a National Action Plan for Health Security

• Comprehensive, multi-sectoral five-year plan to coordinate evidence-based actions of various sectors for the purpose of strengthening country health emergency preparedness

• Operationalizes recommendations and findings of the Joint External Evaluation and other relevant assessments

• Focuses on the priority areas and prioritizes necessary actions

• Facilitates resource mobilization through a coordinated, multi-sectoral approach to improve health security

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Making an impact in countries

Develop systems of the future

Build high performing systems

Build national institutions

Fill critical gaps in emergencies

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WHO EUROPEAN REGION RESOLUTION & ACTION PLAN September 2018

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To ensure… “high-level political and financial commitment to address the full cycle of emergency management, including prevention, preparedness, response and recovery, supported by multisectoral engagement, whole-of-society approaches and effective partnerships”Resolution EUR/RC68/Conf.Doc./5

Implementing the Global Work Plan to WHO European Region -Rationale for the Action Plan

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Key guiding principles of the WHE work

Partnerships & Intersectoral collaboration

All-hazard & One Health approach

Focus on priority countries and needs

WHO leadership & coordination

Country ownership

Strengthening health systems

Framework & principles of the IHR

Sustainable Development Goals

All phase of the emergency

management cycle

Building on sub-regional frameworks

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The action plan is based on three strategic pillars

Build, strengthen and maintain States Parties’ core capacities required under the IHR (2005)

Strengthen event management and compliance with the requirements under the IHR (2005)

Measure progress and promote accountability

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Albania, Armenia, Azerbaijan, Bosnia & Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Serbia (including Kosovo), Tajikistan, Uzbekistan, former Yugoslav Republic of Macedonia

• Hubs are placed in Georgia, Kyrgyzstan, and Serbia

• Two conflict zones: Turkey (“whole of Syria”) and Ukraine

WHE focuses on 15 priority countries in the WHO European Region

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The Emergency Response Framework is the main WHE policy guide that describes how WHO manages the assessment of public health events and grades the response to emergencies

EVENT

Incident Management System provides a standardized yet flexible coordinated approach to managing and operationalizing WHO’s response to the emergency

WHO Emergency Programme is fully functional

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It is better to err on the side of over-resourcing rather than risk failure by under resourcing

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Fortifying our technical expertise through operational partners

• Global Outbreak Alert Response Network (GOARN)

• Emergency Medical Teams (EMT)

• Health Cluster partners (HC)

• Stand-by Partners (SBP)

• Collaborating Centres (CC)

Partnership based on concrete sets of skills & capacities

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European WHO Collaborating Centers (CCs)• Resource institutions which support WHO activities

within many different health areas (the first was aninfluenza reference center established in 1947)

• Currently there are 828 worldwide with 275 in the WHOEuropean Region, 103 can be used for the emergencycycle

*Information regarding the WHO CCs can be found on the WHO website, as well as, the open access WHO CC Database: http://apps.who.int/whocc/

http://apps.who.int/whocc/

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Health Security Interface

Applicable to those public health activities within WHO whose performance involves to some extent the coordination with: international organizations, civil defense, military doctors, law enforcement and armed forces etc.

UN Office for

Disarmament

Affairs

Other UN

OCHA, UNHCR

Informal contact between organization to share information on events of potential deliberate nature

Organization for the

Prohibition of

Chemical Weapons

and Others…

Multi-Sectoral Collaboration

(WHA resolutions 54.14 & 55.16)

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Bringing to the Global Health Goods

Essential Packages of Services for people centered health services, leaving NO ONE BEHHIND, for all hazards with risk specificity

• Political commitment

• Laws and regulations

• Finance

• Guidelines

• SOPs

• HWFs capacity development

• Laboratories

• Infrastructure

• Warehouse

• One Health

• All Government

• Community based

• Partnerships including operational partnerships

ECS, PHC, Hospital, Rehabilitation

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Strategic Interventions in Central Asia

• Provide tailored, targeted technical support to strengthen core capacities: operationalize plans; and improve procedures and implementation of Health Regulations (2005).

• Conducted 9 simulation exercise to test national coordination capacities to respond to flashfloods, earthquakes and out break of communicable diseases. The exercises informed the development of further capacity building activities to strengthen country’s prepare4dness to priority hazards;

• Early detection of and timely and effective response to all-hazards health emergencies (Surveillance, early warning and response, laboratories, training).

• Provision of evidence based informed by strategic assessments, and joint evaluation adopting all hazard approach

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Strategic Interventions in Central Asia

• Leading the Health sector working group

• Conducted policy dialogue on IHR in collaboration with UN agencies led by RC

• Conducted an assessment of emergency care services

• Supported the preparedness for World Nomad Games III

• Prepositioned emergency supplies (IEHK)

• Strengthen hospital safety:

✓ conducted an assessment of hospitals safety

✓ guided the development of planning guidelines to address priority gaps

✓supported the development of hospital preparedness plans

✓provided technical support to review triage guidelines

✓Guided the development of national simulation exercise

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Operational Action Plan Calendar in Central Asia

• June 2019: EWARS trainings in KGZ, Simulation exercise in KAZ

• July 2019: NAPHS in KGZ, ERC training in KAZ, simulation in TJK, simulation guideline dissemination in KGZ, regional joint training on assessment of PoE

• August 2019: High-level IHR roundtable, Assessment of PoE in KGZ

• September 2019: Costing training of NAPHS in KAZ and KGZ

• October 2019: JEE in TJK

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Thank You for your attention!

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