IHR and Country Emergency Preparedness

IHR and Country Emergency Preparedness

Country Health Emergency Preparedness and International Health Regulations

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Vision

At CPI, we strive to play a vital role in advancing health security across the Region, supporting countries in protecting their communities from health crises, strengthening resilience and fostering international collaboration for the well-being of all.

Mission

At CPI, our mission is to empower countries around the Region to protect and enhance the health of its people in the face of health emergencies. We provide strategic, operational and technical support, focusing on preparedness, collaboration, evidence-based action, capacity building, community engagement, innovation and transparency to secure a healthier, safer future for all..

Our values

WHO, as the directing and coordinating authority on international health within the United Nations system, adheres to the UN core values of integrity, professionalism and respect for diversity. The values of the WHO workforce furthermore reflect the principles of human rights, universality and equity established in WHO’s Constitution as well as the ethical standards of the Organization. These values are inspired by the WHO vision of a world in which all peoples attain the highest possible level of health, and our mission to promote health, keep the world safe and serve the vulnerable, with measurable impact for people at country level. We are individually and collectively committed to put these values into practice.

Trusted to serve public health at all times

  • We put people’s health interests first
  • Our actions and recommendations are independent
  • Our decisions are fair, transparent and timely

Professionals committed to excellence in health

  • We uphold the highest standards of professionalism across all roles and specializations
  • We are guided by the best available science, evidence and technical expertise
  • We continuously develop ourselves and innovate to respond to a changing world

Persons of integrity

  • We practice the advice we give to the world
  • We engage with everyone honestly and in good faith
  • We hold ourselves and others accountable for words and actions

Collaborative colleagues and partners

  • We engage with colleagues and partners to strengthen impact at country level
  • We recognize and use the power of diversity to achieve more together
  • We communicate openly with everyone and learn from one another

People caring about people

  • We courageously and selflessly defend everyone’s right to health
  • We show compassion for all human beings and promote sustainable approaches to health
  • We strive to make people feel safe, respected, empowered, fairly treated and duly recognized

Our work

In the Eastern Mediterranean Region, managing epidemics, pandemics and health emergencies presents a wide range of complex challenges. The ongoing humanitarian crises and conflicts across many countries continually expose the Region to infectious disease outbreaks and other public health emergencies. In response to these challenges, the Country Health Emergency Preparedness and International Health Regulations (CPI) Unit at WHO's Health Emergencies Programme in the WHO Regional Office for the Eastern Mediterranean in Cairo, Egypt plays a vital role in providing strategic, operational and technical support to help countries take action to protect global health security, reducing economic impact and enhancing public trust in public health systems, and to meet regional and global commitments within the International Health Regulations 2005 and the 2030 Agenda for Sustainable Development.

Throughout 2022, the Eastern Mediterranean Region wrestled with the persistent COVID-19 pandemic, alongside additional outbreaks of diseases such as acute watery diarrhea, Crimean-Congo haemorrhagic fever (CCHF), dengue, malaria, measles, mpox and polio. Factors contributing to these health crises include climate change, natural disasters, fragile health systems and population movements. CPI has undertaken significant efforts to strengthen rapid response teams, enhance laboratory diagnostics, expand genomic surveillance and integrate the monitoring of respiratory viruses into existing systems.

Moreover, the Region has faced the resurgence of cholera, emphasizing the importance of oral cholera vaccines in outbreak control. In response to emerging vector-borne and zoonotic diseases, CPI provides essential training, mentoring and medical supplies. Technical missions and fieldwork are conducted to improve disease surveillance and response capabilities, with active participation in the Global Influenza Surveillance and Response System.

Despite these efforts, there are ongoing challenges, including protracted emergencies, insufficient investment in infectious hazard preparedness and delays in data sharing. CPI’s continued commitment to addressing these issues and supporting the Region in managing health emergencies remains crucial.

The CPI Unit consists of 10 technical programmes, which include:

:

IHR monitoring and evaluation

One health

Risk communication, community engagement and infodemic management

Points of entry

Mass gatherings

Emergency medical teams

Disaster risk reduction and emergency care systems

Public health emergency operating centers

Operational readiness

Health and security interface

All our work is guided by the Regional Director’s Vision 2023, which defines WHO’s strategy until at least 2023. This vision supports countries’ ongoing efforts to move towards health for all by all – the idea that everyone, from governments and health professionals through to organizations, communities and individuals, can help to maximize health and well-being across the Region. Along with the Vision, WHO developed a strategy which identifies our main priorities for the Region and explains how we will pursue them through specific strategic objectives. The strategy includes clear targets and indicators so that we can measure our progress and report on how we are doing.

Vision 2023 is anchored in and contributes towards implementation of WHO’s Thirteenth General Programme of Work 2019–2023, the 2030 Agenda for Sustainable Development, the Agenda for Humanity and United Nations reform. WHO’s Thirteenth General Programme of Work 2019–2023 defines WHO’s strategy for the 5-year period 2019–2023. It focuses on triple billion targets to achieve measurable impacts on people's health at the country level. The triple billion targets are to ensure by 2023:

One billion more people

  • benefitting from universal health coverage
  • better protected from health emergencies
  • enjoying better health and well-being

Measurable impact is at the heart of all our work and WHO’s mission to transform the future of public health.

More on Country Health Emergency Preparedness and International Health Regulations Unit

The Country Health Emergency Preparedness and International Health Regulations (CPI) Unit is one of several Units at WHO’s Health Emergencies Programme at the WHO Regional Office for the Eastern Mediterranean in Cairo, Egypt. Its 10 technical programmes are overseen by a programme area manager, with two team leads under her supervision. These team leads manage the technical teams for the 10 technical programmes, with some technical staff reporting into the programme area manager, together with administrative staff. The team works closely with WHO headquarters in Geneva, other regional offices in Africa, the Americas, Europe, South-East Asia and the Western Pacific, as well as 22 country offices and country desk officers, ministries of health, collaborating centres and national and international partners, as well as individuals and communities.

CPI’s support for International Health Regulations

At CPI, we support countries in various ways to ensure they effectively implement the International Health Regulations (IHR) Monitoring & Evaluation framework, which is crucial for assessing their progress in meeting the core public health capacities outlined in the IHR 2005. Here's a breakdown of how we provide this support:

Implementing IHR Monitoring & Evaluation (M&E) framework: We work closely with countries to establish and maintain the IHR M&E framework. This framework serves as a structured approach to assess the implementation of core public health capacities in accordance with the IHR 2005.

Gauging progress in fulfilling commitments: We help countries use the IHR M&E framework to gauge their progress in fulfilling the commitments and obligations outlined in the IHR 2005. This process is essential for mutual accountability between States Parties and WHO, fostering global public health security.

Identifying areas needing additional support: Through the IHR M&E framework, we assist countries in identifying areas where they may need additional support to enhance their preparedness and response capacities. This includes pinpointing strengths and areas of improvement.

Promoting mutual accountability: Our work bridges the responsibilities of States Parties and WHO. We encourage transparent reporting and dialogue, ensuring that both parties are accountable for global public health security. By doing so, we assist in recognizing the unique strengths and challenges each country faces in implementing IHR core capacities.

Our approach incorporates a range of tools to support countries comprehensively:

  1. IHR State Party Self-Assessment Annual Report (SPAR): We guide countries in using SPAR to assess their strengths, weaknesses and progress over time. This tool allows them to track improvements in their public health capacities.
  2. Joint External Evaluation (JEE): We provide countries with a comprehensive assessment of their preparedness and response capacity through a team of external and internal experts. This in-depth evaluation identifies specific areas for improvement.
  3. After-Action Review (AAR): We examine the effectiveness of a country's response to specific events, drawing valuable lessons that help enhance future responses. AARs contribute to continuous improvement in preparedness and response efforts.
  4. Simulation Exercises: We assist countries in conducting simulated exercises to test their response capacity in controlled environments. These exercises provide practical experience and help countries refine their preparedness.

CPI's support for One Health

Holistic approach: At CPI, we actively support the One Health approach, which is a holistic and integrated strategy aiming to achieve a sustainable balance for the health of people, animals and ecosystems. One Health includes a comprehensive perspective on health, acknowledging the interconnection of human, animal and environmental well-being.

Shared governance: Our commitment to One Health involves facilitating shared governance, enhancing communication, fostering collaboration and coordinating efforts to address complex and interconnected health issues. We actively promote collaboration and coordination among various stakeholders to ensure a well-coordinated response to health challenges, recognizing that these challenges affect multiple aspects of society.

Interconnected well-being: We understand that the health of humans, domestic and wild animals, plants and the broader environment, including ecosystems, is deeply intertwined. One Health recognizes that the health of all these elements is interdependent and any imbalances can have significant repercussions on global health.

Local and global focus: CPI's role in One Health extends from the community level to the global stage. We help countries identify and tackle health issues that impact multiple stakeholders. We actively engage at both the community and global levels, assisting countries in addressing health concerns that have widespread impacts.

Empowering solutions: Embracing the One Health approach empowers individuals and communities to understand the co-benefits, risks, trade-offs and opportunities to advance equitable and holistic solutions. We work to ensure that people have the knowledge and tools to make informed decisions that promote overall well-being and sustainability.

Active approach: For us, One Health is not just a concept; it is an active, forward-looking approach to healthcare systems. We recognize the interdependence of human, animal and environmental health, and we champion collaboration and coordination among stakeholders. Our approach goes beyond theory; it involves practical steps and initiatives to address the health of people, animals and ecosystems.

Sustainable and equitable outcomes: Together with stakeholders, we work to achieve sustainable and equitable health outcomes. Our goal is to ensure that health improvements are sustainable and accessible to all, regardless of their background or location.

CPI's support for effective risk communication, community engagement and infodemic management

Building trust and community engagement: CPI actively contributes to building trust and community engagement by strategically communicating and collaboratively developing solutions that align with community needs. This approach is essential for effectively managing and resolving emergencies within individual countries or across borders. We emphasize the importance of trust-building and community involvement, which are critical for achieving successful emergency responses and ensuring community needs are met.

Maintaining RCCE teams: To be prepared for unforeseen crises, countries are strongly recommended to maintain risk communication and community engagement (RCCE) teams at their current emergency levels. We encourage countries to retain their RCCE teams at readiness levels to ensure swift and effective responses to unexpected emergencies.

Understanding RCCE: CPI ensures that countries comprehend the significance of risk communication and community engagement. Risk communication involves real-time information exchange and advice to empower individuals to make informed decisions, particularly regarding threats like disease outbreaks. Community engagement fosters relationships with communities as equal partners in developing emergency response solutions, enabling them to contribute throughout the health emergency response cycle. We provide clarity on the dual components of risk communication and community engagement, emphasizing their roles in helping communities make informed decisions and actively participate in the emergency response process.

RCCE in International Health Regulations (IHR) 2005: RCCE is a core capacity within the IHR 2005, a legally binding international instrument on which all WHO Member States rely. Its purpose is to prevent the spread of diseases across borders and respond to health emergencies. We highlight the integral role of RCCE within the IHR 2005, ensuring that it is legally mandated and integral to global health security.

RCCE in Pandemic Influenza Preparedness (PIP): RCCE is one of the five strategies in the Pandemic Influenza Preparedness (PIP) framework. Its key goals include enhancing the sharing of influenza viruses with pandemic potential and improving access to vaccines and pandemic-related supplies, particularly in developing countries. We outline the role of RCCE within the PIP framework, stressing its contribution to preparedness and response in pandemics, especially in resource-limited settings.

RCCE in Health Emergency Preparedness, Response and Resilience (HEPR): RCCE is an integral component of the Health Emergency Preparedness, Response and Resilience (HEPR) architecture. CPI works to ensure that national and subnational health systems are ready to respond rapidly to emergencies, providing communities with high-quality health services in safe settings during and after emergencies. We emphasize the significance of RCCE within the HEPR architecture, highlighting its role in ensuring the readiness of health systems and their ability to serve communities during and after emergencies.

Learning from previous RCCE initiatives: Lessons from past RCCE initiatives during public health emergencies have informed response efforts, leading to improved planning and better integration of risk communication into operational activities. CPI collaborates closely with other technical areas to ensure the culturally acceptable and operationally feasible delivery of information to communities. We stress the importance of learning from previous experiences and underpin our commitment to effective risk communication that aligns with cultural sensitivities and operational realities.

Infodemic management: CPI is dedicated to strengthening countries' capabilities in infodemic management. This involves establishing long-term structures, systems and skills to facilitate tailored, targeted and efficient emergency interventions. By fostering trust, addressing rumours and misinformation, promoting protective measures and ultimately saving lives, infodemic management is a vital public health intervention. We elaborate on our commitment to infodemic management.  

CPI's support for effective points of entry capacities

Critical conduits for global travel and trade: Points of entry, such as airports, seaports and ground crossings are essential as they serve as critical conduits for international travel, transport and trade. They play a frontline role in defending against public health threats. These points must maintain their capabilities and resources for routine operations and be prepared to respond to public health emergencies, including scenarios like natural disasters, chemical spills, acts of terrorism and infectious disease outbreaks. Points of entry are the first line of defense in protecting against health threats that can spread globally. It is crucial to maintain their readiness to respond to various types of emergencies.

An all-hazard approach: CPI promotes an all-hazard approach to ensure countries have the necessary resources and capacities in place. This approach allows counties to respond effectively to a wide range of public health emergencies, irrespective of the specific hazard. By adopting this strategy, countries can establish robust coordination mechanisms, enabling cross-border collaboration for effective emergency response. The all-hazard approach emphasizes the importance of being prepared for a broad spectrum of potential public health emergencies and highlights the significance of cross-border cooperation.

Essential for global health security: Effective points of entry capacities are vital in promoting and protecting global health security. CPI's support empowers countries to meet international standards for these capacities, ensuring the effective management and containment of public health threats at critical entry points. This is vital for protecting the health and well-being of the global population. Points of entry are crucial for global health security, and ensuring they meet international standards is essential to prevent the spread of health threats beyond borders. This safeguarding is essential to protect global public health.

CPI's support for effective planning and preparedness for mass gatherings

Collaborative planning and capacity building: Mass gatherings, such as sporting events, festivals or religious pilgrimages, are essential for global health security. However, they can also present substantial risks and challenges, often straining the resources of the host country. In line with the International Health Regulations (IHR) 2005, WHO works closely with Member States and partners to enhance planning for mass gatherings. CPI provides vital support to countries in developing comprehensive plans, building the necessary capacities and upholding international standards to ensure the safety of these events. Mass gatherings are vital but come with health risks. CPI supports countries in planning and building capacities to meet international standards, ensuring the safety of participants.

Technical assistance for public health risks: CPI offers technical expertise to countries in crafting and implementing effective strategies for managing public health risks associated with mass gatherings. By improving their planning and preparedness, countries can significantly reduce the public health risks tied to these gatherings. This, in turn, ensures that the essential resources and capacities are readily available to address any potential public health emergencies. CPI provides technical assistance to help countries manage health risks associated with mass gatherings. Effective planning reduces these risks and ensures resources are in place for emergencies.

Enhancing global health security: Efficient planning and preparedness for mass gatherings form an integral part of global health security. These efforts are instrumental in protecting the health of individuals attending these events and the broader community. With CPI's support, countries can strengthen their readiness and reduce risks, promoting the well-being of all those involved in these gatherings while protecting public health on a global scale. Preparing for mass gatherings is essential for global health security as it protects participants and the wider community. CPI's support helps countries become more resilient and reduces health risks on a global scale.

CPI's support for emergency medical teams

Guidance and quality assurance: The WHO Emergency Medical Team (EMT) initiative is a global programme with a mission to enhance health systems by orchestrating the deployment of high-quality medical teams in times of emergencies. The EMT programme assumes a vital role in building the response capacities of countries to address health crises while upholding global health security. With CPI's guidance and support, the EMT initiative guarantees that the deployed medical teams adhere to minimum quality standards. This includes smooth integration into pre-existing coordination mechanisms, such as Public Health Emergency Operations Centers or similar coordination structures. EMT is crucial for emergency response. CPI ensures that deployed medical teams meet high-quality standards and are integrated effectively into existing coordination structures.

Collaboration for effective response: The programme closely collaborates with Member States and various partners to ensure that these deployed teams smoothly integrate into existing national or regional response structures. This is achieved through collaborative efforts with local health authorities and organizations, ensuring a well-coordinated, effective and quality response to health emergencies. EMT collaborates with countries and partners for a coordinated response. CPI supports this collaboration to ensure effective and high-quality emergency response.

Contributing to global health security: With CPI's dedicated support, the EMT initiative strengthens countries' emergency response capacities and contributes significantly to global health security, thereby ensuring the health and well-being of communities in need. CPI's support to EMT helps countries improve their emergency response, which is vital for global health security and the well-being of communities in need.

CPI support for disaster risk reduction and emergency care systems

Technical support and capacity building: Through our collaborative efforts with WHO EMRO, CPI plays an essential role in supporting countries in these critical areas:

Identifying hazards and risks: We assist countries in systematically assessing and identifying potential hazards and risks. This foundational step enhances their preparedness and ability to respond effectively to various emergency scenarios. CPI helps countries assess and identify potential hazards and risks to improve their preparedness for emergencies.

Developing robust strategies: We provide guidance and support for countries to craft comprehensive emergency and disaster risk reduction strategies and plans. These plans ensure a proactive approach to managing crises. CPI offers guidance and support to help countries create effective strategies and plans for reducing disaster risks.

Assessing health system preparedness: Our teams work closely with countries to assess the preparedness levels of their entire health systems and healthcare facilities in the face of emergencies and disasters. This in-depth assessment helps identify areas for improvement and informs strategic decision-making. CPI collaborates with countries to assess their health system's readiness for emergencies, identifying areas that need improvement.

Strengthening emergency care systems: We focus on enhancing the capacities of Emergency Care Systems in countries. This includes assessing their current capabilities and establishing clear action priorities to bolster preparedness in handling emergencies and disasters. Furthermore, our approach involves comprehensive capacity-building activities at both prehospital and hospital levels of care. CPI's support extends to enhancing the capabilities of Emergency Care Systems, including assessments and capacity-building at various care levels.

Empowering countries: CPI's dedication to collaboration with WHO EMRO empowers countries to build resilient health systems, enhance readiness for emergencies and effectively protect the health and well-being of their populations in the event of a crisis. CPI collaborates with WHO EMRO to empower countries, helping them build strong health systems and enhance their preparedness for emergencies to protect their populations during crises.

CPI support for public health emergency operations centers

Operational readiness and response coordination: CPI plays a crucial role in helping countries enhance their public health emergency operation centers to improve public health emergency management capabilities. This support is essential for effective response coordination, ensuring that countries can meet IHR 2005 requirements and respond rapidly to public health crises.

Multisectoral coordination hub: Public health emergency operation centers serve as central hubs that coordinate preparedness, response and recovery activities for public health emergencies. Through collaboration with CPI, public health emergency operation centers integrate various sectors and agencies into their operations, ensuring a holistic and well-coordinated response.

Rapid detection and notification: Efficiently detecting and responding to public health hazards is crucial for effective crisis management. CPI empowers public health emergency operation centers to quickly identify various public health threats by consolidating data from diverse surveillance systems. This enables timely notifications to high-level leadership, decision-makers and stakeholders, prompting swift and decisive actions to prevent and mitigate potential risks.

CPI support for enhanced operational readiness

Multisectoral collaborative efforts: Operational readiness involves a collaborative, multisectoral approach where key areas and objectives are developed to strengthen a country's preparedness and response capabilities. CPI works closely with countries to support various aspects of operational readiness.

Risk profiling and early warning systems: CPI assists countries in developing updated risk profiles, which are crucial for identifying potential threats. Additionally, we help establish early warning systems linked to these identified risks. This information is vital for decision-makers, allowing them to allocate resources and funds for preparedness activities and ensuring a swift and effective response.

Contingency plans and business continuity: Operational readiness involves the improvement and update of pre-developed contingency plans, providing clear guidance for response activities during emergencies. CPI also ensures the availability of business continuity plans, guaranteeing the continuous functioning of critical services like healthcare, transportation and communication during crises.

Efficient public health emergency operation centers: Well-functioning public health emergency operations centers are central to operational readiness. They act as coordination hubs, pooling information and resources and facilitating collaboration among emergency management personnel for coordinated preparedness, response and recovery efforts.

Identifying and addressing gaps: Operational readiness assessments often reveal gaps in critical areas. CPI promptly guides countries in addressing and strengthening these gaps, enhancing preparedness and response efficiency. Our support significantly contributes to a country's ability to handle public health emergencies with agility and effectiveness.

CPI support for enhancing the health-security interface

Multisectoral coordination: Operational readiness involves the development of key areas and objectives to enhance a country's preparedness and response capabilities, requiring well-coordinated efforts from all relevant sectors. CPI plays a central role in fostering collaboration across multiple sectors.

Risk profiling and early warning systems: CPI collaborates closely with countries to address key areas, including the development of updated risk profiles and the establishment of fully functioning early warning systems linked to identified risks. This information is crucial for decision-makers, enabling effective resource allocation and a prompt response.

Contingency planning and business continuity: Operational readiness initiatives involve improving and updating pre-developed contingency plans, outlining steps for guiding response activities during emergencies. CPI ensures the availability of business continuity plans, ensuring uninterrupted functioning of critical services during emergency situations.

Efficient public health emergency operations centers: Well-functioning public health emergency operation centers are integral to operational readiness. They serve as central hubs for coordinating information and resources, facilitating collaboration among emergency management personnel to enable preparedness, response and recovery actions.

Identifying and addressing gaps: Operational readiness assessments often reveal existing gaps. In response, CPI promptly guides countries in addressing and strengthening their health-security interface. This support significantly enhances a country’s ability to navigate public health emergencies with agility and effectiveness.