6 April 2023 – Led by the Ministry of Health in Bahrain, and facilitated by the WHO Country Office, a 3-day training of trainers simulation exercise (SimEx) for preparedness for health security took place on 20–22 February 2023. The training was supported by the WHO Regional Office for the Eastern Mediterranean, and with the Gulf Center for Disease Prevention and Control (GCDC) as facilitator, a statement was issued bearing testament to the country’s commitment to achieving Triple Billion Goal 2: 1 billion more people better protected from health emergencies.

Attended by over 25 participants, directly involved in preparedness and response for major public health events at the national level, the simulation exercises were enriched by multidimensional expertise across operational areas, strengthening country preparedness and response to pandemics, zoonotic diseases, climate change, food security and antimicrobial resistance. 

In her opening address, Her Excellency Dr Ejlal Al-Alawi, Assistant Undersecretary for Public Health, noted, “Simulation exercises are necessary to develop, assess and test the functional capabilities of emergency assistance. The Kingdom of Bahrain, through the implementation of the International Health Regulations (IHR 2005), illustrates its responsibility to assess national capabilities, and effectively respond to all risks and emergencies”.

The IHR 2005 are a legally binding agreement across all WHO's Member States to ensure the capability to detect and report potential public health emergencies to strengthen global response. WHO secretariat developed the IHR Monitoring and Evaluation Framework (IHR MEF) which consists of 4 complementary components: one mandatory – the States Parties Annual Report (SPAR); and 3 voluntary – joint external eEvaluations (JEE), after action reviews (AAR) and simulation exercises (SimEx). SimEx can assess the functionality of a country’s health emergency preparedness and response under an actual “real-life” event or a simulated situation. The SimEx conducted used a mixed approach of presentations, group work, and plenary discussions to help stakeholders identify and address gaps in emergency response by enabling participants to practise their roles and responsibilities and gain experience in simulated emergency settings.

H.E. Dr Ejlal Al-Alawi, Assistant Undersecretary for Public Health, emphasized that, “This workshop is of paramount importance as it provides an opportunity to build on our collective expertise, share knowledge and experiences to rapidly detect, investigate and assess potential threats to public health, and to respond immediately and systematically to reduce the health risks”. 

Dr Tasnim Atatrah, WHO Representative in Bahrain, thanked H.E. Dr Ejlal Al-Alawi, for leading the way forward to institutionalize core IHR capacities, “The training of trainers simulation exercises is the first in the WHO Eastern Mediterranean Region, adopting a multisectoral approach to strengthen emergency preparedness to all hazards. Simulation exercises constitute one of the key pillars of the IHR Monitoring and Evaluation Framework. In hosting this opportunity in Bahrain, the Country, under the leadership of the Ministry of Health, is providing a bold statement of the importance of investing in future-ready capacities, which in turn will strengthen preparedness, response and recovery capacities across borders”. 

In the WHO Eastern Mediterranean Region, Bahrain is the first country to have conducted a training of trainers simulation exercises  to increase its preparedness, and with an opportunity to demonstrate continuous strive to “build back better”, to prevent, prepare, respond and recover from health emergencies. Following the Training of Trainers exercise, Bahrain will be able to build capacities at the national and regional levels.

Quotes from participants

Dr Manaf Al Qahtani, Infectious diseases consultant, Bahrain Defense Force (BDF) Hospital: “The Simulation Exercise came at the right time. Building on the momentum of the global response to the COVID-19 pandemic, strengthening knowledge and improving skills. It is important to continue developing national preparedness in the face of emerging infectious or non-infectious health threats. The exercise itself is well structured, allowing for flexibility in terms of broadening participant thinking in how to address the development of a roadmap to better tackle emerging events. In terms of sustainability, lessons learned through the simulation exercise have the potential to inject vital skills into colleges, nursing and medical schools. This is where we can build essential skills in the next generation of physicians, nurses and health care workers, to strengthen resilient workforces and to tackle epidemic events”. 

Dr Adel Al-Sayyad, Chief of Disease Control section, Ministry of Health Bahrain, stated that: “The multisectoral participation we have witnessed this week is key. Coming together with colleagues and institutions representing a wide range of complementary skills and fields provides a strong platform to build common understanding and shared development plans. Different people have different experiences, which will enrich the simulation exercise itself. We come with a background in the medical field, our colleagues and other national stakeholders will bring their own expectations and obstacles, which can be addressed by merging multisectoral knowledge. This practical and collaborative approach will enhance experiences, while developing readiness to structure future capacity building exercises, based on realistic lived settings, and to benefit the stability of health security across the country”. 

Dr Basma Al Saffar, Head of Immunization Group, Ministry of Health Bahrain: “I gained new experiences in participating in this IHR simulation based-scenarios, as the structure builds relevance in our daily work, national capacity to train other stakeholders across sectors, and prepares mindsets in relation to emergency situations we could face in future. Testing preparedness plans on the ground can improve planning ahead of any emergencies in future. While playing out these situations can add value to build skills for the next generation as well. I would like to see these exercises continue to benefit real-life scenarios. During the COVID19 pandemic, Bahrain recruited over 50 000 volunteers to support the national response. Skills practiced during the simulation can enhance volunteers’ capacity in the country and provide real value. If we face future pandemics or emergencies, we need to ensure that the county is well-prepared, and future volunteers are well-trained in facing public health emergency response”.