WHO BENCHMARKS for International Health Regulations (IHR ...

WHO BENCHMARKS for International Health Regulations (IHR) Capacities

FEBRUARY 2019

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© WORLD HEALTH ORGANIZATION 2019

WHO Benchmarks for International Health Regulations (IHR) CapacitiesISBN 978-92-4-151542-9

GENERAL DISCLAIMERS. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

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Les Pandas Roux, France

WHO BENCHMARKS FOR IHR CAPACITIES

2

ACRONYMS 4

ANNEX 1: GLOSSARY 135

ACKNOWLEDGEMENT 5

INTRODUCTION 6

WHAT IS THE BENCHMARK TOOL? 6

PURPOSE OF THE BENCHMARK TOOL 6

WHO IS THE AUDIENCE? 6

DEVELOPMENT PROCESS OF THE TOOL 7

STRUCTURE OF THE TOOL 7

DEFINITIONS 7

BUILDING SYSTEM USING THE BENCHMARKS 8

WHEN TO USE THE BENCHMARK TOOL? 8

HOW TO USE THE BENCHMARK TOOL? 8

WHAT IS THE TOOL ABOUT? 11

WHAT IS THE TOOL NOT ABOUT? 11

PROPOSED REVIEW AND UPDATING THE TOOL 11

BENCHMARKS: TECHNICAL AREAS 12

1. NATIONAL LEGISLATION, POLICY AND FINANCING 13

2. IHR COORDINATION, COMMUNICATION AND ADVOCACY AND REPORTING 21

3. ANTIMICROBIAL RESISTANCE 26

4. ZOONOTIC DISEASE 36

5. FOOD SAFETY 41

6. IMMUNIZATION 47

7. NATIONAL LABORATORY SYSTEM 54

8. BIOSAFETY AND BIOSECURITY 63

9. SURVEILLANCE 69

10. HUMAN RESOURCES 77

11. EMERGENCY PREPAREDNESS 89

12. EMERGENCY RESPONSE OPERATIONS 95

13. LINKING PUBLIC HEALTH AND SECURITY AUTHORITIES 102

14. MEDICAL COUNTERMEASURES AND PERSONNEL DEPLOYMENT 106

15. RISK COMMUNICATION 113

16. POINTS OF ENTRY 121

17. CHEMICAL EVENTS 127

18. RADIATION EMERGENCIES 131

TABLE OF CONTENT


3

ACRONYMS

AEFI adverse event following immunization

AMR antimicrobial resistance

BTWC Biological and Toxin Weapons Convention

EMT emergency medical team

EOC emergency operations centre

FAO Food and Agriculture Organization

GLASS Global Antimicrobial Resistance Surveillance System

GOARN Global Outbreak Alert and Response Network

IAEA International Atomic Energy Agency

IHR International Health Regulations

INFOSAN International Food Safety Authorities Network

INTERPOL International Criminal Police Organization

IPCAT infection prevention and control (IPC) assessment tool

IT information technology

JEE joint external evaluation

MCV measles-containing vaccine

NAPHS National Action Plan for Health Security

NCC National Coordinating Centre

NFP IHR national focal point

OIE World Organisation for Animal Health

OPCW Organisation for the Prohibition of Chemical Weapons

PVS performance of veterinary services

SOP standard operating procedure

SPAR IHR self-assessment annual reporting tool

VPDs vaccine-preventable diseases

WASH water, sanitation and hygiene

WASH FIT water and sanitation for health facility improvement tool

WHA World Health Assembly

WHO World Health Organization


4

ACKNOWLEDGEMENT

The World Health Organization (WHO) would like to express sincere gratitude to all those who contributed to the development of the WHO Benchmarks for IHR Capacities (Benchmarks Tool).

The tool was developed by Dr Nirmal Kandel, Dr Qudsia Huda and Dr Stella Chungong with contributions from their colleagues – Mr Adam Bradshaw, Dr Benedetta Allegranzi, Mr David Bennitz, Dr Elizabeth Mumford, Ms Elizabeth Taylor, Mr Fernando Gonzalez-Martin, Dr Giorgio Cometto, Dr Ian Norton, Mr Jonathan Abrahams, Dr Jose Guerra, Ms Julie Storr, Ms Joanna H Tempowski, Dr Jostacio Lapitan, Dr Jun Xing, Dr Kazunobu Kojima, Dr Kersten Gutschmidt, Dr Lucy Boulanger, Dr Ninglan Wang, Mr Phillippe Gasquet, Dr Sebastian Cognat, Dr Sergez R Eremin, Dr Stéphane De La Rocque and Ms Yuki Minato – at WHO headquarters.

Special thanks go to Dr Ambrose Talisuna, Dr Ali Ahmed Yahaya, Dr Dalia Samhouri, Dr Gyanendra Gongal, Dr Karen Nahapetyan, Dr Masaya Kato, Dr Muang Muang Htike, Mr Nicolas Isla, Dr Nilesh Buddh, Dr Roberta Andraghetti and Mr Vasily Esenamanov, for providing inputs from WHO regional offices.

Sincere gratitude to all the members of a technical working group: Dr Janneth Mghamba, Dr Jaouad Mahjour, Dr Mahmudur Rahman, Dr Nirmal Kandel, Dr Stella Chungong, and Dr Thomas R Frieden.

The WHO is grateful to the following partners and their teams who provided technical inputs in the tool: African Centres for Disease Control and Prevention (Africa CDC), United States Centers for Disease Control and Prevention (US CDC), Public Health England (PHE), Resolve to Save Lives, and The South Asia Field Epidemiology and Technology Network (SAFETYNET).


5

INTRODUCTION

WHAT IS THE BENCHMARK TOOL?Benchmarking is a strategic process often used by businesses and institutes to standardize performance in relation to best practices of their sector. World Health Organization (WHO) and its partners have developed a tool with a list of benchmarks and corresponding actions that can be applied to increase the performance of countries in emergency preparedness through the development and implementation of a National Action Plan for Health Security (NAPHS). The WHO Benchmarks for International Health Regulations 2005 (IHR/IHR (2005)) Capacities are broad in nature to improve IHR capacities for health security and integrate multisectoral concerns at subnational (local and regional/provincial) and national levels. This means that if all benchmarks are achieved and sustained, the level of preparedness of the country would be optimum to prevent, detect and respond to threats and events.

PURPOSE OF THE BENCHMARK TOOLThis document guides States Parties, partners, donors and international and national organizations on suggested actions needed to improve IHR capacities for health security. States Parties and other entities working to reduce the risk of global health threats can use these benchmarks and suggested actions to address gaps, including those identified by IHR monitoring and evaluation framework1 components such as the States Party self-assessment annual

reporting tool, voluntary external evaluation such as the joint external evaluation (JEE), after-action reviews and simulation exercises. This document can help countries delineate the relevant steps they can take to reach capacity levels as defined in each benchmark.

WHO IS THE AUDIENCE?The main audiences for this benchmark document are:

States Parties to the IHR, to develop activities for the NAPHS.Cl inical agencies, civi l society and special ized organizat ions at local , subnational, national, regional and global levels, to support the implementation of the NAPHS.Development partners, to confirm that their health security assistance is consistent with evolving needs and to provide objective milestones to help guide and determine the effectiveness of assistance.WHO Secretariat, to be able to promote and monitor consistency of IHR progress and NAPHS implementation.WHO country and regional offices, to be able to prioritize assistance.

1 IHR monitoring and evaluation framework (https://www.who.int/ihr/publications/WHO-WHE-CPI-2018.51/en/, accessed 30 January 2019).


6

For the propose of this document the following definitions are used:

BENCHMARK Denotes a standard or point of reference for the capacity. Setting benchmarks facilitates the development of plans to increase capacity levels (limited, developed, demonstrated and sustainable) and adopt best practices with a target of reaching sustainable capacity for each benchmark.

ACTION Denotes a set of activities in each capacity level of the benchmark. These actions define the steps that need to be taken to progress from one level to the next for the given benchmarks.

DEVELOPMENT PROCESS OF THE TOOLFollowing the recommendation of the IHR review committee on second extensions for establishing national public health capacities and on IHR Implementation, the WHO Secretariat developed the IHR monitoring and evaluation framework and through global consultations developed monitoring and evaluation tools such as the new IHR States Parties self-assessment annual reporting tool (SPAR) and the JEE.

In May 2018, as per the decision of the Seventy-first World Health Assembly decision on the implementation of the IHR five-year global strategic plan to improve public health preparedness and response, 2018–2023,2 the WHO Secretariat commenced to develop the benchmark tool with suggested actions at each capacity level for the technical areas or capacities that can capture the outcome of the different monitoring and evaluation processes (such as the SPAR and the JEE), which inform the development of national action plans for health security.3 These suggested actions can provide guidance to develop activities to build capacity needed to move from one capacity level to the next; stepping up from level 1 to 2, and 2 to 3 and beyond.

A preliminary draft of this document was shared with a working group of technical experts. Feedback was incorporated, and the revised tool was subsequently piloted and finalized.

STRUCTURE OF THE TOOLThe tool covers all 13 IHR capacities described in the SPAR and 19 technical areas described in the JEE tool that are needed to prevent, detect, assess, notify

and respond to public health risks and acute events of domestic and international concern. For each area, one to four indicators is used to assess the country’s progress towards implementation of the individual capacity, as assessed at five levels. The benchmark tool reflects the amalgam between the JEE and the new annual reporting tool so that all the essential actions required for each level are captured. Where necessary, all essential actions that are not reflected in both the tools are added to corresponding capacity levels of each benchmark. Some capacities and technical areas requiring similar types of actions for incremental progress have been combined, notably IHR coordination and reporting, national laboratory system and biosafety and biosecurity.

DEFINITIONS

2 Implementation of the International Health Regulations (2005): five-year global strategic plan to improve public health preparedness and response, 2018–2023. Seventy-First World Health Assembly Provisional Agenda Item 11.2. WHA71(15) 26 May 2018 (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71(15)-en.pdf, accessed 30 January 2019).3 Public health preparedness and response. Seventy-First World Health Assembly Provisional Agenda Item 11.2. 11 April 2018 (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_8-en.pdf, accessed 30 January 2019).


7

BUILDING SYSTEM USING THE BENCHMARKSCollective and coordinated actions described in the benchmarks assist countries in strengthening a system for health security. The system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health security. These benchmark actions are necessary to strengthen health systems capacity (preparedness capacity) of countries to prevent, detect and respond to threats and events. These benchmark actions serve the following three purposes of strengthening the system. First, they allow a definition of desirable attributes – what actions are required for health security at each level of the benchmark. Second, they provide a way of defining health security priorities for countries, development partners and the WHO. Third, they provide a useful way of clarifying essential actions that require a more integrated response and recognize the interdependence of each action of the benchmarks.

WHEN TO USE THE BENCHMARK TOOL?The tool should be used during the planning process when a planning team is identifying and prioritizing activities for the various steps of the NAPHS framework.4

HOW TO USE THE BENCHMARK TOOL?The tool provides a set of actions for each level. When translating priority actions from the evaluation findings, benchmark actions can guide the development of activities in a stepwise process:

R e v i e w t h e p r i o r i t y recommendations based on the situation analysis of the selected technical areas.

Review the benchmark actions and determine wh ich capac i ty l eve l a county would like to achieve. The planning team can use actions mentioned in the tool.

Identify the actions that countries need to establish to achieve the selected level.

Develop a list of activities fo r each act ion that countries need to put in place to achieve the desired level for all actions.

STEP

STEP

STEP

STEP

01

02

03

04

4 NAPHS for all: a 3 step strategic framework for national action plan for health security. Geneva: World Health Organization; 2018 (http://apps.who.int/iris/bitstream/handle/10665/278961/WHO-WHE-CPI-2018.52-eng.pdf, accessed 30 January 2019).


8

The above figure is an example of applying the benchmark to the recommendations. The priority recommendation is to “establish event-based surveillance.” Benchmark actions are then used to identify or develop activities. The benchmark tool provides a set of actions to develop and establish event-based surveillance. To establish event-based surveillance, the country should have guidelines and standard operating procedures (SOPs). They can select the actions and elaborate activities that are required for that action depending on the country context while drafting the plan.

Benchmark actions may additionally be used to help develop priority recommendations during the JEE or to help track incremental progress made from one level to the next.

Establish

event-based

surveillance.

Develop guidelines and standard

operating procedures (SOPs).

Establish a designated unit at all needed

levels with an operational plan and

procedures.

Develop and put in place case

definitions and the process of detection,

assessment and reporting of the event

(clusters or outbreaks) for country

priority diseases, and disseminate to

national and subnational levels.

Establish a process to capture events

from the community (people from the

community identified, verification teams

at facilities identified, SOPs and flow

of information available) and make the

data available at all needed levels.

Establish systems to capture events

from various other sources (such as

media, social media, private sectors).

Form a working group to develop

guidelines and SOPs for event-based

surveillance.

Identify a focal point for drafting

working documents.

Finalize the guidelines and SOPs.

Develop a training package to roll out

the guidelines and SOPs.

Conduct five trainings (one at the

national level and four at the regional

level).

PRIORITY

RECOMMENDATION

BENCHMARK ACTIONS FOR EVENT-BASED

SURVEILLANCE

IDENTIFY AND DEVELOP ACTIVITIES


9

CAPACITY

LEVEL

ACTIONS TAKEN TO GO UP ONE STEP TO BEING BETTER PREPAREDThese suggested standardized actions define the steps to be taken to move from one capacity level to the next. For example, actions listed in level 2 are suggested actions to achieve limited capacity.

01NO CAPACITY

The country has to develop and implement all activities listed in level 2 to achieve the limited capacity for each function.

02LIMITED

CAPACITY

ACTIONS TO ACHIEVE THIS LEVEL:

Conduct relevant stakeholder analysis and disseminate to those who need a list of stakeholders, points of contact for each stakeholder, and establish communication channels to support collaboration and coordination.

Identify the people or units responsible for disseminating policy for implementation.

Establish and document how implementation will occur and be reported. Conduct and disseminate detailed assessment of gaps, needs and plans

to support effective implementation.

03DEVELOPED

CAPACITY


Develop and implement procedures, processes and plans at national level. Develop training materials and train some staff, at least at the national level. Establish systems to manage a minimum number of risks.

04DEMONSTRATED

CAPACITY


Integrate capacities tested by actual events or exercises and found to be functional into routine systems.

All staff are trained at national and subnational levels. Outliers are identified, and steps are taken to address these outliers. Systems are functioning at all levels of the health system.

05SUSTAINABLE

CAPACITY


Systems and capacities are now sustainable, including fully funded ones. Monitoring and evaluation occur systematically, and accreditation/certification

is done in a transparent manner. Evidence-based metrics are met (such as reporting in 24 hours). Collaboration/information is shared with other countries as needed and

appropriate.


10

WHAT IS THE TOOL ABOUT? A list of benchmarks that is required to sustain

IHR capacities. A list of actions that can increase IHR capacities. Is informed by technical experts. A starting point for development of a technically

sound plan for health security.

WHAT IS THE TOOL NOT ABOUT? A list of mandatory activities. Completely applicable to every context. An exhaustive list of actions/recommendations.

PROPOSED REVIEW AND UPDATING THE TOOLOnline materials will be developed and shared to help areas step up preparedness, and the tool will be updated following implementation.


11

BEN

CHM

ARKS

:TE

CHN

ICAL

ARE

AS


12

NAT

ION

AL L

EGIS

LATI

ON

, PO

LICY

AN

D FI

NAN

CIN

G

01LE

GIS

LATI

ON

AN

D P

OLI

CY:

An a

dequ

ate

lega

l fra

mew

ork

for S

tate

s Pa

rtie

s is

ess

entia

l to

supp

ort a

nd e

nabl

e th

e im

plem

enta

tion

of a

ll th

eir o

blig

atio

ns a

nd ri

ghts

of t

he

IHR

. Thi

s ca

n in

clud

e th

e cr

eatio

n of

new

legi

slat

ion

and/

or th

e re

visi

on o

f exi

stin

g le

gisl

atio

n, re

gula

tions

or o

ther

inst

rum

ents

to fa

cilit

ate

impl

emen

tatio

n an

d co

mpl

ianc

e w

ith IH

R (2

005)

. A la

ck o

f app

ropr

iate

legi

slat

ion

or p

olic

y ca

n be

a m

ajor

bar

rier t

o im

plem

enta

tion

and

shou

ld

be c

onsi

dere

d a

prio

rity

to e

nabl

e ot

her t

echn

ical

are

as to

be

impl

emen

ted

effe

ctiv

ely.

FIN

AN

CE:

Stat

es P

artie

s sh

ould

hav

e th

e pr

ovis

ion

of a

dequ

ate

fund

ing

for I

HR

impl

emen

tatio

n th

roug

h th

e na

tiona

l bud

get o

r oth

er m

echa

nism

s. T

he

coun

try

shou

ld h

ave

acce

ss to

fina

ncia

l res

ourc

es th

at c

an b

e ac

cess

ed o

n tim

e an

d di

strib

uted

in re

spon

se to

pub

lic h

ealth

em

erge

ncie

s fo

r tim

ely

and

adeq

uate

pre

pare

dnes

s an

d re

spon

se.

IMPA

CT:

Legi

slat

ion

and

finan

cing

is in

pla

ce in

all

rele

vant

sec

tors

to s

uppo

rt IH

R im

plem

enta

tion

incl

udin

g re

leva

nt c

ore

capa

city

dev

elop

men

t and

m

aint

enan

ce.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Cur

rent

legi

slat

ion

incl

udin

g la

ws,

regu

latio

ns, a

dmin

istra

tive

requ

irem

ents

, pol

icie

s or

oth

er g

over

nmen

t ins

trum

ents

, pro

ven

to b

e ad

equa

te

in a

ll rel

evan

t sec

tors

to s

uppo

rt IH

R im

plem

enta

tion.

(2) A

dequ

ate

finan

ces

avai

labl

e to

ena

ble

timel

y, ef

ficie

nt a

nd e

ffect

ive

IHR

impl

emen

tatio

n an

d re

spon

se to

all p

ublic

hea

lth e

mer

genc

ies.


13

CAPA

CITY

LEVE

L

Benc

hmar

k 1.

1: D

omes

tic le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts a

re a

vaila

ble

in a

ll re

leva

nt

sect

ors

and

effe

ctiv

ely

enab

le c

ompl

ianc

e w

ith th

e IH

RO

bjec

tive:

To

asse

ss, a

djus

t and

alig

n do

mes

tic le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts in

all

rele

vant

sec

tors

to e

nabl

e co

mpl

ianc

e w

ith th

e IH

R

01N

O C

APAC

ITY

No

asse

ssm

ent o

f rel

evan

t leg

isla

tion,

law

s, re

gula

tions

, pol

icy

and

adm

inis

trat

ive

requ

irem

ents

, and

oth

er g

over

nmen

t in

stru

men

ts fo

r IH

R im

plem

enta

tion.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d co

nven

e ke

y st

akeh

olde

rs re

late

d to

the

revi

ew, f

orm

ulat

ion

and

impl

emen

tatio

n of

legi

slat

ion

and

polic

ies.

As

sess

cur

rent

rele

vant

legi

slat

ion,

law

s, re

gula

tions

, pol

icy

and

adm

inis

trat

ive

requ

irem

ents

for I

HR

impl

emen

tatio

n an

d id

entif

y ga

ps, i

nclu

ding

for r

epor

ting,

pre

vent

ion

and

cont

rol.

D

evel

op a

n im

plem

enta

tion

plan

for t

he fo

rmul

atio

n/re

visi

on/a

djus

tmen

t and

app

rova

l of p

riorit

ized

legi

slat

ion/

regu

latio

ns

and

polic

y (in

clud

ing

regu

lato

ry o

r par

liam

enta

ry p

roce

ss b

ased

on

the

coun

try’

s pr

actic

es, a

s ne

cess

ary)

.

Dev

elop

adv

ocac

y m

ater

ials

and

pac

kage

to ra

ise

awar

enes

s of

the

requ

irem

ents

of a

djus

tmen

ts to

par

liam

enta

rians

, go

vern

men

t, op

posi

tions

and

oth

er re

leva

nt s

take

hold

ers.

D

evel

op a

n or

ient

atio

n pa

ckag

e to

impl

emen

t the

legi

slat

ion,

law

s, re

gula

tions

, pol

icy

and

adm

inis

trat

ive

requ

irem

ents

. I

dent

ify le

gisl

ative

/pol

icy

cham

pion

(s) o

r bro

ker(s

) who

can

adv

ocat

e fo

r the

law

or p

olic

y to

reac

h a

succ

essf

ul e

nd s

tate

.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t an

orie

ntat

ion

with

rele

vant

sta

keho

lder

s re

gard

ing

adju

stm

ent i

n th

e le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts.

D

evel

op a

mec

hani

sm to

impl

emen

t the

se le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts.

D

ocum

ent t

he e

xist

ence

and

use

of a

ppro

pria

te le

gisl

atio

n in

all

rele

vant

sec

tors

invo

lved

in IH

R im

plem

enta

tion.

D

evel

op o

r adj

ust t

he le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts fo

r im

plem

enta

tion

of IH

R ca

paci

ties

for f

ood

safe

ty, a

nd if

requ

ired

for c

hem

ical

saf

ety.


14

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

the

use

of re

leva

nt le

gisl

atio

n, la

ws,

regu

latio

ns, p

olic

y an

d ad

min

istr

ativ

e re

quire

men

ts, a

nd d

eter

min

e w

heth

er th

ey

cove

r mos

t asp

ects

of I

HR

impl

emen

tatio

n.

Iden

tify

spec

ific

area

s5 tha

t req

uire

legi

slat

ion

refe

renc

es (t

hese

are

refe

renc

e la

ws

or re

gula

tions

that

can

sup

port

IHR

impl

emen

tatio

n) s

uch

as e

stab

lishi

ng th

e IH

R na

tiona

l foc

al p

oint

(NFP

) or t

o m

anda

te th

e op

erat

ion.

D

evel

op o

r doc

umen

t leg

isla

tion

refe

renc

es fo

r che

mic

al s

afet

y an

d ra

diat

ion

emer

genc

y th

at c

ontr

ibut

e to

che

mic

al a

nd

radi

o-nu

clea

r eve

nts

prep

ared

ness

, det

ectio

n an

d re

spon

se.

D

ocum

ent t

hese

legi

slat

ion

refe

renc

es a

nd re

leva

nt in

terp

reta

tions

that

can

ass

ist i

n IH

R im

plem

enta

tion.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nfirm

that

rele

vant

legi

slat

ion,

law

s, re

gula

tions

, pol

icy

and

adm

inis

trat

ive

requ

irem

ents

cov

er a

ll as

pect

s of

IHR

impl

emen

tatio

n ba

sed

on th

e ris

k pr

ofile

of t

he c

ount

ry.

D

evel

op o

r doc

umen

t leg

isla

tion

refe

renc

es fo

r any

out

stan

ding

issu

es (i

nclu

ding

radi

atio

n em

erge

ncie

s) th

at c

ontr

ibut

e to

pr

epar

edne

ss, d

etec

tion

and

resp

onse

.

Doc

umen

t the

se le

gisl

atio

n re

fere

nces

and

rele

vant

inte

rpre

tatio

ns th

at c

an a

ssis

t in

IHR

impl

emen

tatio

n.

5 The

se a

re a

reas

not

spe

cific

ally

add

ress

ed b

y ex

istin

g la

ws

or re

gula

tions

.


15

CAPA

CITY

LEVE

L

Benc

hmar

k 1.

2: F

inan

cing

6 is

avai

labl

e fo

r the

impl

emen

tatio

n of

IHR

capa

citie

sO

bjec

tive:

To

ensu

re fi

nanc

ing

is a

vaila

ble

for t

he im

plem

enta

tion

of IH

R ca

paci

ties

01N

O C

APAC

ITY

No

budg

et li

ne o

r bud

geta

ry a

lloca

tion7 a

vaila

ble

to fi

nanc

e th

e im

plem

enta

tion

of IH

R ca

paci

ties,

and

fina

ncin

g is

han

dled

th

roug

h ex

trab

udge

tary

mea

ns8 .

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d co

nven

e ke

y st

akeh

olde

rs re

late

d to

the

revi

ew o

f fina

ncin

g fo

r im

plem

enta

tion

of IH

R ca

paci

ties,

incl

udin

g bu

dget

ary

allo

catio

n an

d ex

tern

al c

ontr

ibut

ion

for t

he im

plem

enta

tion

of IH

R ca

paci

ties.

Re

view

the

natio

nal a

ctio

n pl

an o

r any

rele

vant

pla

n fo

r the

impl

emen

tatio

n of

IHR

capa

citie

s (if

not

dev

elop

ed, f

ollo

w

guid

elin

es a

nd d

evel

op th

e na

tiona

l act

ion

plan

).

Revi

ew th

e co

st e

stim

ates

and

cur

rent

ly a

vaila

ble

fund

s fo

r the

impl

emen

tatio

n of

IHR

capa

citie

s; if

a c

oste

d pl

an is

no

t ava

ilabl

e, th

en id

entif

y fo

cal p

oint

s of

key

sta

keho

lder

s an

d de

velo

p th

e co

stin

g. If

nec

essa

ry, h

ire c

ostin

g ex

pert

s to

es

timat

e th

e co

st o

f the

pla

n w

orki

ng c

lose

ly w

ith k

ey te

chni

cal f

ocal

poi

nts

of e

ach

tech

nica

l are

a.

Cond

uct a

reso

urce

map

ping

on

dom

estic

and

/or e

xter

nal f

unds

for t

he im

plem

enta

tion

of IH

R ca

paci

ties.

Al

loca

te th

e bu

dget

, eith

er d

omes

tic o

r ext

erna

l fun

ds, t

o th

e re

leva

nt s

ecto

rs a

nd th

eir r

espe

ctiv

e m

inis

trie

s to

sup

port

the

impl

emen

tatio

n of

IHR

capa

citie

s fo

r bio

logi

cal h

azar

ds a

t the

nat

iona

l lev

el.

D

evel

op th

e re

sour

ce m

obili

zatio

n st

rate

gy a

nd a

dvoc

acy

tool

s fo

r the

fina

ncin

g an

d id

entif

y ke

y st

akeh

olde

rs.

D

evel

op a

mec

hani

sm to

lobb

y fo

r dom

estic

reso

urce

s (b

oth

gove

rnm

ent a

nd p

rivat

e se

ctor

s).

6 Fin

anci

ng re

fers

to fu

nds

and

reso

urce

s id

entifi

ed, a

lloca

ted,

dis

trib

uted

and

exe

cute

d w

ith re

gard

to a

ctiv

ities

and

inte

rven

tions

. It d

oes

not c

onsi

der c

ostin

g or

iden

tifyi

ng h

ow m

any

reso

urce

s or

fund

s ar

e ne

cess

ary

for t

he im

plem

enta

tion

of a

ctiv

ities

or i

nter

vent

ions

. 7 A

bud

get l

ine

exis

ts, a

nd a

bud

get i

s al

loca

ted

(the

budg

et li

ne is

fund

ed).

8 Acc

ount

s he

ld b

y go

vern

men

t bod

ies,

but

not

incl

uded

in th

e go

vern

men

t bud

get.


16

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

reso

urce

map

ping

sta

tus

to a

lloca

te b

udge

t rat

iona

lly to

eve

ry s

ecto

r at t

he n

atio

nal l

evel

.

Allo

cate

ava

ilabl

e bu

dget

from

dom

estic

and

ext

erna

l sou

rces

for h

uman

hea

lth, v

eter

inar

y pu

blic

hea

lth, a

gric

ultu

re, a

nd a

ll ot

her r

elev

ant m

inis

trie

s or

sec

tors

, to

supp

ort t

he im

plem

enta

tion

of a

ll IH

R ca

paci

ties

at th

e na

tiona

l lev

el.

Im

plem

ent a

nd re

view

the

use

of a

vaila

ble

finan

cing

and

its

effe

ctiv

enes

s.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

reso

urce

map

ping

sta

tus

to ra

tiona

lly a

lloca

te b

udge

t to

ever

y se

ctor

at n

atio

nal a

nd s

ubna

tiona

l lev

els.

Al

loca

te s

uffic

ient

9 bud

get a

t nat

iona

l and

sub

natio

nal l

evel

s fo

r the

impl

emen

tatio

n of

all

IHR

capa

citie

s in

all

rele

vant

m

inis

trie

s or

sec

tors

.

Mon

itor b

udge

t dis

trib

utio

n an

d ex

pend

iture

by

all t

he re

leva

nt m

inis

trie

s at

nat

iona

l and

sub

natio

nal l

evel

s.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t reg

ular

mee

tings

to re

view

impl

emen

tatio

n of

the

allo

cate

d bu

dget

by

all r

elev

ant m

inis

trie

s or

sec

tors

.

Dev

elop

a to

ol to

mon

itor t

hat t

imel

y di

strib

utio

n an

d us

e of

the

budg

et a

re c

oord

inat

ed fo

r act

iviti

es a

nd in

terv

entio

ns to

im

plem

ent I

HR

capa

citie

s.

D

ocum

ent a

nd d

isse

min

ate

info

rmat

ion

on th

e tim

ely

dist

ribut

ion

and

effe

ctiv

e us

e of

fund

s to

incr

ease

hea

lth s

ecur

ity

(suc

h as

pre

vent

ing

or s

topp

ing

the

spre

ad o

f dis

ease

), at

the

natio

nal a

nd s

ubna

tiona

l lev

els

in a

ll re

leva

nt m

inis

trie

s or

se

ctor

s.

9 Thi

s re

fers

to a

cces

s to

fund

s by

rele

vant

min

istr

ies

or g

over

nmen

t bod

ies

for t

he im

plem

enta

tion

of a

ll IH

R ca

paci

ties.

Suf

ficie

ncy

is m

easu

red,

whe

re p

ossi

ble,

by

com

parin

g bu

dget

al

loca

tion

amou

nts

to re

sour

ce n

eeds

iden

tified

in n

atio

nal p

lans

rela

ted

to IH

R an

d/or

hea

lth s

ecur

ity.


17

CAPA

CITY

LEVE

L

Benc

hmar

k 1.

3: F

inan

cing

ava

ilabl

e fo

r tim

ely

resp

onse

to p

ublic

hea

lth e

mer

genc

ies10

Obj

ectiv

e: T

o de

velo

p a

finan

cing

mec

hani

sm to

ens

ure

that

fund

s ar

e av

aila

ble

for t

imel

y re

spon

se to

pub

lic h

ealth

em

erge

ncie

s

01N

O C

APAC

ITY

N

o m

echa

nism

of fi

nanc

ing

exis

ts to

resp

ond

to p

ublic

hea

lth e

mer

genc

ies.

Fu

nds

are

allo

cate

d an

d di

strib

uted

in a

n ad

hoc

man

ner f

rom

diff

eren

t sou

rces

dur

ing

publ

ic h

ealth

em

erge

ncie

s.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d co

nven

e ke

y st

akeh

olde

rs to

revi

ew th

e st

atus

of t

he e

mer

genc

y fin

anci

ng m

echa

nism

11 to

resp

ond

to p

ublic

he

alth

em

erge

ncie

s.

Revi

ew th

e em

erge

ncy

publ

ic fi

nanc

ing

mec

hani

sm, p

artic

ular

ly th

e ac

cept

ance

and

rapi

d di

strib

utio

n of

fund

s to

resp

ond

to p

ublic

hea

lth e

mer

genc

ies.

Co

nduc

t sta

keho

lder

ana

lysi

s to

iden

tify

dom

estic

and

ext

erna

l par

tner

s w

ho c

an s

uppo

rt m

obili

zing

fund

s du

ring

emer

genc

ies,

and

, if n

eces

sary

and

app

ropr

iate

, est

ablis

h a

mem

oran

dum

of u

nder

stan

ding

with

thes

e st

akeh

olde

rs.

D

evel

op o

r rev

ise

the

mec

hani

sm a

nd s

truc

ture

to re

ceiv

e an

d ra

pidl

y di

strib

ute

fund

s du

ring

emer

genc

ies.

Con

duct

a

sim

ulat

ion

exer

cise

or a

fter-

actio

n re

view

to a

sses

s fu

nctio

nalit

y of

the

new

fina

nce

polic

y or

pro

cedu

res.

Doc

umen

t ou

tcom

es a

nd m

ake

nece

ssar

y ch

ange

s to

opt

imiz

e pr

oced

ure.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

and

ens

ure

func

tiona

lity

of th

e em

erge

ncy

publ

ic fi

nanc

ing

mec

hani

sm, p

artic

ular

ly th

e m

obili

zatio

n of

fund

s w

hen

need

ed a

t the

nat

iona

l, st

ate,

pro

vinc

ial a

nd re

gion

al le

vels

for a

ll re

leva

nt s

ecto

rs.

D

evel

op a

nd d

isse

min

ate

prot

ocol

s or

mec

hani

sms

for t

he ti

mel

y ex

ecut

ion12

of f

unds

by

all r

elev

ant s

ecto

rs.

Co

nduc

t a fi

eld

test

of t

he m

echa

nism

and

upd

ate

if ne

cess

ary.

Dem

onst

rate

and

doc

umen

t tha

t the

fund

s ar

e m

obili

zed

in a

dvan

ce o

f a p

ublic

hea

lth e

mer

genc

y.

10 D

efine

d by

the

coun

try

thro

ugh

a se

t of t

rigge

rs th

at d

ecla

re a

situ

atio

n as

a p

ublic

hea

lth e

mer

genc

y.

11 A

spe

cial

set

of p

roce

sses

or c

hann

els

in p

lace

that

act

ivat

es a

spe

cial

em

erge

ncy

publ

ic fi

nanc

ing

mec

hani

sm, a

llow

s fo

r rap

id re

cept

ion

and

dist

ribut

ion

of fu

nds,

and

circ

umve

nts

the

vario

us c

heck

s an

d ba

lanc

es o

f the

nor

mal

pub

lic fi

nanc

ing

mec

hani

sm.

12 R

espo

nse

to p

ublic

hea

lth e

mer

genc

ies

incl

udes

a s

erie

s of

inte

rven

tions

(suc

h as

sup

ply

and

equi

pmen

t pro

cure

men

t, hu

man

reso

urce

con

trac

ting

and

depl

oym

ent,

logi

stic

al

arra

ngem

ents

), an

d en

gage

s ac

tors

not

usu

ally

invo

lved

with

pub

lic s

ecto

r ser

vice

s (s

uch

as n

ongo

vern

men

tal o

rgan

izat

ions

and

the

priv

ate

sect

or),

whi

ch u

nder

nor

mal

circ

umst

ance

s ca

n ta

ke a

fair

amou

nt o

f wor

k an

d tim

e an

d m

ay n

ot e

ven

be p

ossi

ble.

Mec

hani

sms,

incl

udin

g fa

st-t

rack

exe

cutio

n pr

oced

ures

and

lette

rs o

f und

erst

andi

ng w

ith n

onst

ate

acto

rs, n

eed

to b

e in

pl

ace

befo

re a

n em

erge

ncy

occu

rs, t

o al

low

for e

xped

ited

spen

ding

of f

unds

for a

spec

ts th

at a

re c

ruci

al to

em

erge

ncy

resp

onse

.


18

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

emon

stra

te th

at a

ll re

leva

nt m

inis

tries

hav

e ca

paci

ty to

acc

ess

and

utiliz

e th

e em

erge

ncy

publ

ic fi

nanc

ing

mec

hani

sm

for e

arly

det

ectio

n an

d re

spon

se o

pera

tions

.

Dev

elop

SO

P’s

to s

uppo

rt ac

tors

not

usu

ally

invo

lved

with

pub

lic s

ecto

r ser

vice

s, s

uch

as n

ongo

vern

men

tal o

rgan

izat

ions

an

d th

e pr

ivat

e se

ctor

to a

cces

s em

erge

ncy

fund

s w

hen

need

ed.

D

evel

op S

OP’

s or

MoU

’s th

at fa

st-t

rack

pro

cure

men

t and

ser

vice

agr

eem

ents

that

can

be

activ

ated

dur

ing

emer

genc

ies

to

exp

edite

resp

onse

.

Dev

elop

acc

ount

ing

and

repo

rting

pro

cedu

res

for a

ccou

ntab

ility

and

trans

pare

ncy

of a

ll em

erge

ncy

SOP

and

MO

U’s

that

will

be

used

dur

ing

emer

genc

y re

spon

se.

Re

view

the

effe

ctiv

enes

s of

em

erge

ncy

finan

cing

mec

hani

sm fo

llow

ing

any

resp

onse

to a

pub

lic h

ealth

em

erge

ncie

s

and

adju

st p

roce

dure

s to

ens

ure

spee

d, tr

ansp

aren

cy a

nd a

ccou

ntab

ility

of a

ll fu

nds.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

an e

mer

genc

y co

ntin

genc

y fu

nd a

t the

nat

iona

l lev

el w

ith th

e su

ppor

t of u

rgen

t res

pons

e, a

nd w

hen

requ

ired

a na

tiona

l aut

horit

y w

hich

can

coo

rdin

ate

the

rece

ipt a

nd d

istr

ibut

ion

of fu

nds

to lo

cal a

nd in

term

edia

te le

vels

.

Esta

blis

h a

link

and/

or m

emor

andu

m o

f und

erst

andi

ng w

ith o

ther

regi

onal

or g

loba

l em

erge

ncy

cont

inge

ncy

fund

s, th

roug

h w

hich

a n

atio

nal a

utho

rity

can

coor

dina

te a

nd d

istr

ibut

e fu

nds.

Es

tabl

ish

a sy

stem

for a

ccou

ntab

ility

of t

he d

istr

ibut

ion

and

use

of th

ese

fund

s an

d pu

blis

h in

form

atio

n do

cum

entin

g tr

ansp

aren

cy in

exp

endi

ture

and

pro

gram

me

impa

cts

tow

ards

pro

tect

ing

heal

th.


19

TOO

LS:

St

reng

then

ing

heal

th s

ecur

ity b

y im

plem

entin

g th

e In

tern

atio

nal H

ealth

Reg

ulat

ions

(200

5) –

Gen

eral

Info

rmat

ion.

In

tern

atio

nal H

ealth

Reg

ulat

ions

(200

5). T

hird

edi

tion.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

016

Su

ppor

t to

natio

nal l

egis

latio

n fo

r IH

R im

plem

enta

tion.

IH

R (2

005)

: Gui

danc

e on

impl

emen

tatio

n in

nat

iona

l leg

isla

tion.

D

eliv

erin

g gl

obal

hea

lth s

ecur

ity th

roug

h su

stai

nabl

e fin

anci

ng. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

8

Fund

ing

for e

mer

genc

ies


20

IHR

COO

RDIN

ATIO

N, C

OM

MU

NIC

ATIO

N A

ND

ADVO

CACY

AN

D RE

PORT

ING

02

IMPA

CT:

A m

echa

nism

for m

ultis

ecto

ral/m

ultid

isci

plin

ary

coor

dina

tion,

com

mun

icat

ion

and

part

ners

hips

to p

reve

nt, d

etec

t, as

sess

and

resp

ond

to a

ny

publ

ic h

ealth

eve

nt o

r em

erge

ncy

is in

pla

ce. A

n IH

R N

FP th

at is

alw

ays

acce

ssib

le to

com

mun

icat

e w

ith th

e re

gion

al W

HO

IHR

Cont

act P

oint

s an

d w

ith a

ll re

leva

nt s

ecto

rs a

nd o

ther

sta

keho

lder

s in

the

coun

try.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Est

ablis

hmen

t of a

func

tiona

l mul

tisec

tora

l and

mul

tidis

cipl

inar

y m

echa

nism

for t

he c

oord

inat

ion

and

inte

grat

ion

of re

leva

nt s

ecto

rs in

th

e im

plem

enta

tion

of IH

R an

d to

resp

ond

to a

ny p

ublic

hea

lth e

vent

s an

d em

erge

ncie

s. (2

) Reg

ular

test

ing

of th

e m

echa

nism

thro

ugh

actu

al

expe

rienc

e an

d/or

exe

rcis

es a

nd s

ubse

quen

t im

prov

emen

t of a

rran

gem

ents

and

pro

cedu

res.

Each

cou

ntry

requ

ires

a w

ell-s

uppo

rted,

ade

quat

ely

train

ed te

am o

f nat

iona

l foc

al p

oint

(s) (

NFP

s) fo

r the

IHR

to e

nsur

e ef

fect

ive

coor

dina

tion,

com

mun

icat

ion

and

part

ners

hips

to p

reve

nt, d

etec

t, as

sess

and

resp

ond

to a

ny p

ublic

hea

lth e

vent

s. T

he c

ount

ry e

nsur

es s

usta

inab

le fu

nctio

ning

of t

he IH

R N

FPs

for I

HR

com

mun

icat

ions

, coo

rdin

atio

n an

d pa

rtner

ship

.


21

CAPA

CITY

LEVE

L

Benc

hmar

k 2.

1: T

he IH

R N

FP is

fully

func

tiona

l O

bjec

tive:

To

esta

blis

h a

fully

func

tiona

l IH

R N

FP

01N

O C

APAC

ITY

Ther

e is

no

sust

aina

ble

or c

onsi

sten

t NFP

func

tioni

ng fo

r the

IHR.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

De

sign

ate

or e

stab

lish

an N

FP in

line

with

the

IHR

requ

irem

ents

.

Esta

blis

h te

rms

of re

fere

nce

outli

ning

the

role

and

resp

onsi

bilit

ies

of IH

R N

FPs

in fu

lfillin

g re

leva

nt o

blig

atio

ns o

f the

IHR.

M

aint

ain

and

regu

larly

upd

ate

a co

ntac

t dire

ctor

y in

clud

ing

all t

he m

embe

rs o

f NFP

and

cap

acita

te N

FPs

for 2

4 ho

urs

a da

y, se

ven

days

a w

eek

(24/

7) a

cces

sibi

lity.

Co

nduc

t tra

inin

g fo

r NFP

s.

Esta

blis

h SO

Ps fo

r com

mun

icat

ing

and

coor

dina

ting

with

WH

O, in

clud

ing

trigg

er a

nd p

roce

ss fo

r not

ifica

tion

and

repo

rting

.

Esta

blis

h SO

Ps fo

r com

mun

icat

ion

amon

g re

leva

nt s

ecto

rs, in

clud

ing

thre

shol

ds fo

r rep

ortin

g an

d re

spon

se.

De

velo

p ac

tion

plan

s fo

r mul

tisec

tora

l/mul

tidis

cipl

inar

y co

ordi

natio

n an

d co

mm

unic

atio

n m

echa

nism

s in

a v

arie

ty o

f set

tings

in

clud

ing

durin

g tim

es o

f hig

h ris

k, de

liber

ate

even

ts a

nd m

ass

gath

erin

g ev

ents

.

Prov

ide

annu

al re

ports

to th

e W

orld

Hea

lth A

ssem

bly

on IH

R ca

paci

ty d

evel

opm

ent.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent S

OPs

for c

omm

unic

atin

g an

d co

ordi

natin

g be

twee

n N

FPs

and

WH

O a

nd re

view

per

form

ance

regu

larly

.

Impl

emen

t SO

Ps fo

r com

mun

icat

ing

betw

een

the

NFP

and

rele

vant

sec

tors

incl

udin

g th

ose

resp

onsi

ble

for s

urve

illan

ce a

nd

repo

rtin

g, p

oint

s of

ent

ry, p

ublic

hea

lth s

ervi

ces,

clin

ics

and

hosp

itals

and

oth

er g

over

nmen

t dep

artm

ents

/min

istr

ies

and

revi

ew p

erfo

rman

ce re

gula

rly.

Es

tabl

ish

SOPs

for c

omm

unic

atio

n an

d co

ordi

natio

n be

twee

n th

e N

FP a

nd n

ongo

vern

men

tal a

genc

ies,

incl

udin

g m

edia

and

ci

vil s

ocie

ty.

Re

gula

rly te

st th

e m

echa

nism

for m

ultis

ecto

ral c

olla

bora

tion

and

com

mun

icat

ion

thro

ugh

actu

al e

xper

ienc

e an

d/or

sc

enar

ios

for h

igh

risk,

del

iber

ate

or m

ass

gath

erin

g ev

ents

.

Dev

elop

com

mun

icat

ion

chan

nels

, suc

h as

web

site

upd

ates

or n

ewsl

ette

rs, t

o ap

pris

e re

leva

nt s

ecto

rs a

nd p

artn

ers

on

deve

lopm

ents

in th

e re

latio

n to

IHR

impl

emen

tatio

n.


22

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t for

mal

eva

luat

ion

of th

e ro

le o

f NFP

s an

d th

e co

ordi

natio

n m

echa

nism

.

Cond

uct r

egul

ar re

fresh

er tr

aini

ng fo

r NFP

s an

d or

ient

atio

n/tra

inin

g fo

r new

sta

ff.

Revi

ew N

FP m

aste

ry o

f inf

orm

atio

n an

d be

st p

ract

ices

.

Rout

inel

y co

nduc

t afte

r-ac

tion

revi

ews

or s

imul

atio

ns a

nd a

pply

the

less

ons

lear

nt re

latin

g to

coo

rdin

atio

n an

d N

FP ro

le,

prio

ritiz

ed fo

r act

ions

with

in n

atio

nal a

ctio

n pl

ans.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

edic

ate

sust

aine

d re

sour

ces

(fina

ncia

l, hu

man

, tec

hnic

al) t

hat a

re a

cces

sibl

e an

d av

aila

ble

for t

he N

FP a

nd re

late

d ac

tiviti

es.

D

ocum

ent a

nd s

hare

less

ons

lear

nt re

late

d to

NFP

bes

t pra

ctic

es.

Pr

ovid

e su

ppor

t to

NFP

s in

oth

er c

ount

ries

as re

ques

ted

incl

udin

g th

roug

h bi

late

ral a

nd re

gion

al a

rran

gem

ents

.


23

CAPA

CITY

LEVE

L

Benc

hmar

k 2.

2: M

ultis

ecto

ral I

HR

coor

dina

tion

mec

hani

sm e

ffec

tivel

y su

ppor

ts th

e im

plem

enta

tion

of p

reve

ntio

n, d

etec

tion

and

resp

onse

act

iviti

es

Obj

ectiv

e: T

o es

tabl

ish

a m

ultis

ecto

ral I

HR

coor

dina

tion

mec

hani

sm to

sup

port

the

impl

emen

tatio

n of

pre

vent

ion,

det

ectio

n an

d re

spon

se a

ctiv

ities

01N

O C

APAC

ITY

No

mul

tisec

tora

l coo

rdin

atio

n m

echa

nism

exi

sts.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t a s

take

hold

er a

naly

sis

and

esta

blis

h a

mul

tisec

tora

l coo

rdin

atio

n m

echa

nism

that

mee

ts re

gula

rly to

dis

cuss

an

d pr

omot

e IH

R is

sues

(dev

elop

a p

roto

col,

term

s of

refe

renc

e an

d id

entif

y re

sour

ces

need

ed fo

r the

mec

hani

sm).

Re

view

exi

stin

g na

tiona

l pla

ns fr

om re

leva

nt s

ecto

rs a

nd in

crea

se c

oord

inat

ion

and

harm

oniz

atio

n of

reso

urce

s an

d ac

tiviti

es w

ithin

the

heal

th s

yste

m a

s w

ell a

s ac

ross

rele

vant

sec

tors

.

Cond

uct a

n O

IE p

erfo

rman

ce o

f vet

erin

ary

serv

ices

(OIE

PVS

) eva

luat

ion

(or o

ther

PVS

ass

essm

ents

) or,

if al

read

y do

ne in

th

e pa

st tw

o or

thre

e ye

ars,

revi

ew th

e O

IE P

VS e

valu

atio

n fin

ding

s an

d th

eir i

mpl

emen

tatio

n st

atus

.

Doc

umen

t and

dis

sem

inat

e ev

iden

ce th

at th

e co

ordi

natio

n m

echa

nism

is w

orki

ng to

add

ress

zoo

nose

s an

d ot

her e

xist

ing

or n

ew h

ealth

eve

nts

at th

e hu

man

–an

imal

inte

rfac

e.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Cr

eate

/upd

ate

the

natio

nal a

ctio

n pl

an fo

r im

prov

ing

heal

th s

ecur

ity a

nd IH

R ca

paci

ty b

ased

on

IHR

mon

itorin

g an

d ev

alua

tion

resu

lts.

U

pdat

e or

revi

ew th

e co

ordi

natio

n m

echa

nism

to a

ddre

ss z

oono

ses

and

othe

r exi

stin

g or

new

hea

lth e

vent

s at

th

e hu

man

–an

imal

inte

rfac

e.

Doc

umen

t and

dis

sem

inat

e ev

iden

ce th

at th

e co

ordi

natio

n m

echa

nism

for f

ood

safe

ty a

mon

g st

akeh

olde

rs fr

om a

ll re

leva

nt

sect

ors

is w

orki

ng a

s pe

r the

pro

toco

l.


24

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t reg

ular

mul

tisec

tora

l coo

rdin

atio

n m

eetin

gs a

nd e

nsur

e th

at th

e ou

tcom

es o

f the

se m

eetin

gs a

re d

isse

min

ated

to

the

exte

rnal

and

inte

rnal

aud

ienc

e, w

ell d

ocum

ente

d an

d ac

ted

upon

.

Dev

elop

per

form

ance

-bas

ed in

dica

tors

and

regu

larly

mea

sure

out

com

es re

late

d to

NFP

s an

d IH

R co

mpl

ianc

e.

Doc

umen

t and

dis

sem

inat

e ev

iden

ce th

at th

e co

ordi

natio

n m

echa

nism

for c

hem

ical

saf

ety

amon

g st

akeh

olde

rs fr

om a

ll re

leva

nt s

ecto

rs is

wor

king

as

per t

he p

roto

col.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Pr

ovid

e su

stai

ned

fund

ing

for t

he m

ultis

ecto

ral c

oord

inat

ion

mec

hani

sm.

D

ocum

ent a

nd d

isse

min

ate

evid

ence

that

the

coor

dina

tion

mec

hani

sm fo

r rad

iatio

n em

erge

ncie

s am

ong

stak

ehol

ders

from

al

l rel

evan

t sec

tors

and

nat

iona

l rad

iatio

n sa

fety

aut

horit

ies

is w

orki

ng a

s pe

r the

pro

toco

l.

Test

and

revi

se re

leva

nt p

roce

sses

rela

ted

to th

e co

ordi

natio

n m

echa

nism

in th

e ab

senc

e of

any

eve

nts

or e

mer

genc

ies.

D

ocum

ent a

nd s

hare

bes

t pra

ctic

es.

TOO

LS:

N

atio

nal I

HR

foca

l poi

nt g

uide

W

HO

gui

danc

e fo

r the

use

of A

nnex

2 o

f the

Inte

rnat

iona

l Hea

lth R

egul

atio

ns (2

005)


25

ANTI

MIC

ROBI

AL R

ESIS

TAN

CE

03

IMPA

CT:

Dec

isiv

e an

d co

mpr

ehen

sive

act

ion

to p

reve

nt th

e em

erge

nce

and

redu

ce th

e sp

read

of A

MR.

Cou

ntrie

s w

ill (i

n lin

e w

ith th

e gl

obal

act

ion

plan

) in

crea

se a

war

enes

s of

AM

R ris

ks a

nd h

ow to

resp

ond

to th

em; s

treng

then

sur

veill

ance

and

labo

rato

ry c

apac

ity; e

nhan

ce in

fect

ion

prev

entio

n an

d co

ntro

l act

iviti

es; e

nsur

e un

inte

rrup

ted

acce

ss to

ess

entia

l ant

imic

robi

als

of a

ssur

ed q

ualit

y; re

gula

te a

nd p

rom

ote

the

appr

opria

te u

se o

f an

timic

robi

als

in h

uman

med

icin

e, v

eter

inar

y m

edic

ine,

food

pro

duct

ion

and

othe

r fiel

ds a

s ap

prop

riate

; and

sup

port

initi

ativ

es to

fost

er th

e de

velo

pmen

t and

app

ropr

iate

use

of n

ew a

ntim

icro

bial

age

nts,

vac

cine

s an

d di

agno

stic

tool

s.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Mul

tisec

tora

l nat

iona

l act

ion

plan

to c

omba

t AM

R ha

s be

en p

rodu

ced

and

mad

e pu

blic

. (2)

Impl

emen

tatio

n of

the

AMR

natio

nal a

ctio

n pl

an/

sect

or p

lans

, with

mon

itorin

g an

d ye

arly

repo

rtin

g on

pro

gres

s (in

clud

ing

repo

rtin

g to

the

inte

rnat

iona

l lev

el) i

s in

pla

ce. (

The

JEE

tool

revi

ews

the

coun

try’

s se

lf-as

sess

ed re

spon

se to

the

glob

al m

onito

ring

surv

ey o

n AM

R.)

A fu

nctio

nal s

yste

m in

pla

ce fo

r the

nat

iona

l res

pons

e to

pre

vent

and

com

bat a

ntim

icro

bial

resi

stan

ce (A

MR)

with

a O

ne H

ealth

app

roac

h, in

clud

ing:

Mul

tisec

tora

l wor

k sp

anni

ng h

uman

, ani

mal

, cro

ps, f

ood

safe

ty a

nd e

nviro

nmen

tal a

spec

ts –

this

com

pris

es d

evel

opin

g an

d im

plem

entin

g a

natio

nal

actio

n pl

an to

com

bat A

MR,

con

sist

ent w

ith th

e gl

obal

act

ion

plan

on

AMR.

Su

rvei

llanc

e ca

paci

ty fo

r AM

R an

d an

timic

robi

al u

se a

t the

nat

iona

l lev

el, f

ollo

win

g an

d us

ing

inte

rnat

iona

lly a

gree

d sy

stem

s su

ch a

s th

e W

HO

Glo

bal

Antim

icro

bial

Res

ista

nce

Surv

eilla

nce

Syst

em (G

LASS

) and

the

OIE

glo

bal d

atab

ase

on u

se o

f ant

imic

robi

al a

gent

s in

ani

mal

s.

Prev

entio

n of

AM

R in

hea

lthca

re fa

cilit

ies,

food

pro

duct

ion

and

the

com

mun

ity, t

hrou

gh in

fect

ion

prev

entio

n an

d co

ntro

l mea

sure

s.

Ensu

ring

appr

opria

te u

se o

f ant

imic

robi

als,

incl

udin

g as

surin

g qu

ality

of a

vaila

ble

med

icin

es, c

onse

rvat

ion

of e

xist

ing

treat

men

ts a

nd a

cces

s to

app

ropr

iate

an

timic

robi

als

whe

n ne

eded

, whi

le re

duci

ng in

appr

opria

te u

se.


26

CAPA

CITY

LEVE

L

Benc

hmar

k 3.

1: E

ffec

tive

mul

tisec

tora

l coo

rdin

atio

n on

AM

R O

bjec

tive:

To

deve

lop

and

impl

emen

t a m

ultis

ecto

ral n

atio

nal a

ctio

n pl

an o

n AM

R

01N

O C

APAC

ITY

No

natio

nal a

ctio

n pl

an fo

r AM

R.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a na

tiona

l mul

tisec

tora

l AM

R co

ordi

natin

g co

mm

ittee

.

Und

erta

ke a

situ

atio

n an

alys

is to

iden

tify

maj

or ri

sks

for d

evel

opm

ent a

nd tr

ansm

issi

on o

f AM

R, a

nd w

here

the

impa

ct o

f re

sist

ance

wou

ld b

e gr

eate

st.

Id

entif

y pr

ogra

mm

es a

nd a

ctiv

ities

rela

ting

to k

ey A

MR

obje

ctiv

es th

at n

eed

to b

e de

velo

ped

or s

cale

d up

.

Iden

tify

a he

alth

min

istr

y le

ad fo

r AM

R, d

evel

op a

cle

ar te

rms

of re

fere

nce

and

coor

dina

te a

ctiv

ities

of t

he re

leva

nt m

inis

trie

s on

AM

R an

d st

ewar

dshi

p.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

pla

n of

act

ion

to a

ddre

ss A

MR

in li

ne w

ith th

e G

loba

l Act

ion

Plan

(GAP

) on

AMR.

Su

bmit

a pl

an fo

r app

rova

l thr

ough

rele

vant

gov

erna

nce

mec

hani

sms

(suc

h as

offi

ce o

f hea

d of

sta

te, c

abin

et, o

r min

istr

ies

of h

ealth

and

agr

icul

ture

).

Dev

elop

term

s of

refe

renc

e fo

r a m

ultis

ecto

ral g

over

nanc

e m

echa

nism

, with

cle

ar li

nes

of a

ccou

ntab

ility

bet

wee

n th

e AM

R co

ordi

natin

g co

mm

ittee

and

the

high

leve

l One

Hea

lth g

roup

.

Org

aniz

e ef

fect

ive

coor

dina

tion

thro

ugh

regu

lar m

eetin

gs.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y pr

iorit

y ac

tions

(bas

ed o

n ris

k an

d fe

asib

ility

) fro

m th

e na

tiona

l act

ion

plan

, dev

elop

an

impl

emen

tatio

n pl

an w

ith

resp

onsi

ble

agen

cies

with

est

ablis

hed

timel

ines

, and

beg

in im

plem

enta

tion

of th

ese

actio

ns.

D

evel

op a

nd im

plem

ent a

n AM

R na

tiona

l act

ion

plan

mon

itorin

g fr

amew

ork.

Re

view

pla

ns a

nd p

rogr

ess

thro

ugh

regu

lar m

eetin

gs o

f the

AM

R go

vern

ance

com

mitt

ee.

Id

entif

y an

d m

ap s

usta

ined

fund

ing

for p

lann

ed a

ctiv

ities

in th

e AM

R na

tiona

l act

ion

plan

.


27

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

edic

ate

sust

ain

fund

ing

for p

lann

ed a

ctiv

ities

in th

e AM

R na

tiona

l act

ion

plan

.

Ensu

re k

ey a

ctiv

ities

are

inco

rpor

ated

in p

lans

and

bud

gets

of r

elev

ant p

rogr

amm

es a

nd a

genc

ies.

En

sure

regu

lar m

onito

ring

of p

rogr

ess

with

dat

a su

bmitt

ed to

regi

onal

and

glo

bal l

evel

s.

Defi

ne c

lear

ly s

peci

fied

actio

ns w

ithin

pla

nnin

g an

d go

vern

ance

mec

hani

sms

for a

ll ke

y se

ctor

s in

volv

ed.

Id

entif

y po

tent

ial b

arrie

rs a

nd/o

r cha

lleng

es to

impl

emen

ting

the

natio

nal a

ctio

n pl

an a

nd a

ppro

ache

s to

ove

rcom

e th

ese

barr

iers

.


28

CAPA

CITY

LEVE

L

Benc

hmar

k 3.

2: S

urve

illan

ce s

yste

m o

f AM

R is

in p

lace

O

bjec

tive:

To

deve

lop

a na

tiona

l AM

R su

rvei

llanc

e sy

stem

that

inte

grat

es s

urve

illan

ce o

f AM

R in

pat

hoge

ns o

f con

cern

to

hum

an a

nd a

nim

al h

ealth

and

agr

icul

ture

01N

O C

APAC

ITY

Non

e of

the

labo

rato

ries

that

con

duct

ant

ibio

tic s

usce

ptib

ility

test

ing

are

gene

ratin

g da

ta (a

ntib

iotic

sus

cept

ibili

ty a

nd

acco

mpa

nyin

g cl

inic

al a

nd e

pide

mio

logi

cal d

ata)

and

ther

e is

no

surv

eilla

nce

syst

em re

port

ing

on A

MR.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

esig

nate

a n

atio

nal c

oord

inat

ing

cent

re to

ove

rsee

the

deve

lopm

ent a

nd fu

nctio

ning

of t

he n

atio

nal A

MR

surv

eilla

nce

syst

em.

Co

mpl

ete

an a

sses

smen

t of e

xist

ing

labo

rato

ry c

apac

ities

for i

dent

ifica

tion

and

antib

iotic

sus

cept

ibili

ty te

stin

g of

com

mon

ba

cter

ia in

clud

ing

Myc

obac

teriu

m tu

berc

ulos

is.

D

efine

prio

rity

spec

imen

s, p

atho

gens

and

dru

g–bu

g co

mbi

natio

ns fo

r nat

iona

l rep

ortin

g.

Des

igna

te a

nat

iona

l ref

eren

ce la

bora

tory

to s

uppo

rt A

MR

surv

eilla

nce

and

deve

lop

SOPs

for v

erifi

catio

n an

d ad

ditio

nal

test

ing

and

iden

tify

an e

xter

nal q

ualit

y as

sess

men

t pro

vide

r for

the

natio

nal r

efer

ence

labo

rato

ry.

D

esig

nate

labo

rato

ries

and

secu

re la

bora

tory

reag

ents

to c

ondu

ct d

etec

tion

and

repo

rtin

g of

som

e pr

iorit

y AM

R pa

thog

ens.

Es

tabl

ish

One

Hea

lth A

MR

trai

ning

and

men

tors

hip

prog

ram

mes

for n

atio

nal a

nd c

ount

ry la

bora

torie

s.

Dev

elop

and

initi

ate

trai

ning

pro

gram

mes

for d

ata

colle

ctio

n an

d re

port

ing

of A

MR

at n

atio

nal a

nd re

gion

al le

vels

.

Initi

ate

AMR

surv

eilla

nce

at p

ilot o

r rep

rese

ntat

ive

regi

onal

and

refe

rral

hos

pita

ls.


29

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

De

fine

labo

rato

ry s

tand

ards

and

cap

acity

requ

irem

ents

that

labo

rato

ries

mus

t mee

t to

parti

cipa

te in

nat

iona

l sur

veilla

nce.

De

velo

p st

eps

to s

treng

then

labo

rato

ry c

apac

ity to

sus

tain

ably

iden

tify

and

perfo

rm id

entifi

catio

n an

d an

tibio

tic s

usce

ptib

ility

test

ing

of c

omm

on b

acte

ria in

clud

ing

M. t

uber

culo

sis.

Esta

blis

h an

ext

erna

l qua

lity

asse

ssm

ent p

rogr

amm

e fo

r the

nat

iona

l ref

eren

ce la

bora

tory

and

ens

ure

that

the

natio

nal

refe

renc

e la

bora

tory

can

con

duct

con

firm

ator

y or

add

ition

al te

stin

g.

Defi

ne n

atio

nal A

MR

surv

eilla

nce

obje

ctiv

es a

nd d

evel

op a

nat

iona

l AM

R su

rvei

llanc

e st

rate

gy.

Es

tabl

ish

SOPs

, pro

toco

ls a

nd d

atab

ases

for s

urve

illanc

e da

ta, a

sys

tem

for r

epor

ting

to m

inis

tries

of h

ealth

and

agr

icul

ture

, an

d a

mec

hani

sm to

ana

lyse

dat

a an

d re

port

back

to fa

cilit

ies

and

to W

HO.

De

velo

p a

natio

nal s

urve

illanc

e pr

otoc

ol in

clud

ing:

sur

veilla

nce

targ

ets,

labo

rato

ry s

tand

ards

, prio

rity

spec

imen

s, pa

thog

ens

and

drug

–bu

g co

mbi

natio

ns, d

efine

d da

tase

ts, m

etric

s, da

ta p

rodu

ctio

n, a

nalys

is a

nd re

porti

ng, q

ualit

y m

anag

emen

t, mon

itorin

g an

d ev

alua

tion)

.

Desi

gnat

e fu

nctio

nal A

MR

surv

eilla

nce

site

s.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ev

alua

te e

xist

ing

AMR

and

drug

-res

ista

nt T

B su

rvei

llanc

e sy

stem

s, d

isse

min

ate

resu

lts a

nd d

evel

op a

n ac

tion

plan

for

impl

emen

tatio

n of

a n

atio

nal s

urve

illanc

e sy

stem

.

Esta

blis

h ex

tern

al q

ualit

y as

sess

men

t pro

gram

me

for a

ll lab

orat

orie

s (h

uman

and

ani

mal

) gen

erat

ing

data

for A

MR

surv

eilla

nce.

De

velo

p an

d m

aint

ain

sust

aina

ble

supp

ort f

or A

MR

and

drug

-res

istan

t TB

surv

eilla

nce

infra

stru

ctur

e in

clud

ing

labo

rato

ry s

uppl

y cha

in.

Ex

pand

AM

R te

stin

g an

d su

rvei

llanc

e to

incl

ude

othe

r clin

ical

site

s an

d/or

oth

er a

reas

of t

he h

ealth

care

sys

tem

(suc

h as

priv

ate

sect

or).

Co

llect

pop

ulat

ion-

base

d de

nom

inat

ors,

suc

h as

thos

e re

com

men

ded

by W

HO

GLA

SS.

D

evel

op a

nd im

plem

ent s

trate

gies

for m

onito

ring

natio

nal A

MR

and

drug

-res

ista

nt T

B.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

En

hanc

e m

onito

ring

of a

ntib

iotic

-res

ista

nce

patte

rns

and

geno

typi

ng, a

s w

ell a

ntib

iotic

usa

ge a

nd m

anag

emen

t pra

ctic

es

at m

ultip

le p

oint

s in

the

prod

uctio

n ch

ain

for f

ood

anim

als

and

reta

il m

eat.

D

isse

min

ate

repo

rts

rela

ting

to m

easu

ring

the

prop

ortio

n of

AM

R pa

thog

ens

amon

g sp

ecim

ens

or is

olat

es, r

esul

ts fr

om

part

icip

atio

n in

inte

rnat

iona

l ext

erna

l qua

lity

asse

ssm

ent r

ound

s of

the

natio

nal r

efer

ence

labo

rato

ry, a

nd in

cide

nce

of

infe

ctio

ns c

ause

d by

AM

R pa

thog

ens

at s

entin

el s

ites

(com

mun

ity a

nd h

ospi

tal a

cqui

red)

.

Dem

onst

rate

the

use

of th

is in

form

atio

n fo

r pol

icy

chan

ges,

impr

ovin

g fa

cilit

ies

and

adap

ting

prev

entio

n an

d co

ntro

l stra

tegi

es.


30

CAPA

CITY

LEVE

L

Benc

hmar

k 3.

3: In

fect

ion

prev

entio

n an

d co

ntro

l is

in p

lace

O

bjec

tive:

To

deve

lop

a fu

nctio

ning

infe

ctio

n pr

even

tion

and

cont

rol s

yste

m fo

r hea

lthca

re fa

cilit

ies

and

farm

s

01N

O C

APAC

ITY

Syst

emat

ic e

fforts

, nat

iona

l infe

ctio

n pr

even

tion

and

cont

rol (

IPC)

pro

gram

mes

and

“wat

er, s

anita

tion

and

hygi

ene”

(WAS

H) s

tand

ards

, or

resp

onsi

ble

pers

ons

for i

nfec

tion

prev

entio

n an

d co

ntro

l in h

uman

hea

lthca

re fa

cilit

ies

to p

rom

ote

infe

ctio

n pr

even

tion

and

prev

ent

trans

mis

sion

of r

esis

tant

bac

teria

in th

e an

imal

food

pro

duct

ion

sect

or e

ither

do

not e

xist

or a

re a

t the

dev

elop

men

t sta

ge.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

WH

O re

com

men

datio

ns o

n co

re c

ompo

nent

s fo

r effe

ctiv

e IP

C pr

ogra

mm

es a

nd th

e na

tiona

l and

faci

lity

prac

tical

m

anua

ls s

uppo

rtin

g th

eir i

mpl

emen

tatio

n.

Use

IPC

asse

ssm

ent t

ools

(IPC

AT) t

o as

sess

the

core

com

pone

nts

of IP

C pr

ogra

mm

es a

t the

nat

iona

l (IP

CAT2

; too

l 2) a

nd

faci

lity

(IPCA

F; fa

cilit

y le

vel)

leve

ls a

nd id

entif

y pr

ecis

e ar

eas/

core

com

pone

nts

requ

iring

act

ion.

Dev

elop

and

impl

emen

t an

actio

n pl

an, in

form

ed b

y as

sess

men

t res

ults

and

follo

win

g th

e fiv

e-st

ep c

ycle

des

crib

ed in

the

prac

tical

m

anua

ls, t

hat a

ddre

sses

the

iden

tified

prio

rity

core

com

pone

nts

at th

e na

tiona

l and

faci

lity

leve

ls (a

t lea

st a

t maj

or h

ospi

tal c

entre

s),

core

com

pone

nt o

ne (I

PC p

rogr

amm

e) a

nd c

ore

com

pone

nt e

ight

(WAS

H),

acco

rdin

g to

the

WH

O re

quire

men

ts/a

ctio

n ch

eckli

sts.

Es

tabl

ish

a N

atio

nal I

PC C

omm

ittee

and

dev

elop

Nat

iona

l IPC

Com

mitt

ee te

rms

of re

fere

nce

and

loca

l IPC

com

mitt

ees

at

dist

rict a

nd/o

r fac

ility

leve

l, if

an a

ctio

n pl

an is

not

in p

lace

.

Dev

elop

a n

atio

nal I

PC p

olic

y an

d pl

an fo

r ani

mal

hea

lth.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op n

atio

nal I

PC g

uide

lines

for h

uman

and

ani

mal

hea

lth s

ecto

rs (I

PC in

ani

mal

pro

duct

ion)

.

Iden

tify

and

allo

cate

ade

quat

e re

sour

ces

to s

uppo

rt s

elec

ted

heal

thca

re fa

cilit

ies/

farm

s to

impl

emen

t IPC

act

ion

plan

s,

incl

udin

g IP

C gu

idel

ines

.

Use

IPC

asse

ssm

ent t

ools

at n

atio

nal (

IPCA

T2) a

nd fa

cilit

y (IP

CAF)

leve

ls to

iden

tify

prec

ise

area

s re

quiri

ng a

dditi

onal

act

iviti

es to

im

prov

e or

put

in p

lace

add

ition

al IP

C co

re c

ompo

nent

s an

d to

gui

de th

e de

velo

pmen

t of a

det

aile

d im

prov

emen

t pla

n of

act

ion.

Im

plem

ent t

he a

ctio

n pl

an, i

nfor

med

by

asse

ssm

ent r

esul

ts a

nd fo

llow

ing

the

five-

step

cyc

le d

escr

ibed

in th

e pr

actic

al

man

uals

, acc

ordi

ng to

the

WH

O re

quire

men

ts/a

ctio

n ch

eckl

ists

for t

he p

riorit

y co

re c

ompo

nent

s id

entifi

ed.

Re

fer t

o th

e re

com

men

datio

ns a

nd re

quire

men

ts fo

r IPC

gui

delin

es, a

nd tr

ain

adeq

uate

hea

lthca

re w

orke

rs o

n is

sued

gui

delin

es.

M

onito

r IPC

and

WAS

H im

plem

enta

tion

in s

elec

ted

heal

thca

re fa

cilit

ies

usin

g IP

CAF,

hand

hyg

iene

sel

f-as

sess

men

t fr

amew

ork,

han

d hy

gien

e co

mpl

ianc

e ob

serv

atio

n to

ols

WAS

H F

IT to

ol.


31

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

U

se th

e na

tiona

l IPC

ass

essm

ent t

ool (

IPCA

T2) t

o id

entif

y pr

ecis

e ar

eas

still

requ

iring

act

ion

and

upda

te th

e pl

an o

f act

ion.

M

anda

te a

nd s

uppo

rt IP

C im

prov

emen

t at a

ll he

alth

care

faci

litie

s, re

com

men

ding

the

use

of th

e in

fect

ion

prev

entio

n an

d co

ntro

l ass

essm

ent f

ram

ewor

k (IP

CAF)

and

the

WAS

H fi

t too

l and

ant

ibio

tic s

tew

ards

hip

prog

ram

s.

Upd

ate

and

impl

emen

t act

ion

plan

s, in

form

ed b

y as

sess

men

t res

ults

and

follo

win

g th

e fiv

e-st

ep c

ycle

des

crib

ed in

the

prac

tical

man

uals

, tha

t pro

gres

sive

ly c

over

all

reco

mm

ende

d IP

C pr

iorit

y co

re c

ompo

nent

s at

the

natio

nal a

nd fa

cilit

y le

vels

ac

cord

ing

to th

e W

HO

requ

irem

ents

/act

ion

chec

klis

ts fo

r the

prio

rity

core

com

pone

nts

iden

tified

.

Incl

ude

spec

ific

inte

rven

tions

for A

MR

prev

entio

n ta

ilore

d to

the

loca

l epi

dem

iolo

gica

l situ

atio

n in

thes

e pl

ans.

Sh

are

the

plan

s w

ith n

atio

nal,

subn

atio

nal a

nd lo

cal I

PC c

omm

ittee

s an

d in

corp

orat

e gu

idan

ce fr

om th

em.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Pr

ovid

e ef

fect

ive

supp

ort t

o he

alth

care

faci

lity

IPC

prog

ram

mes

nat

ionw

ide.

En

sure

that

hea

lthca

re fa

cilit

ies

unde

rtak

e an

nual

IPCA

F an

d W

ASH

fit a

sses

smen

ts a

s pa

rt o

f the

ir re

view

cyc

le to

add

ress

lo

ng-t

erm

sus

tain

abili

ty.

Es

tabl

ish

a na

tiona

l sys

tem

for c

ontin

uous

mon

itorin

g of

pro

gres

s in

fulfi

lling

the

IPC

core

com

pone

nts

(i.e.

repe

at

asse

ssm

ents

at l

east

ann

ually

) and

kee

p tr

ack

of c

hang

es a

nd s

core

s an

d de

velo

p a

long

-ter

m im

prov

emen

t pla

n.

Anal

yse

and

regu

larly

repo

rt n

atio

nal I

PC a

nd W

ASH

dat

a an

d su

ppor

t dis

cuss

ions

on

actio

ns to

inco

rpor

ate

less

ons

lear

ned

in th

e lo

ng-t

erm

impr

ovem

ent p

lan.

D

ocum

ent t

he in

cide

nce

of p

atie

nt a

nd h

ealth

care

wor

ker i

nfec

tions

, inc

ludi

ng M

. tub

ercu

losi

s, a

nd th

e ef

fect

iven

ess

of

mea

sure

s to

redu

ce th

eir o

ccur

renc

e.


32

CAPA

CITY

LEVE

L

Benc

hmar

k 3.

4: O

ptim

ize

use

of a

ntim

icro

bial

med

icin

es in

hum

an a

nd a

nim

al h

ealth

and

agr

icul

ture

O

bjec

tive:

To

ensu

re a

ppro

pria

te u

se o

f all

antim

icro

bial

s in

hum

an a

nd a

nim

al h

ealth

and

agr

icul

ture

01N

O C

APAC

ITY

No

or w

eak

polic

y an

d re

gula

tions

on

appr

opria

te u

se, a

vaila

bilit

y an

d qu

ality

of a

ntim

icro

bial

s.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

U

nder

take

an

asse

ssm

ent o

f ste

war

dshi

p po

licie

s an

d ac

tiviti

es, i

nclu

ding

regu

lato

ry fr

amew

ork

and

supp

ly c

hain

m

anag

emen

t of a

ntim

icro

bial

s, u

sing

a m

ultis

ecto

ral a

ppro

ach.

Re

view

the

esse

ntia

l med

icin

es li

st a

nd c

linic

al g

uide

lines

that

pro

mot

e ap

prop

riate

use

.

Asse

ss e

xist

ing

mon

itorin

g of

ant

imic

robi

al u

se a

nd c

onsu

mpt

ion.

D

evel

op a

dra

ft na

tiona

l ant

imic

robi

al s

tew

ards

hip

plan

or s

trat

egy

and

natio

nal l

egis

latio

n th

at re

gula

te u

se, a

vaila

bilit

y an

d qu

ality

of a

ntim

icro

bial

s.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op/u

pdat

e an

d di

ssem

inat

e na

tiona

l ste

war

dshi

p an

d cl

inic

al/t

reat

men

t gui

delin

es th

at in

clud

e th

e Es

sent

ial

Med

icin

es L

ist A

WaR

e (A

cces

s, W

atch

, Res

erve

) cat

egor

izat

ion

for a

ntib

iotic

s pr

omot

ing

appr

opria

te u

se o

f ant

imic

robi

als.

Im

plem

ent s

tew

ards

hip

prac

tices

at d

esig

nate

d he

alth

care

faci

litie

s.

Esta

blis

h SO

Ps, p

roto

cols

and

dat

abas

es fo

r mon

itorin

g an

timic

robi

al u

se in

hum

ans

and

anim

als.

Im

plem

ent a

ntim

icro

bial

ste

war

dshi

p pr

ogra

mm

es, i

nclu

ding

mon

itorin

g of

ant

imic

robi

al u

se, e

duca

tion/

com

mun

icat

ion,

an

d ot

her i

nter

vent

ions

to im

prov

e an

tibio

tic u

se, a

t des

igna

ted

faci

litie

s.

Dev

elop

or r

evie

w th

e na

tiona

l reg

ulat

ory

fram

ewor

k fo

r app

ropr

iate

use

of a

ntim

icro

bial

s in

hum

ans.

Ap

prov

e an

d en

act l

egis

latio

n an

d re

gula

tions

on

impo

rt, m

arke

ting

auth

oriz

atio

n, p

rodu

ctio

n an

d us

e of

ant

imic

robi

als.


33

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

onito

r and

eva

luat

e st

ewar

dshi

p pr

ogra

mm

es c

ondu

cted

, inc

ludi

ng th

e an

alys

is o

f ant

imic

robi

al u

se d

ata.

D

evel

op a

nd d

isse

min

ate

info

rmat

ion,

edu

catio

n an

d co

mm

unic

atio

n m

ater

ials

on

drug

resi

stan

ce a

nd d

rug

use

acro

ss

both

hum

an a

nd a

nim

al s

ecto

rs. T

hese

incl

ude

the

use

of e

vide

nce

gene

rate

d fro

m A

MR

and

antim

icro

bial

use

sur

veill

ance

to

info

rm a

ntib

iotic

-use

pra

ctic

es.

D

evel

op a

nat

iona

l reg

ulat

ory

fram

ewor

k fo

r app

ropr

iate

use

of a

fford

able

, qua

lity

assu

red

antim

icro

bial

s in

hum

ans

and

anim

als.

Ex

pand

ant

imic

robi

al s

tew

ards

hip

activ

ities

to a

ll he

alth

care

faci

litie

s.

Reco

mm

end

and

impl

emen

t the

pha

sing

out

of a

ntim

icro

bial

s us

ed a

s an

imal

gro

wth

pro

mot

ion.

M

ap e

xist

ing

rele

vant

legi

slat

ion

and

begi

n th

e re

view

pro

cess

for c

oher

ence

.

Dev

elop

and

impl

emen

t leg

isla

tion

on “p

resc

riptio

n on

ly” s

ales

of k

ey a

ntib

iotic

s.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

ntin

ue to

mon

itor a

ntim

icro

bial

ste

war

dshi

p ac

tiviti

es a

nd u

pdat

e th

e na

tiona

l ste

war

dshi

p pl

an o

n a

timel

y ba

sis

and

publ

icly

repo

rt o

n th

e re

sults

.

Trac

k an

tibio

tic d

ispe

nsin

g an

d se

t nat

iona

l tar

gets

for i

mpr

ovem

ent.

M

easu

re a

ntib

iotic

use

and

ass

ess

appr

opria

tene

ss.

M

onito

r ant

ibio

tic q

ualit

y an

d ad

dres

s dr

iver

s of

pre

scrib

ing

beha

viou

rs.

Im

plem

ent a

nat

iona

l reg

ulat

ory

fram

ewor

k fo

r app

ropr

iate

use

of a

fford

able

, qua

lity

assu

red

antim

icro

bial

s in

hum

ans

and

anim

als.

M

onito

r “pr

escr

iptio

n on

ly” s

ales

of k

ey a

ntib

iotic

s.

Com

plet

e th

e re

view

of r

elev

ant l

egis

latio

n an

d en

act a

men

dmen

ts to

mak

e le

gisl

atio

n co

here

nt.


34

TOO

LS:

G

uide

line

on c

ore

com

pone

nts

of in

fect

ion

prev

entio

n an

d co

ntro

l pro

gram

mes

at t

he n

atio

nal a

nd a

cute

hea

lth c

are

faci

lity

leve

l.

WH

O c

ore

com

pone

nts

for I

PC –

Impl

emen

tatio

n to

ols

and

reso

urce

s

Nat

iona

l and

faci

lity

prac

tical

man

uals

sup

port

ing

thei

r im

plem

enta

tion

IP

CAF,

hand

hyg

iene

sel

f-as

sess

men

t fra

mew

ork,

han

d hy

gien

e co

mpl

ianc

e ob

serv

atio

n to

ols,

WAS

H F

IT to

ol

Shar

ing

FAO

tool

s fo

r vet

erin

ary

labo

rato

ry a

sses

smen

t. Fo

od a

nd A

gric

ultu

re O

rgan

izat

ion

N

atio

nal a

ntim

icro

bial

resi

stan

ce s

urve

illan

ce s

yste

ms

and

part

icip

atio

n in

the

Glo

bal A

ntim

icro

bial

Res

ista

nce

Surv

eilla

nce

Syst

em (G

LASS

):

A gu

ide

to p

lann

ing,

impl

emen

tatio

n an

d m

onito

ring

and

eval

uatio

n. W

orld

Hea

lth O

rgan

izat

ion;

201

6.

OIE

dat

a co

llect

ion

tem

plat

e. P

aris

: Wor

ld O

rgan

isat

ion

for A

nim

al H

ealth

; 201

7

OIE

sta

ndar

ds a

nd re

com

men

datio

ns [f

acts

heet

]. Pa

ris: W

orld

Org

anis

atio

n fo

r Ani

mal

Hea

lth; 2

016

W

HO

Glo

bal a

ctio

n pl

an o

n an

timic

robi

al re

sist

ance

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

015

G

uide

lines

on

core

com

pone

nts

of in

fect

ion

prev

entio

n an

d co

ntro

l pro

gram

mes

at t

he n

atio

nal a

nd a

cute

hea

lth c

are

faci

lity.

G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

6

Nat

iona

l act

ion

plan

for c

omba

ting

antib

iotic

-res

ista

nt b

acte

ria. A

tlant

a: C

ente

rs fo

r Dis

ease

Con

trol a

nd P

reve

ntio

n; 2

015

Ex

ecut

ive

sum

mar

y: Th

e se

lect

ion

and

use

of e

ssen

tial m

edic

ines

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

017


35

ZOO

NO

TIC

DISE

ASE

04

IMPA

CT:

Func

tiona

l ani

mal

hea

lth, e

nviro

nmen

t and

hum

an h

ealth

sys

tem

s w

ork

indi

vidu

ally

and

col

labo

rativ

ely

thro

ugh

docu

men

ted

mec

hani

sms

and

oper

atio

nal f

ram

ewor

ks, u

sing

a m

ultis

ecto

ral O

ne H

ealth

app

roac

h an

d ba

sed

on in

tern

atio

nal s

tand

ards

, gui

danc

e an

d be

st p

ract

ices

, to

min

imiz

e th

e tr

ansm

issi

on o

f zoo

notic

dis

ease

s to

hum

an p

opul

atio

ns.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Agr

eem

ent b

y th

e an

imal

hea

lth a

nd p

ublic

hea

lth s

ecto

rs o

n a

com

mon

list

of z

oono

tic d

isea

ses/

path

ogen

s of

gre

ates

t nat

iona

l pub

lic

heal

th c

once

rn. (

2) E

xist

ence

of f

unct

iona

l cap

aciti

es in

the

anim

al h

ealth

and

pub

lic h

ealth

sec

tors

and

of c

olla

bora

tion,

coo

rdin

atio

n an

d co

mm

unic

atio

n be

twee

n th

em fo

r pre

pare

dnes

s, d

etec

tion,

ass

essm

ent a

nd re

spon

se to

zoo

notic

dis

ease

s.

Func

tiona

l mul

tisec

tora

l, mul

tidis

cipl

inar

y m

echa

nism

s, p

olic

ies,

sys

tem

s an

d pr

actic

es a

re in

pla

ce to

min

imiz

e th

e tr

ansm

issi

on a

nd s

prea

d of

zoo

notic

di

seas

es b

etw

een

anim

als

and

hum

ans.


36

CAPA

CITY

LEVE

L

Benc

hmar

k 4.

1: C

oord

inat

ed s

urve

illan

ce s

yste

m is

in p

lace

for p

riorit

y zo

onot

ic d

isea

ses/

path

ogen

s O

bjec

tive:

Str

engt

hen

coor

dina

ted

surv

eilla

nce

syst

ems

for p

riorit

y zo

onot

ic d

isea

ses/

path

ogen

s

01N

O C

APAC

ITY

No

join

tly a

gree

d up

on li

st o

f prio

rity

dise

ases

to fo

cus

coor

dina

ted

surv

eilla

nce

effo

rts.

N

o or

gani

zed

coor

dina

ted

surv

eilla

nce

syst

em in

pla

ce to

con

nect

ani

mal

and

pub

lic h

ealth

sys

tem

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y ke

y st

akeh

olde

rs a

nd fo

cal p

oint

s fro

m a

nim

al h

ealth

(dom

estic

ani

mal

s an

d w

ildlif

e), h

uman

hea

lth, e

nviro

nmen

tal

heal

th a

nd o

ther

key

sec

tors

.

Revi

ew a

nd a

sses

s su

rvei

llanc

e ca

paci

ty in

eac

h se

ctor

and

any

exi

stin

g co

ordi

natio

n or

dat

a sh

arin

g m

echa

nism

bet

wee

n th

e re

leva

nt s

ecto

rs.

Jo

intly

defi

ne a

nd p

riorit

ize

zoon

otic

dis

ease

s of

gre

ates

t nat

iona

l pub

lic h

ealth

con

cern

for t

he c

ount

ry th

roug

h a

One

H

ealth

app

roac

h th

at in

volv

es a

ll re

leva

nt s

take

hold

ers.

D

evel

op s

trat

egy,

guid

elin

es a

nd S

OPs

for c

oord

inat

ed s

urve

illan

ce a

nd re

port

ing

of a

t lea

st tw

o pr

iorit

y zo

onot

ic d

isea

ses

of g

reat

est n

atio

nal p

ublic

hea

lth c

once

rn.

D

evel

op a

dequ

ate

labo

rato

ry c

apac

ity a

nd s

tand

ards

with

in re

leva

nt s

ecto

rs to

det

ect z

oono

tic d

isea

ses.

Dev

elop

ope

ratio

nal p

lans

for t

he m

anag

emen

t of a

t lea

st tw

o pr

iorit

y zo

onot

ic d

isea

ses

of g

reat

est n

atio

nal p

ublic

hea

lth

conc

ern.

D

evel

op a

nd d

isse

min

ate

trai

ning

pac

kage

s on

the

oper

atio

nal p

lan,

ass

ocia

ted

guid

elin

es a

nd S

OPs

.

Des

igna

te a

foca

l poi

nt o

r uni

t with

in th

e an

imal

and

hum

an h

ealth

sec

tors

and

oth

er re

leva

nt s

ecto

rs a

nd fo

rmal

ize

a co

ordi

natio

n m

echa

nism

for p

riorit

y zo

onot

ic d

isea

ses/

path

ogen

s.


37

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

anim

al–

hum

an in

terf

aces

and

pro

cedu

res

to e

xcha

nge

surv

eilla

nce

info

rmat

ion

on z

oono

tic d

isea

ses

amon

g re

leva

nt s

ecto

rs (a

nd w

ider

whe

n ne

eded

), id

eally

thro

ugh

an e

lect

roni

c sy

stem

.

Esta

blis

h an

inte

rope

rabi

lity

plat

form

or i

nfor

mat

ion

shar

ing

mec

hani

sm b

etw

een

the

rele

vant

sec

tors

to in

itiat

e co

ordi

nate

d su

rvei

llanc

e ac

tiviti

es.

Im

plem

ent t

he o

pera

tiona

l pla

n an

d al

loca

te re

sour

ces

for t

he p

reve

ntio

n an

d de

tect

ion

of p

riorit

y zo

onot

ic d

isea

ses

of

grea

test

nat

iona

l pub

lic h

ealth

con

cern

.

Trai

n re

spon

sibl

e st

aff f

or s

peci

fic a

spec

ts o

f the

sur

veill

ance

and

man

agem

ent o

f prio

rity

zoon

otic

dis

ease

s at

nat

iona

l and

su

bnat

iona

l lev

els.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ex

pand

labo

rato

ry-e

nhan

ced

coor

dina

ted

surv

eilla

nce

to a

ll pr

iorit

y zo

onot

ic d

isea

ses/

path

ogen

s at

all

leve

ls (n

atio

nal,

inte

rmed

iate

and

loca

l lev

els)

in a

ll se

ctor

s.

Enha

nce

the

inte

rope

rabi

lity

plat

form

or i

nfor

mat

ion

shar

ing

mec

hani

sm b

etw

een

the

rele

vant

sec

tors

, ide

ally

thro

ugh

linki

ng e

xist

ing

or e

stab

lishi

ng n

ew e

lect

roni

c sy

stem

s w

here

app

licab

le.

Tr

ain

addi

tiona

l sta

ff ac

ross

all

rele

vant

sec

tors

in th

e su

rvei

llanc

e an

d m

anag

emen

t of z

oono

tic d

isea

ses

at s

ubna

tiona

l le

vels

.

Use

coo

rdin

ated

sur

veill

ance

dat

a to

info

rm d

isea

se p

reve

ntio

n an

d co

ntro

l effo

rts

acro

ss a

ll re

leva

nt s

ecto

rs.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Al

loca

te a

vaila

ble

and

sust

aina

ble

reso

urce

s fo

r coo

rdin

ated

sur

veill

ance

and

man

agem

ent o

f all

prio

rity

zoon

otic

dis

ease

s ac

ross

rele

vant

sec

tors

.

Test

sur

veill

ance

sys

tem

cap

acity

regu

larly

with

all

rele

vant

sec

tors

to d

etec

t zoo

notic

eve

nts

and

the

man

agem

ent o

f zo

onot

ic d

isea

ses

eith

er b

y an

afte

r-ac

tion

revi

ew o

r sim

ulat

ion

exer

cise

.

Use

coo

rdin

ated

sur

veill

ance

dat

a to

info

rm a

nd e

valu

ate

dise

ase

prev

entio

n an

d co

ntro

l effo

rts

acro

ss a

ll re

leva

nt s

ecto

rs.

Ba

sed

on th

e re

sults

of t

hese

exe

rcis

es o

r rev

iew

s, u

pdat

e th

e gu

idel

ines

, SO

Ps a

nd o

pera

tiona

l pla

n w

here

app

ropr

iate

.


38

CAPA

CITY

LEVE

L

Benc

hmar

k 4.

2: F

unct

iona

l mec

hani

sm to

resp

ond

to p

riorit

y zo

onot

ic d

isea

ses

in p

lace

O

bjec

tive:

Str

engt

hen

mec

hani

sm to

resp

ond

to z

oono

tic d

isea

ses

01N

O C

APAC

ITY

No

coor

dina

ted

resp

onse

mec

hani

sm fo

r prio

rity

zoon

otic

dis

ease

s.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

and

ass

ess

exis

ting

mul

tisec

tora

l pol

icy,

stra

tegy

, pla

n an

d/or

mec

hani

sm fo

r res

pond

ing

to p

riorit

y zo

onot

ic e

vent

s.

Dev

elop

gui

delin

es a

nd S

OPs

for c

oord

inat

ed re

spon

se to

zoo

notic

eve

nts

and

mor

e w

idel

y fo

r the

man

agem

ent o

f prio

rity

zoon

otic

dis

ease

s by

all

rele

vant

sec

tors

.

Des

igna

te a

foca

l poi

nt fr

om e

ach

sect

or (a

nim

al (d

omes

tic a

nim

als

and

wild

life)

, hum

an a

nd e

nviro

nmen

tal h

ealth

) for

re

spon

se c

oord

inat

ion.

D

evel

op a

nd d

isse

min

ate

trai

ning

pac

kage

s on

thes

e gu

idel

ines

and

SO

Ps.

Pu

blis

h th

ese

polic

ies/

stra

tegi

es a

nd p

lan.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

mul

tisec

tora

l One

Hea

lth o

pera

tiona

l pla

n, w

ith th

e pr

ovis

ion

of re

sour

ces,

for a

coo

rdin

ated

resp

onse

to a

n ou

tbre

ak o

f at l

east

two

prio

rity

zoon

otic

dis

ease

s by

all

rele

vant

sec

tors

.

Trai

n st

aff o

f hum

an, a

nim

al (d

omes

tic a

nim

als

and

wild

life)

, and

env

ironm

enta

l hea

lth s

ecto

rs o

n th

ese

guid

elin

es, S

OPs

an

d op

erat

ion

plan

.

Esta

blis

h a

com

mun

icat

ion

mec

hani

sm fo

r rap

idly

ale

rtin

g al

l rel

evan

t sec

tors

to p

riorit

y zo

onot

ic o

utbr

eak

even

ts to

in

crea

se s

ecto

r aw

aren

ess

and

decr

ease

the

time

to c

ondu

ct a

coo

rdin

ated

out

brea

k re

spon

se.

En

sure

that

acc

ess

to la

bora

tory

cap

acity

to d

etec

t pat

hoge

ns fo

r any

prio

rity

zoon

oses

is in

clud

ed in

the

resp

onse

pla

ns.


39

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

isse

min

ate

and

expa

nd th

e op

erat

iona

l pla

n to

resp

ond

to a

ll pr

iorit

y zo

onot

ic d

isea

ses

to th

e in

term

edia

te a

nd lo

cal l

evel

s fo

r all

the

rele

vant

sec

tors

.

Regu

larly

ana

lyse

and

pro

duce

repo

rts

on th

e tim

elin

ess

of in

form

atio

n ex

chan

ge a

nd a

ctiv

atio

n of

resp

onse

mec

hani

sms

betw

een

sect

ors.

D

evel

op n

ext s

teps

for i

mpr

ovin

g re

spon

se ti

mel

ines

.

Mon

itor a

nd e

valu

ate

the

mul

tisec

tora

l coo

rdin

atio

n m

echa

nism

for c

resp

onse

regu

larly

.

Revi

ew a

nd u

pdat

e th

e op

erat

iona

l pla

n/m

echa

nism

bas

ed o

n th

e re

sults

of m

onito

ring

and

eval

uatio

n.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t afte

r-ac

tion

revi

ews

and/

or s

imul

atio

n ex

erci

ses

to te

st th

e op

erat

iona

lity

of th

e re

spon

se to

zoo

notic

dis

ease

s ev

ents

acr

oss

all r

elev

ant s

ecto

rs.

Re

view

and

upd

ate

the

oper

atio

nal p

lan/

mec

hani

sm b

ased

on

the

resu

lts.

D

ocum

ent a

nd d

isse

min

ate

the

resu

lts a

nd le

sson

s le

arne

d fro

m e

ffort

s to

min

imiz

e an

imal

-to-

hum

an s

prea

d of

dis

ease

.

TOO

LS:

Im

plem

enta

tion

of th

e IH

R at

the

hum

an-a

nim

al-h

ealth

inte

rfac

e

Glo

bal e

arly

war

ning

sys

tem

for m

ajor

ani

mal

dis

ease

incl

udin

g zo

onos

es (G

LEW

S)

Man

agin

g pu

blic

hea

lth ri

sks

at th

e hu

man

-ani

mal

-env

ironm

ent i

nter

face

N

egle

cted

zoo

notic

dis

ease

Zo

onot

ic d

isea

ses

Zo

onot

ic d

isea

ses:

a g

uide

to e

stab

lishi

ng c

olla

bora

tion

betw

een

anim

al a

nd h

uman

hea

lth s

ecto

rs a

t the

cou

ntry

leve

l.

Zoon

otic

– S

urve

illan

ce a

nd C

ontro

l

One

Hea

lth

Anim

al H

ealth

in th

e W

orld

Re

sour

ces

– W

orld

org

anis

atio

n of

ani

mal

hea

lth (O

IE)

O

IE in

tern

atio

nal s

tand

ards

H

andb

ook

for t

he a

sses

smen

t of c

apac

ities

at t

he h

uman

–an

imal

inte

rface

. Wor

ld H

ealth

Org

aniz

atio

n an

d th

e W

orld

Org

anis

atio

n fo

r Ani

mal

Hea

lth; 2

017


40

FOO

D SA

FETY

05

IMPA

CT:

Tim

ely

dete

ctio

n an

d ef

fect

ive

resp

onse

of p

oten

tial f

ood-

rela

ted

even

ts in

col

labo

ratio

n w

ith o

ther

sec

tors

resp

onsi

ble

for f

ood

safe

ty.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Exi

sten

ce o

f ind

icat

or-b

ased

dis

ease

sur

veilla

nce

or e

vent

-bas

ed d

isea

se s

urve

illanc

e an

d su

ppor

ting

labo

rato

ry a

naly

sis

to d

etec

t and

ass

ign

aetio

logy

for f

oodb

orne

dis

ease

s or

orig

in o

f con

tam

inat

ion

even

t, an

d in

vest

igat

ion

of h

azar

ds in

food

s lin

ked

to c

ases

, out

brea

ks o

r eve

nts.

(2

) Exi

sten

ce o

f a n

atio

nal f

ood

safe

ty e

mer

genc

y pl

an. (

3) E

xist

ence

of a

des

igna

ted

Inte

rnat

iona

l Foo

d Sa

fety

Aut

horit

ies

Net

wor

k (IN

FOSA

N)

Emer

genc

y Co

ntac

t Poi

nt, a

nd th

e O

IE F

ocal

Poi

nt o

n An

imal

Pro

duct

ion

Food

Saf

ety

with

a c

entr

al c

oord

inat

ion

mec

hani

sm in

pla

ce.

A fu

nctio

nal s

yste

m is

in p

lace

for s

urve

illan

ce a

nd re

spon

se c

apac

ity o

f Sta

tes

Part

ies

for f

oodb

orne

dis

ease

and

food

con

tam

inat

ion

risks

or e

vent

s w

ith

effe

ctiv

e co

mm

unic

atio

n an

d co

llabo

ratio

n am

ong

the

sect

ors

resp

onsi

ble

for f

ood

safe

ty.


41

CAPA

CITY

LEVE

L

Benc

hmar

k 5.

1: S

urve

illan

ce s

yste

ms

in p

lace

for t

he d

etec

tion

and

mon

itorin

g of

food

born

e di

seas

es a

nd fo

od c

onta

min

atio

n O

bjec

tive:

Str

engt

hen

surv

eilla

nce

syst

ems

for f

oodb

orne

dis

ease

s an

d fo

od c

onta

min

atio

n

01N

O C

APAC

ITY

No

or v

ery

limite

d su

rvei

llanc

e sy

stem

in p

lace

for f

oodb

orne

dis

ease

or f

or fo

od c

onta

min

atio

n (c

hem

ical

and

mic

robi

olog

ical

) m

onito

ring.

Th

e co

untr

y ha

s to

dev

elop

and

impl

emen

t all

activ

ities

that

are

list

ed in

leve

l 2 to

ach

ieve

lim

ited

capa

city

for t

he s

urve

illan

ce

syst

em.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

food

born

e di

seas

e su

rvei

llanc

e an

d fo

od c

onta

min

atio

n m

onito

ring

capa

city

, and

ass

ess

gaps

and

nee

ds.

Id

entif

y ke

y st

akeh

olde

rs a

nd

foca

l poi

nts

for f

oodb

orne

dis

ease

su

rvei

llanc

e an

d fo

od c

onta

min

atio

n m

onito

ring.

Id

entif

y re

spon

sibl

e gr

oups

in re

leva

nt

agen

cies

to c

oord

inat

e de

velo

pmen

t an

d im

plem

enta

tion

of fo

odbo

rne

dise

ase

surv

eilla

nce

and

food

co

ntam

inat

ion

mon

itorin

g sy

stem

(s).

D

evel

op a

str

ateg

y to

mon

itor

trend

s an

d de

tect

food

born

e ev

ents

to

inco

rpor

ate

with

in th

e na

tiona

l co

mm

unic

able

dis

ease

sur

veill

ance

st

rate

gy (s

ee s

urve

illan

ce te

chni

cal

area

).

Link

sur

veill

ance

act

iviti

es w

ith th

e su

rvei

llanc

e te

chni

cal a

rea

benc

hmar

ks.

Esta

blis

h in

dica

tor-

base

d di

seas

e su

rvei

llanc

e (o

r)

D

evel

op g

uide

lines

and

SO

Ps fo

r pr

iorit

y fo

odbo

rne

dise

ases

.

Esta

blis

h a

desi

gnat

ed u

nit a

t all

leve

ls w

ith o

pera

tiona

l pla

n an

d pr

oced

ures

.

Esta

blis

h an

d di

ssem

inat

e ca

se

defin

ition

s, p

roce

ss o

f det

ectio

n,

asse

ssm

ent a

nd re

port

ing

of c

ases

(u

ser m

anua

l or g

uide

lines

) to

natio

nal a

nd s

ubna

tiona

l lev

els.

Esta

blis

h ev

ent-

base

d di

seas

e su

rvei

llanc

e

D

evel

op g

uide

lines

and

SO

PS.

Es

tabl

ish

a de

sign

ated

uni

t at a

ll ne

eded

leve

ls w

ith o

pera

tiona

l pla

n an

d pr

oced

ures

.

Dev

elop

and

put

in p

lace

cas

e de

finiti

ons,

pro

cess

of d

etec

tion,

as

sess

men

t and

repo

rtin

g of

ev

ents

(clu

ster

s or

out

brea

ks)

for c

ount

ry p

riorit

y di

seas

es, a

nd

diss

emin

atio

n to

nat

iona

l and

su

bnat

iona

l lev

els.

Es

tabl

ish

a pr

oces

s to

cap

ture

ev

ents

from

com

mun

ity a

nd o

ther

so

urce

s (s

uch

as m

edia

, soc

ial

med

ia, p

rivat

e se

ctor

), an

d m

ake

the

data

ava

ilabl

e at

all

need

ed

leve

ls.


42

D

evel

op g

uide

lines

and

SO

Ps fo

r the

de

tect

ion

of fo

odbo

rne

even

ts a

nd

impl

emen

t ind

icat

or-/

even

t-ba

sed

dise

ase

surv

eilla

nce

(refe

r to

indi

cato

r-/

even

t-ba

sed

dise

ase

surv

eilla

nce

colu

mns

for r

espe

ctiv

e be

nchm

arks

).13

D

evel

op a

nd d

isse

min

ate

a tr

aini

ng

pack

age

on th

ese

guid

elin

es a

nd S

OPs

.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

ctio

ns (d

escr

ibed

abo

ve) f

or b

oth

indi

cato

r- a

nd e

vent

-bas

ed d

isea

se s

urve

illan

ce s

yste

ms

at n

atio

nal a

nd

inte

rmed

iate

leve

ls (d

istr

ict,

prov

ince

, reg

ion

or s

tate

).

Dev

elop

a la

bora

tory

pro

toco

l for

the

inve

stig

atio

n of

food

born

e di

seas

es a

nd fo

od c

onta

min

atio

n.

Trai

n st

aff o

n th

ese

prot

ocol

s w

ith th

e pr

ovis

ion

of la

bora

tory

logi

stic

s in

des

igna

ted

labo

rato

ries.

En

sure

pro

visi

on o

f res

ourc

es fo

r the

inve

stig

atio

n of

food

born

e di

seas

e or

food

con

tam

inat

ion

even

ts a

t the

nat

iona

l lev

el.

This

sho

uld

incl

ude

inve

stig

atio

ns in

to h

azar

ds in

food

s lin

ked

to c

ases

, out

brea

ks o

r eve

nts.

Te

st fo

r foo

dbor

ne d

isea

ses

and/

or c

onta

min

atio

n fo

r the

cas

es o

r eve

nts

dete

cted

thro

ugh

indi

cato

r- o

r eve

nt-b

ased

di

seas

e su

rvei

llanc

e to

ass

ign

aetio

logy

.

Dev

elop

or a

dopt

the

risk

asse

ssm

ent p

roto

col o

f acu

te fo

odbo

rne

even

ts (c

hem

ical

and

mic

robi

olog

ical

).14

D

evel

op a

n in

form

atio

n-sh

arin

g pr

otoc

ol a

nd m

echa

nism

that

will

app

ly to

all

rele

vant

sta

keho

lder

s in

volv

ed in

food

born

e di

seas

e su

rvei

llanc

e an

d fo

od c

onta

min

atio

n m

onito

ring.

15, 2

2

13 S

treng

then

ing

surv

eilla

nce

of a

nd re

spon

se to

food

born

e di

seas

es.

14 F

ood

safe

ty ri

sk a

naly

sis:

A g

uide

for n

atio

nal f

ood

safe

ty a

utho

ritie

s. R

ome:

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n of

the

Uni

ted

Nat

ions

; 200

9.

15 A

ssur

ing

food

saf

ety

and

qual

ity: g

uide

lines

for s

treng

then

ing

natio

nal f

ood

cont

rol s

yste

ms.

Rom

e: F

ood

and

Agric

ultu

re O

rgan

izat

ion

of th

e U

nite

d N

atio

ns.


43

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Tr

ain

staf

f at n

atio

nal a

nd s

ubna

tiona

l lev

els

to c

ondu

ct ri

sk a

sses

smen

t of a

cute

food

born

e ev

ents

.

Allo

cate

or i

dent

ify re

sour

ces

for s

uch

trai

ning

and

risk

ass

essm

ents

.

Cond

uct r

isk

asse

ssm

ents

of a

cute

food

born

e ev

ents

(che

mic

al a

nd m

icro

biol

ogic

al) a

nd p

ublis

h a

perio

dic

repo

rt (s

uch

as

an e

pide

mio

logi

cal b

ulle

tin).16

,17,

18,1

9

Tr

ain

iden

tified

food

born

e di

seas

e su

rvei

llanc

e an

d fo

od c

onta

min

atio

n m

onito

ring

foca

l poi

nts

in th

e su

rvei

llanc

e of

suc

h ha

zard

s.

Cond

uct a

Tot

al D

iet S

tudy

or s

imila

r stu

dy a

nd im

plem

ent o

utco

mes

to c

ompl

emen

t the

exi

stin

g na

tiona

l mon

itorin

g an

d su

rvei

llanc

e st

rate

gy.20

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t an

afte

r-ac

tion

revi

ew o

f a fo

odbo

rne

even

t or a

sim

ulat

ion

exer

cise

in th

e ab

senc

e of

a re

al e

vent

to te

st th

e ca

paci

ty o

f sur

veill

ance

and

mon

itorin

g sy

stem

s.

Doc

umen

t find

ings

and

iden

tify

area

s fo

r im

prov

emen

t; up

date

the

stra

tegy

, gui

delin

es a

nd S

OPs

, if a

ppro

pria

te.

Sh

are

outc

ome

with

all

rele

vant

sta

keho

lder

s.

16 P

rinci

ples

and

met

hods

for t

he ri

sk a

sses

smen

t of c

hem

ical

s in

food

: Env

ironm

enta

l Hea

lth C

riter

ia 2

40. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

9.

17 H

azar

d ch

arac

teriz

atio

n fo

r pat

hoge

ns in

food

and

wat

er: M

icro

biol

ogic

al ri

sk a

sses

smen

t ser

ies

3, g

uide

lines

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

003.

18

Exp

osur

e as

sess

men

t of m

icro

biol

ogic

al h

azar

ds in

food

: Mic

robi

olog

ical

risk

ass

essm

ent s

erie

s 7,

gui

delin

es. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

8.

19 R

isk

char

acte

rizat

ion

of m

icro

biol

ogic

al h

azar

ds in

food

: Mic

robi

olog

ical

risk

ass

essm

ent s

erie

s 17

, gui

delin

es. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

9.

20 T

owar

ds a

har

mon

ised

tota

l die

t stu

dy a

ppro

ach:

a g

uida

nce

docu

men

t. W

orld

Hea

lth O

rgan

izat

ion,

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n of

the

Uni

ted

Nat

ions

and

Eur

opea

n Fo

od S

afet

y Au

thor

ity; 2

011.


44

CAPA

CITY

LEVE

L

Benc

hmar

k 5.

2: A

func

tiona

l mec

hani

sm is

in p

lace

for t

he re

spon

se a

nd m

anag

emen

t of f

ood

safe

ty e

mer

genc

ies

Obj

ectiv

e: S

tren

gthe

n m

echa

nism

s fo

r res

pons

e an

d m

anag

emen

t of f

ood

safe

ty e

mer

genc

ies

01N

O C

APAC

ITY

No

mec

hani

sm fo

r the

resp

onse

and

man

agem

ent o

f foo

d sa

fety

em

erge

ncie

s ha

s be

en e

stab

lishe

d or

in p

lace

, or i

s ve

ry

limite

d.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

the

mec

hani

sm, i

f it e

xist

s, fo

r the

resp

onse

and

man

agem

ent o

f foo

d sa

fety

em

erge

ncie

s to

iden

tify

and

asse

ss

gaps

and

nee

ds, w

ith re

fere

nce

to re

leva

nt F

ood

and

Agric

ultu

re O

rgan

izat

ion

(FAO

)/W

HO

gui

delin

es.21

,22,

23,2

4

Id

entif

y ke

y go

vern

men

t age

ncie

s in

volv

ed in

the

resp

onse

and

man

agem

ent o

f foo

d sa

fety

em

erge

ncie

s.

Dev

elop

SO

Ps a

nd g

uide

lines

for t

he re

spon

se a

nd m

anag

emen

t of f

ood

safe

ty e

mer

genc

ies

(The

se g

uide

lines

sho

uld

be

part

of t

he o

vera

ll su

rvei

llanc

e gu

idel

ine

for f

oodb

orne

dis

ease

s an

d co

ntam

inat

ion)

.25

D

esig

nate

an

INFO

SAN

Em

erge

ncy

Cont

act P

oint

in th

e go

vern

men

t age

ncy

resp

onsi

ble

for t

he re

spon

se a

nd m

anag

emen

t of

food

saf

ety

emer

genc

ies.

26

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

com

mun

icat

ion

chan

nels

am

ong

all r

elev

ant s

ecto

rs in

clud

ing

betw

een

the

INFO

SAN

Em

erge

ncy

Cont

act P

oint

an

d th

e IH

R N

atio

nal F

ocal

Poi

nt.

D

esig

nate

INFO

SAN

Foc

al P

oint

s w

ith re

spon

sibi

lity

for f

ood

safe

ty a

t app

ropr

iate

leve

ls in

oth

er g

over

nmen

t age

ncie

s.

Deve

lop

a co

ordi

natio

n m

echa

nism

with

SOP

s lin

king

all r

elev

ant s

ecto

rs to

geth

er w

ith a

defi

ned

set o

f rol

es a

nd re

spon

sibi

litie

s.

Dev

elop

and

dis

sem

inat

e tr

aini

ng p

acka

ges

on S

OPs

and

gui

delin

es fo

r the

resp

onse

and

man

agem

ent o

f foo

d sa

fety

em

erge

ncie

s.

21 F

AO/W

HO

fram

ewor

k fo

r dev

elop

ing

natio

nal f

ood

safe

ty e

mer

genc

y re

spon

se p

lans

. Rom

e: F

ood

and

Agric

ultu

re O

rgan

izat

ion

of th

e U

nite

d N

atio

ns a

nd W

orld

Hea

lth O

rgan

izat

ion;

201

0.22

FAO

/WH

O g

uide

for a

pplic

atio

n of

risk

ana

lysi

s pr

inci

ples

and

pro

cedu

res

durin

g fo

od s

afet

y em

erge

ncie

s. R

ome:

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n of

the

Uni

ted

Nat

ions

; 201

1.

23 F

AO/W

HO

gui

de fo

r dev

elop

ing

and

impr

ovin

g na

tiona

l foo

d re

call

syst

ems.

Rom

e: F

ood

and

Agric

ultu

re O

rgan

izat

ion

of th

e U

nite

d N

atio

ns a

nd W

orld

Hea

lth O

rgan

izat

ion;

201

2.

24 F

oodb

orne

dis

ease

out

brea

ks: g

uide

lines

for i

nves

tigat

ion

and

cont

rol.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

008.

25

Ris

k m

anag

emen

t and

food

saf

ety:

cons

ulta

tion

repo

rt. R

ome:

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n of

the

Uni

ted

Nat

ions

; 199

8.

26 IN

FOSA

N m

embe

r rol

es a

nd re

spon

sibi

litie

s. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

5.


45

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op s

trat

egie

s an

d gu

idan

ce to

com

mun

icat

e w

ith p

artn

ers,

sta

keho

lder

s, g

ener

al p

ublic

, int

erna

tiona

l org

aniz

atio

ns

and

appl

icab

le re

gion

al a

nd in

tern

atio

nal n

etw

orks

, and

orie

nt th

em o

n th

ese

stra

tegi

es a

nd g

uida

nce.

27

D

evel

op a

nd d

isse

min

ate

risk

com

mun

icat

ion

mes

sage

s to

the

publ

ic, t

hrou

gh a

ppro

pria

te m

edia

, dur

ing

food

saf

ety

emer

genc

ies.

28

Es

tabl

ish

info

rmat

ion

shar

ing

mec

hani

sms

at re

gion

al a

nd in

tern

atio

nal l

evel

s.

Esta

blis

h a

mec

hani

sm o

f sha

ring

info

rmat

ion

regu

larly

by

the

INFO

SAN

Em

erge

ncy

Cont

act P

oint

with

the

IHR

NFP

, IN

FOSA

N F

ocal

Poi

nts

and

all r

elev

ant s

ecto

rs d

urin

g a

food

saf

ety

emer

genc

y.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t afte

r-ac

tion

revi

ews

of re

spon

se to

food

saf

ety

even

ts o

r dev

elop

an

exer

cise

in th

e ab

senc

e of

a re

al e

vent

to

asse

ss a

nd re

view

the

resp

onse

, col

labo

ratio

n an

d co

mm

unic

atio

n m

echa

nism

s.

Ensu

re p

artic

ipat

ion

of th

e IN

FOSA

N E

mer

genc

y Co

ntac

t Poi

nt in

INFO

SAN

sim

ulat

ion

exer

cise

s or

real

food

saf

ety

emer

genc

ies,

with

the

INFO

SAN

Sec

reta

riat.

D

ocum

ent a

nd d

isse

min

ate

the

findi

ngs

in te

rms

of ti

mel

ines

s, in

form

atio

n ex

chan

ge, p

ublic

hea

lth ri

sk m

essa

ging

, ef

ficie

ncy

and

effe

ctiv

enes

s of

resp

onse

, col

labo

ratio

n an

d co

mm

unic

atio

n.

Revi

ew a

nd u

pdat

e th

e m

anag

emen

t and

resp

onse

pla

n ba

sed

on th

ese

findi

ngs.

27 A

ssur

ing

food

saf

ety

and

qual

ity: g

uide

lines

for s

treng

then

ing

natio

nal f

ood

cont

rol s

yste

ms.

Rom

e: F

ood

and

Agric

ultu

re O

rgan

izat

ion

of th

e U

nite

d N

atio

ns; 2

003.

28

Ris

k co

mm

unic

atio

n ap

plie

d to

food

saf

ety

hand

book

(201

6). R

ome:

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n of

the

Uni

ted

Nat

ions

and

Wor

ld H

ealth

Org

aniz

atio

n; 2

017.

TOO

LS:

Fo

od s

afet

y. [W

HO

web

site

] (ht

tp://

ww

w.w

ho.in

t/fo

odsa

fety

/en/

, acc

esse

d 30

Jan

uary

201

9).


46

IMM

UN

IZAT

ION

06

IMPA

CT:

Effe

ctiv

e pr

otec

tion

thro

ugh

achi

evem

ent a

nd m

aint

enan

ce o

f im

mun

izat

ion

agai

nst m

easl

es a

nd o

ther

epi

dem

ic-p

rone

vac

cine

-pre

vent

able

di

seas

es (V

PDs)

. Mea

sles

imm

uniz

atio

n is

em

phas

ized

bec

ause

it is

wid

ely

reco

gniz

ed a

s a

prox

y in

dica

tor f

or o

vera

ll im

mun

izat

ion

agai

nst V

PDs

and

beca

use

mea

sles

is a

con

tinue

d ca

use

of s

ubst

antia

l avo

idab

le m

orbi

dity

and

mor

talit

y. C

ount

ries

will

als

o id

entif

y an

d ta

rget

imm

uniz

atio

n to

pop

ulat

ions

at r

isk

of o

ther

epi

dem

ic-p

rone

VPD

s of

nat

iona

l im

port

ance

(suc

h as

cho

lera

, Jap

anes

e en

ceph

aliti

s, m

enin

goco

ccal

dis

ease

, ty

phoi

d an

d ye

llow

feve

r). D

isea

ses

that

are

tran

sfer

able

from

ani

mal

s to

hum

ans,

suc

h as

ant

hrax

and

rabi

es, a

re a

lso

incl

uded

.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: 90

-95%

cov

erag

e of

the

coun

try’

s 12

-mon

th-o

ld p

opul

atio

n w

ith a

t lea

st o

ne d

ose

of m

easl

es-c

onta

inin

g va

ccin

e (M

CV),

as d

emon

stra

ted

by

cove

rage

sur

veys

.

A na

tiona

l vac

cine

del

iver

y sy

stem

is in

pla

ce –

with

nat

ionw

ide

reac

h, e

ffect

ive

dist

ribut

ion,

eas

y ac

cess

for m

argi

naliz

ed p

opul

atio

ns, a

dequ

ate

cold

cha

in

and

ongo

ing

qual

ity c

ontro

l – to

resp

ond

to e

xist

ing

and

new

dis

ease

thre

ats.


47

CAPA

CITY

LEVE

L

Benc

hmar

k 6.

1: O

ptim

um v

acci

ne c

over

age

(mea

sles

) as

part

of a

nat

iona

l pro

gram

me

Obj

ectiv

e: In

crea

se v

acci

ne c

over

age

for p

riorit

y va

ccin

e pr

even

tabl

e di

seas

es in

the

coun

try

01N

O C

APAC

ITY

Less

than

50%

of t

he c

ount

ry’s

12-

mon

th-o

ld p

opul

atio

n ha

s re

ceiv

ed a

t lea

st o

ne d

ose

of M

CV, a

s de

mon

stra

ted

by c

over

age

surv

eys

or a

dmin

istr

ativ

e da

ta.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

As

sess

and

map

exi

stin

g co

vera

ge d

ata

to id

entif

y hi

gh-r

isk

area

s an

d po

pula

tions

to ta

rget

con

trol o

f sel

ecte

d VP

Ds.

Ev

alua

te im

mun

izat

ion

surv

eilla

nce

data

, im

mun

izat

ion

regi

strie

s, im

mun

izat

ion

data

and

repo

rtin

g sy

stem

s to

iden

tify

area

s fo

r stre

ngth

enin

g of

imm

uniz

atio

n da

ta m

anag

emen

t.

Esta

blis

h a

mul

tista

keho

lder

wor

king

gro

up to

dev

elop

pla

ns to

est

ablis

h a

natio

nal v

acci

natio

n re

gist

ry.

In

tegr

ate

the

WH

O G

loba

l Vac

cine

Act

ion

Plan

era

dica

tion

and

elim

inat

ion

goal

s in

to th

e na

tiona

l im

mun

izat

ion

plan

.

Dev

elop

and

dis

sem

inat

e gu

idan

ce a

nd to

ols

to in

crea

se ro

utin

e im

mun

izat

ion

serv

ices

, with

a fo

cus

on fi

rst-

dose

mea

sles

co

vera

ge a

nd c

ondu

ct a

ctiv

ities

to e

nsur

e 50

–69

% fi

rst-

dose

mea

sles

cov

erag

e of

the

coun

try’

s 12

-mon

th-o

ld p

opul

atio

n w

ith a

t lea

st o

ne d

ose

of M

CV.

D

evel

op p

lans

to p

erfo

rm c

atch

-up

cam

paig

ns o

r sup

plem

enta

l im

mun

izat

ion

activ

ities

, bas

ed o

n ep

idem

iolo

gic

and

cove

rage

dat

a.

Dev

elop

a s

tand

ardi

zed

syst

em o

f mon

itorin

g an

d re

port

ing

of a

dver

se e

vent

s fo

llow

ing

imm

uniz

atio

n.


48

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

U

se m

appi

ng a

nd a

sses

smen

t dat

a to

pla

n ta

rget

ed a

ctiv

ities

for r

outin

e an

d su

pple

men

tal i

mm

uniz

atio

n fo

r hig

h-ris

k ar

eas

and

popu

latio

ns.

In

trodu

ce th

e na

tiona

l vac

cine

regi

stry

in ta

rget

juris

dict

ions

.

Fina

lize

and

appr

ove

a na

tiona

l im

mun

izat

ion

plan

to: i

mpr

ove

cove

rage

and

intro

duce

vac

cine

into

targ

eted

pop

ulat

ions

, de

velo

p st

eps

to o

pera

tiona

lize

the

plan

, and

dis

sem

inat

e th

e im

mun

izat

ion

plan

to k

ey s

take

hold

ers.

D

isse

min

ate

mes

sagi

ng to

ols

to im

prov

e kn

owle

dge-

base

d ca

paci

ties

(com

mun

icat

ion

and

educ

atio

n) o

f hea

lthca

re s

taff

for c

omm

unity

soc

ializ

atio

n.

Dev

elop

gui

delin

es, S

OPs

, tra

inin

g m

ater

ials

and

tool

kits

on

pre-

and

pos

tser

vice

gui

danc

e fo

r im

mun

izat

ions

; and

trai

n he

alth

care

wor

kers

.

Cond

uct a

ctiv

ities

to a

chie

ve 7

0–89

% fi

rst-

dose

mea

sles

cov

erag

e of

the

coun

try’

s 12

-mon

th-o

ld p

opul

atio

n w

ith a

t lea

st

one

dose

of M

CV.

D

evel

op g

uide

lines

and

tool

s fo

r saf

ety

and

was

te m

anag

emen

t and

dis

sem

inat

e to

all

heal

th fa

cilit

ies.

O

pera

tiona

lize

a st

anda

rdiz

ed s

yste

m o

f mon

itorin

g an

d re

port

ing

of a

dver

se e

vent

s fo

llow

ing

imm

uniz

atio

n (A

EFIs

) at a

ll he

alth

faci

litie

s.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd im

plem

ent s

trat

egie

s to

incr

ease

imm

uniz

atio

n co

vera

ge in

all

grou

ps w

ith <

90%

firs

t-do

se M

CV c

over

age.

Im

plem

ent a

nat

iona

l pla

n, fi

naliz

ed a

nd a

ppro

ved

by n

atio

nal a

nd s

tate

/dis

tric

t/pr

ovin

ce a

utho

ritie

s, to

ach

ieve

95%

na

tiona

l lev

el c

over

age

by 2

020.

D

evel

op q

ualit

y as

sura

nce

stan

dard

s an

d m

echa

nism

s fo

r im

mun

izat

ions

at d

esig

nate

d he

alth

faci

litie

s.

Cond

uct a

ctiv

ities

to e

nsur

e 90

% fi

rst-

dose

mea

sles

cov

erag

e of

the

coun

try’

s 12

-mon

th-o

ld p

opul

atio

n w

ith a

t lea

st o

ne

dose

of M

CV.

Im

plem

ent a

rout

ine

mon

itorin

g an

d ev

alua

tion

syst

em fo

r hea

lth w

orke

rs w

ho p

erfo

rm im

mun

izat

ion.

Pr

omot

e im

mun

izat

ions

and

sen

sitiz

e co

mm

uniti

es th

roug

h ro

utin

e m

essa

ging

via

trad

ition

al/s

ocia

l med

ia, a

nd e

ngag

ing

civi

l soc

iety

org

aniz

atio

ns a

nd re

ligio

us le

ader

s.

Eval

uate

and

val

idat

e th

e AE

FI re

port

ing

syst

em.


49

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Se

cure

sus

tain

able

dom

estic

fund

ing

for i

mm

uniz

atio

ns.

Es

tabl

ish

full

func

tiona

lity

and

inte

grat

e th

e na

tiona

l vac

cine

regi

stry

with

nat

iona

l hea

lth in

form

atio

n sy

stem

s,

if ap

prop

riate

to th

e na

tiona

l con

text

.

Cond

uct a

ctiv

ities

to e

nsur

e 95

% fi

rst-

dose

mea

sles

cov

erag

e of

the

coun

try’

s 12

-mon

th-o

ld p

opul

atio

n w

ith a

t lea

st o

ne

dose

of M

CV.

Co

nduc

t for

mal

sur

veys

of h

ard-

to-r

each

are

as to

ens

ure

that

cov

erag

e ra

tes

amon

g vu

lner

able

pop

ulat

ions

are

>90

%.

Co

nduc

t an

eval

uatio

n of

sur

veill

ance

dat

a to

ens

ure

that

the

case

-bas

ed s

urve

illan

ce s

yste

m is

suf

ficie

ntly

sen

sitiv

e to

de

tect

cas

es (s

uch

as m

easl

es im

mun

oglo

bulin

M n

egat

ive

febr

ile ra

sh in

cide

nce

rate

≥2

per 1

00 0

00 p

opul

atio

n) a

t the

di

stric

t/pr

ovin

ce/s

tate

leve

ls.


50

CAPA

CITY

LEVE

L

Benc

hmar

k 6.

2: P

rovi

sion

of n

atio

nal v

acci

ne a

cces

s an

d de

liver

y O

bjec

tive:

Str

engt

heni

ng c

apac

ity fo

r vac

cine

acc

ess

and

deliv

ery

to ta

rget

pop

ulat

ion

01N

O C

APAC

ITY

No

plan

is in

pla

ce fo

r nat

ionw

ide

vacc

ine

deliv

ery,

nor h

ave

plan

s be

en d

rafte

d to

pro

vide

vac

cine

s th

roug

hout

the

coun

try

to

targ

et p

opul

atio

ns; o

r ina

dequ

ate

vacc

ine

proc

urem

ent a

nd fo

reca

stin

g ha

s le

d to

regu

lar s

tock

-out

s at

the

cent

ral o

r dis

tric

t le

vels

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

mpl

ete

a re

view

of p

lans

, pol

icie

s an

d pr

oced

ures

for v

acci

ne d

eliv

ery

syst

ems

and

use

resu

lts to

gui

de v

acci

ne

proc

urem

ent,

acce

ss a

nd d

eliv

ery

of ta

rget

ed v

acci

nes.

Co

mpl

ete

a re

view

of c

old-

chai

n qu

ality

ass

uran

ce a

nd s

afet

y m

easu

res

with

in v

acci

ne s

tora

ge a

nd d

eliv

ery

syst

ems

to

optim

ize

supp

ly c

hain

man

agem

ent.

Re

view

nat

iona

l law

s an

d re

gula

tions

for t

he p

rocu

rem

ent o

f vac

cine

s fro

m n

atio

nal a

nd in

tern

atio

nal s

ourc

es d

urin

g pu

blic

he

alth

em

erge

ncie

s.

Iden

tify

barr

iers

to p

rocu

ring,

rece

ivin

g, s

torin

g an

d de

ploy

ing

vacc

ines

to ta

rget

ed p

opul

atio

ns.

D

evel

op n

atio

nal g

uida

nce

docu

men

ts fo

r vac

cine

sto

ckpi

le a

nd d

eplo

ymen

t, an

d ob

tain

app

rova

l fro

m m

inis

try

of h

ealth

(a

nd m

inis

try

of a

gric

ultu

re, w

here

app

licab

le).

Es

tabl

ish

a co

ld c

hain

for v

acci

ne d

eliv

ery

to a

t lea

st 4

0% o

f dis

tric

ts o

r 40%

of t

he ta

rget

pop

ulat

ion.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t a d

etai

led

asse

ssm

ent o

f exi

stin

g co

ld c

hain

equ

ipm

ent,

incl

udin

g th

e fu

nctio

ning

of c

old

chai

n eq

uipm

ent,

and

iden

tify

bottl

enec

ks to

mai

ntai

ning

nee

ded

cold

cha

in in

fras

truc

ture

at t

he d

istr

ict/

stat

e/pr

ovin

ce le

vels

; use

ass

essm

ent

data

to o

pera

tiona

lize

a pl

an to

ser

vice

/pro

cure

nee

ded

cold

cha

in in

fras

truc

ture

.

Dev

elop

nat

iona

l gui

delin

es fo

r vac

cine

del

iver

y to

targ

eted

pop

ulat

ions

with

ste

ps to

ope

ratio

naliz

e th

e pl

an.

D

evel

op a

nd d

isse

min

ate

prot

ocol

s, S

OPs

, tec

hnic

al g

uide

lines

and

tool

kits

for s

tora

ge, t

rans

port

atio

n an

d de

ploy

men

t of

vacc

ines

to h

ealth

care

wor

kers

and

sta

ff.

Esta

blis

h a

cold

cha

in fo

r vac

cine

del

iver

y to

at l

east

40–

59%

of d

istr

icts

or 4

0–59

% o

f the

targ

et p

opul

atio

n.

Esta

blis

h pr

oced

ures

for p

rocu

rem

ent,

stor

age

and

tran

spor

tatio

n of

vac

cine

s du

ring

publ

ic h

ealth

em

erge

ncie

s.


51

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Pr

ocur

e an

d se

rvic

e co

ld c

hain

equ

ipm

ent i

n ar

eas

iden

tified

by

a co

mpr

ehen

sive

ass

essm

ent.

Tr

ain

heal

thca

re w

orke

rs a

nd o

ther

imm

uniz

atio

n st

aff o

n pr

otoc

ols,

SO

Ps, t

echn

ical

gui

delin

es a

nd to

olki

ts fo

r sto

rage

, tr

ansp

orta

tion

and

depl

oym

ent o

f vac

cine

s.

Esta

blis

h a

cold

cha

in fo

r vac

cine

del

iver

y to

at l

east

60–

79%

of d

istr

icts

or 6

0–79

% o

f the

targ

et p

opul

atio

n.

Cond

uct q

ualit

y as

sura

nce

of c

old

chai

n eq

uipm

ent a

nd d

eliv

ery

syst

ems.

D

evel

op a

resp

onse

doc

umen

t to

obse

rve

appr

opria

te a

utho

rizat

ions

, cle

aran

ces,

eth

ical

nor

ms

and

perm

issi

ons

durin

g va

ccin

e de

liver

y.

Esta

blis

h an

inve

ntor

y sy

stem

that

mon

itors

and

tran

smits

vac

cine

sup

ply

and

requ

irem

ents

at a

ll ne

eded

leve

ls.

D

evel

op tr

aini

ng a

nd e

xerc

ises

for h

azar

d-sp

ecifi

c re

spon

se a

nd m

anag

emen

t pla

ns w

ith s

ecto

rs, s

take

hold

ers

and

othe

r ag

enci

es.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Se

cure

sus

tain

able

fund

ing

for v

acci

ne d

eliv

ery

syst

ems,

incl

udin

g fo

r pro

cure

men

t and

rout

ine

repa

ir of

col

d ch

ain

equi

pmen

t.

Esta

blis

h a

cold

cha

in fo

r vac

cine

del

iver

y to

mor

e th

an 8

0% o

f dis

tric

ts o

r mor

e th

an 8

0% o

f the

targ

et p

opul

atio

n.

Cond

uct a

func

tiona

l exe

rcis

e (e

ither

a s

imul

atio

n or

vac

cine

cam

paig

n) to

test

vac

cine

del

iver

y sy

stem

s in

a m

ass

cam

paig

n or

pub

lic h

ealth

em

erge

ncy

setti

ng.

Ro

utin

ely

anal

yse

the

inve

ntor

y sy

stem

to m

onito

r vac

cine

sup

ply

need

s an

d fo

reca

st re

quire

men

ts, w

ith a

ntic

ipat

ed

proc

urem

ent.

As

sess

vac

cine

del

iver

y as

sess

men

t in

hard

-to-

reac

h ar

eas,

targ

eted

bas

ed o

n ex

istin

g co

vera

ge/r

egis

try/

surv

eilla

nce

data

, an

d us

e re

sults

to im

prov

e va

ccin

e de

liver

y to

thes

e ar

eas.

D

evel

op a

nat

iona

l str

ateg

ic fr

amew

ork

to p

riorit

ize

reso

urce

s an

d in

vest

men

ts in

imm

uniz

atio

n.

Esta

blis

h a

func

tiona

l nat

iona

l bod

y to

ass

ess

and

reco

mm

end

an e

vide

nce-

base

d na

tiona

l vac

cine

pol

icy.


52

TOO

LS:

G

loba

l Vac

cine

Act

ion

Plan

— e

ndor

sed

by a

ll 19

4 M

embe

r Sta

tes

of th

e W

orld

Hea

lth A

ssem

bly

in M

ay 2

012;

pro

vide

s a

fram

ewor

k to

pre

vent

m

illio

ns o

f dea

ths

by 2

020

thro

ugh

mor

e eq

uita

ble

acce

ss to

exi

stin

g va

ccin

es fo

r peo

ple

in a

ll co

mm

uniti

es

Trai

ning

for m

id-le

vel M

anag

ers

(MLM

) — m

odul

ar tr

aini

ng p

rogr

am o

n al

l asp

ects

of i

mm

uniz

atio

n de

liver

y, in

clud

ing

cold

cha

in, v

acci

nes,

saf

e in

ject

ion

equi

pmen

t; pa

rtne

ring

with

the

com

mun

ity; i

mm

uniz

atio

n sa

fety

; sup

port

ive

supe

rvis

ion;

mon

itorin

g th

e im

mun

izat

ion

syst

em; a

nnua

l im

mun

izat

ion

plan

ning

and

bud

get;

EPI c

over

age

surv

eys;

VPD

sur

veill

ance

Pl

anni

ng a

nd Im

plem

entin

g H

igh-

Qua

lity

Supp

lem

enta

ry Im

mun

izat

ion

Activ

ities

for I

njec

tabl

e Va

ccin

es —

201

6 gu

idan

ce d

ocum

ent o

n SI

A pl

anni

ng a

nd im

plem

enta

tion,

usi

ng m

easl

es a

nd ru

bella

vac

cine

s as

an

exam

ple

W

HO

reco

mm

enda

tions

for r

outin

e im

mun

izat

ion

–su

mm

ary

of o

ptim

al im

mun

izat

ion

sche

dule

s fo

r use

by

prog

ram

me

man

ager

s

Glo

bal R

outin

e Im

mun

izat

ion

Stra

tegi

es a

nd P

ract

ices

(GRI

SP) —

com

pani

on d

ocum

ent t

o G

VAP;

pro

vide

s a

cohe

sive

del

iver

y an

d ad

voca

cy

plat

form

to p

rom

ote

rout

ine

imm

uniz

atio

ns

WH

O V

acci

ne P

reve

ntab

le D

isea

se S

tand

ards

- up

date

d st

anda

rds

for s

urve

illan

ce o

f VPD

s a

reso

urce

for t

he im

mun

izat

ions


53

29 N

atio

nal l

abor

ator

y sy

stem

is a

col

labo

rativ

e co

mm

unity

of c

linic

al la

bora

torie

s, p

ublic

hea

lth la

bora

torie

s an

d m

any

indi

vidu

al p

artn

ers

who

initi

ate

test

s an

d/or

use

test

resu

lts.

30 T

ests

list

in e

ach

coun

try

incl

udes

six

test

ing

met

hods

sel

ecte

d ac

cord

ing

to IH

R’s

imm

edia

tely

not

ifiab

le li

st a

nd th

e W

HO

top

10 c

ause

s of

dea

th in

low

-inco

me

coun

trie

s: p

olym

eras

e ch

ain

reac

tion

test

ing

for i

nflu

enza

viru

s; v

irus

cultu

re fo

r pol

iovi

rus;

ser

olog

y fo

r HIV

; mic

rosc

opy

for M

. tub

ercu

losi

s; ra

pid

diag

nost

ic te

stin

g fo

r Pla

smod

ium

spp

.; an

d ba

cter

ial c

ultu

re fo

r Sa

lmon

ella

ent

eriti

dis

sero

type

typh

i. Th

ese

six

met

hods

are

crit

ical

to th

e de

tect

ion

of e

pide

mic

-pro

ne e

mer

ging

dis

ease

s. C

ompe

tenc

y in

thes

e m

etho

ds is

indi

cate

d by

suc

cess

ful t

estin

g fo

r the

spe

cific

pat

hoge

ns li

sted

. The

rem

aini

ng fo

ur te

sts

shou

ld b

e se

lect

ed b

y th

e co

untr

y ba

sed

on m

ajor

nat

iona

l pub

lic h

ealth

con

cern

s.

NAT

ION

AL L

ABO

RATO

RY S

YSTE

M

07

IMPA

CT:

Effe

ctiv

e us

e of

a n

atio

nwid

e la

bora

tory

sys

tem

, inc

ludi

ng a

ll re

leva

nt s

ecto

rs, c

apab

le o

f saf

ely

and

accu

rate

ly d

etec

ting

and

char

acte

rizin

g pa

thog

ens

caus

ing

epid

emic

dis

ease

, incl

udin

g bo

th k

now

n an

d un

know

n th

reat

s, fr

om a

ll par

ts o

f the

cou

ntry

. Exp

ande

d de

ploy

men

t, ut

iliza

tion

and

sust

ainm

ent o

f mod

ern,

saf

e, s

ecur

e, a

fford

able

and

app

ropr

iate

dia

gnos

tics

test

s or

dev

ices

est

ablis

hed.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) A n

atio

nwid

e la

bora

tory

sys

tem

abl

e to

relia

bly

cond

uct t

ests

30 a

t lea

st fo

r prio

rity

dise

ases

of t

he c

ount

ry o

n ap

prop

riate

ly id

entifi

ed a

nd

colle

cted

, and

sus

pect

ed o

r con

firm

ed o

utbr

eak

spec

imen

s tr

ansp

orte

d sa

fely

and

sec

urel

y to

acc

redi

ted

labo

rato

ries

from

at l

east

80%

of

inte

rmed

iate

leve

ls/d

istr

icts

in th

e co

untr

y. (2

) Exi

sten

ce o

f nat

iona

l qua

lity

labo

rato

ry s

tand

ards

and

sys

tem

for l

icen

sing

labo

rato

ries.

Surv

eilla

nce

with

a n

atio

nal l

abor

ator

y sy

stem

,29 in

clud

ing

all r

elev

ant s

ecto

rs, p

artic

ular

ly in

hum

an a

nd a

nim

al (d

omes

tic a

nim

als

and

wild

life)

hea

lth, a

nd

effe

ctiv

e m

oder

n po

int-

of-c

are

and

labo

rato

ry-b

ased

dia

gnos

tics

is in

pla

ce.


54

CAPA

CITY

LEVE

L

Benc

hmar

k 7.

1: L

abor

ator

y te

stin

g fo

r det

ectio

n of

prio

rity

dise

ases

is in

pla

ce

Obj

ectiv

e: S

tren

gthe

ning

labo

rato

ry te

stin

g fo

r det

ectio

n of

prio

rity

dise

ases

01N

O C

APAC

ITY

Coun

try

has

not t

aken

a ri

sk-b

ased

app

roac

h to

det

erm

ine

test

ing

for p

riorit

y di

seas

es.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

clea

r SO

Ps a

nd n

eces

sary

agr

eem

ents

with

inte

rnat

iona

l lab

orat

orie

s to

per

form

dia

gnos

tic a

nd c

onfir

mat

ory

test

ing

of s

peci

men

s an

d su

ppor

t out

brea

k de

tect

ion

and

resp

onse

s w

hen

loca

l cap

acity

is n

ot a

vaila

ble.

D

efine

10

core

test

s ba

sed

on th

e pr

iorit

y di

seas

es li

st (l

ink

this

with

the

surv

eilla

nce

benc

hmar

k).

Se

lect

at l

east

five

prio

rity

dise

ases

for t

estin

g us

ing

the

resu

lts o

f ris

k an

alys

is, s

urve

illan

ce d

ata

and

prio

ritiz

atio

n m

etho

dolo

gies

.

Asse

ss la

bora

tory

alg

orith

ms,

sta

ndar

ds a

nd te

stin

g ca

paci

ty in

clud

ing

equi

pmen

t inv

ento

ry fo

r the

10

prio

rity

dise

ases

.

Asse

ss th

e ca

paci

ty a

nd e

ssen

tial f

unct

ioni

ng o

f tar

get h

uman

and

ani

mal

hea

lth la

bora

torie

s to

mee

t dia

gnos

tic a

nd

confi

rmat

ory

requ

irem

ents

for p

riorit

y di

seas

es.

D

evel

op p

lan,

bas

ed o

n as

sess

men

t, to

targ

et h

uman

and

ani

mal

hea

lth la

bora

torie

s fo

r cap

acity

bui

ldin

g an

d es

sent

ial

func

tioni

ng to

mee

t dia

gnos

tic a

nd c

onfir

mat

ory

requ

irem

ents

for p

riorit

y di

seas

es, e

nsur

ing

that

pro

ficie

ncy

is

dem

onst

rabl

e fo

r bac

terio

logy

, ser

olog

y, po

lym

eras

e ch

ain

reac

tion

and

othe

rs.

Es

tabl

ish

dom

estic

ext

erna

l qua

lity

asse

ssm

ent p

rogr

amm

es fo

r all

prio

rity

test

s or

cov

er th

em w

ith in

tern

atio

nal e

xter

nal

qual

ity a

sses

smen

t sch

emes

.

Dev

elop

a n

atio

nal l

abor

ator

y po

licy

that

iden

tifies

exp

ecte

d ca

paci

ties

at e

ach

leve

l of t

he n

atio

nal l

abor

ator

y sy

stem

.

Dev

elop

a h

ands

-on-

trai

ning

cur

ricul

um fo

r all

labo

rato

ry s

taff

that

incl

udes

task

-bas

ed tr

aini

ng, r

efre

sher

trai

ning

and

m

ento

ring

in th

eir a

ppro

pria

te te

chni

cal a

nd a

dmin

istr

ativ

e ar

eas.

Co

nduc

t a h

ands

-on

trai

ning

or r

efre

sher

trai

ning

ses

sion

for p

ublic

hea

lth la

bora

tory

sta

ff on

tech

niqu

es to

dia

gnos

e th

e co

untr

y’s

prio

rity

dise

ases

.

Dev

elop

and

dis

sem

inat

e te

stin

g SO

Ps a

nd q

ualit

y co

ntro

l SO

Ps fo

r all

core

test

s fo

r prio

rity

dise

ases

; and

est

ablis

h su

pply

an

d pr

ocur

emen

t cha

ins.

Tr

ain

rele

vant

labo

rato

ry s

taff

on te

chni

ques

use

d fo

r cor

e te

stin

g an

d do

cum

ent q

ualit

y co

ntro

l res

ults

.


55

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd d

isse

min

ate

test

ing

SOPs

and

pro

cure

men

t cha

ins

to c

ondu

ct te

stin

g fo

r at l

east

10

prio

rity

dise

ases

.

Mak

e av

aila

ble

exte

rnal

qua

lity

asse

ssm

ent f

or a

t lea

st th

ree/

four

cor

e te

sts

for p

riorit

y di

seas

es a

t nat

iona

l or c

entr

al

labo

rato

ries.

Be

gin

esta

blis

hing

a c

ompr

ehen

sive

qua

lity

man

agem

ent s

yste

m in

labo

rato

ries

that

con

duct

cor

e te

sts

for p

riorit

y di

seas

es.

Re

gula

rly tr

ain

staf

f on

the

test

ing,

and

doc

umen

t qua

lity

cont

rol r

esul

ts.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd d

isse

min

ate

test

ing

SOPs

; pro

cure

men

t cha

ins

shou

ld c

ondu

ct te

stin

g fo

r at l

east

15

prio

rity

dise

ases

.

Cond

uct q

ualit

y as

sura

nce

for a

ll co

re te

sts.

D

evel

op a

str

ateg

ic fr

amew

ork

to p

riorit

ize

natio

nal i

nves

tmen

ts in

to la

bora

tory

sys

tem

sus

tain

abili

ty.

Co

nduc

t mon

itorin

g an

d ev

alua

tion

to d

ocum

ent d

iagn

ostic

s, d

ata

qual

ity a

nd s

taff

perf

orm

ance

, and

inco

rpor

ate

reco

mm

enda

tions

into

the

natio

nal l

abor

ator

y st

rate

gic

plan

.

Esta

blis

h a

natio

nal e

xter

nal q

ualit

y as

sess

men

t pro

gram

me

for p

ublic

hea

lth la

bora

torie

s.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ex

pand

ext

erna

l qua

lity

asse

ssm

ent p

rogr

amm

es to

incl

ude

test

ing

in th

e pr

ivat

e se

ctor

and

ani

mal

hea

lth la

bora

torie

s.

Secu

re s

usta

inab

le fi

nanc

ing

for t

he la

bora

tory

sys

tem

to s

uppo

rt o

ngoi

ng te

stin

g of

prio

rity

dise

ases

.


56

CAPA

CITY

LEVE

L

Benc

hmar

k 7.

2: S

peci

men

refe

rral

and

tran

spor

t sys

tem

are

in p

lace

for a

ll re

leva

nt s

ecto

rs

Obj

ectiv

e: S

tren

gthe

n sp

ecim

en re

ferr

al a

nd tr

ansp

ort s

yste

m

01N

O C

APAC

ITY

No

syst

em in

pla

ce fo

r tra

nspo

rtin

g sp

ecim

ens

from

inte

rmed

iate

leve

ls/d

istr

icts

to n

atio

nal l

abor

ator

ies;

or o

nly

ad h

oc

tran

spor

tatio

n is

ava

ilabl

e.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

exi

stin

g sp

ecim

en re

ferr

al a

nd tr

ansp

orta

tion

netw

orks

for p

riorit

y di

seas

es, m

ap e

xist

ing

labo

rato

ry c

apac

ity fo

r pr

iorit

y di

seas

es31

, and

est

ablis

h re

ferr

al n

etw

orks

for e

ach

path

ogen

.

Conv

ene

hum

an a

nd a

nim

al h

ealth

sec

tors

and

oth

er s

take

hold

ers

to a

sses

s re

ferr

al m

echa

nism

s an

d lin

kage

s am

ong

vario

us le

vels

of h

ealth

faci

litie

s, in

clud

ing

inte

rnat

iona

l net

wor

ks w

ith g

uida

nce

and

tool

s fo

r dis

sem

inat

ion.

D

evel

op S

OPs

(as

part

of d

isea

se o

utbr

eak

inve

stig

atio

n pr

otoc

ols)

for s

peci

men

col

lect

ion,

man

agem

ent a

nd

tran

spor

tatio

n an

d sh

are

with

all

leve

ls.

Tr

ain

staf

f of c

ourie

r com

pany

and

hea

lth fa

cilit

y on

app

ropr

iate

man

agem

ent o

f spe

cim

ens

from

sus

pect

ed c

ases

of

prio

rity

dise

ases

.

Esta

blis

h a

serv

ice

agre

emen

t with

a c

ourie

r com

pany

(pub

lic o

r priv

ate)

for s

peci

men

tran

spor

tatio

n fro

m a

t lea

st 5

0% o

f he

alth

faci

litie

s in

the

publ

ic s

ecto

r thr

ough

out a

ll m

ajor

sub

divi

sion

s of

the

coun

try.

Es

tabl

ish

a m

echa

nism

to e

nsur

e tr

ansp

orta

tion

of s

peci

men

s fro

m 5

0% o

f all

heal

th fa

cilit

ies

to n

atio

nal l

abor

ator

ies.

Pr

ovid

e pr

epos

ition

out

brea

k in

vest

igat

ion

kits

(sam

ple

colle

ctio

n an

d tr

ansp

orta

tion

kits

) in

at le

ast 5

0% o

f hea

lth fa

cilit

ies.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ex

pand

a s

ervi

ce a

gree

men

t with

a c

ourie

r com

pany

(pub

lic o

r priv

ate)

for s

peci

men

tran

spor

tatio

n fro

m a

t lea

st 8

0% o

f the

he

alth

faci

litie

s.

Esta

blis

h a

mec

hani

sm to

ens

ure

tran

spor

tatio

n of

spe

cim

ens

from

50–

80%

of a

ll he

alth

faci

litie

s to

nat

iona

l lab

orat

orie

s.

Impl

emen

t sta

ff tr

aini

ng p

rogr

amm

es a

nd s

tand

ards

at t

he n

atio

nal l

evel

for t

he s

afe

ship

men

t of i

nfec

tious

sub

stan

ces

follo

win

g av

aila

ble

WH

O g

uida

nce.

Pr

ovid

e pr

epos

ition

out

brea

k in

vest

igat

ion

kits

(sam

ple

colle

ctio

n an

d tr

ansp

orta

tion

kits

) at 8

0% o

r mor

e he

alth

faci

litie

s.

31 T

hese

are

the

prio

rity

dise

ases

defi

ned

in th

e te

chni

cal a

reas

of s

urve

illan

ce, z

oono

sis

and

food

saf

ety.


57

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a m

echa

nism

to e

nsur

e tr

ansp

orta

tion

of s

peci

men

s fro

m a

t lea

st 8

0% o

f all

heal

th fa

cilit

ies

to n

atio

nal

labo

rato

ries

cove

ring

all g

eogr

aphi

c ar

eas

of th

e co

untr

y.

Prov

ide

prep

ositi

on o

utbr

eak

inve

stig

atio

n ki

ts (s

ampl

e co

llect

ion

and

tran

spor

tatio

n ki

ts) a

t all

the

heal

th fa

cilit

ies.

Co

nduc

t reg

ular

revi

ews

of s

peci

men

tran

spor

tatio

n sy

stem

s to

con

firm

that

spe

cim

ens

are

bein

g tr

ansp

orte

d pr

ompt

ly

and

in a

man

ner t

hat m

aint

ains

saf

ety

and

spec

imen

qua

lity.

Es

tabl

ish

a sy

stem

to c

olle

ct a

nd te

st s

peci

men

s fro

m h

ard-

to-r

each

are

as.

D

evel

op a

mec

hani

sm to

ens

ure

that

sta

ff at

the

natio

nal l

evel

hav

e in

tern

atio

nally

reco

gniz

ed c

ertifi

catio

n to

shi

p po

tent

ially

infe

ctio

us s

peci

men

s.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t eva

luat

ion

or s

imul

atio

n ex

erci

ses

to c

onfir

m fu

nctio

nalit

y of

spe

cim

en re

ferr

al s

yste

ms

in a

ll he

alth

faci

litie

s.

Ensu

re c

omm

itted

sus

tain

able

fund

ing

for t

he n

atio

nal s

tand

ard

of s

peci

men

col

lect

ion,

han

dlin

g, p

rese

rvat

ion,

pro

tect

ion,

tr

ansp

orta

tion,

dis

posa

l, pa

ckag

ing

and

impo

rt/e

xpor

t pro

cedu

res.


58

Benc

hmar

k 7.

3: E

ffec

tive

natio

nal d

iagn

ostic

net

wor

k is

in p

lace

O

bjec

tive:

Est

ablis

h ef

fect

ive

natio

nal d

iagn

ostic

net

wor

k

01N

O C

APAC

ITY

No

evid

ence

of u

se o

f rap

id a

nd a

ccur

ate

poin

t-of

-car

e an

d fa

rm-b

ased

dia

gnos

tics

and

labo

rato

ry-b

ased

dia

gnos

tics,

and

no

tier-

spec

ific

diag

nost

ic te

stin

g st

rate

gies

are

doc

umen

ted.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y in

tern

atio

nal l

abor

ator

ies

with

test

ing

capa

city

for c

onfir

mat

ory

labo

rato

ry d

iagn

ostic

s w

hen

they

are

not

cur

rent

ly

avai

labl

e in

the

coun

try.

D

evel

op a

nat

iona

l lab

orat

ory

polic

y th

at id

entifi

es th

e ex

pect

ed c

apac

ities

at e

ach

leve

l of t

he n

atio

nal l

abor

ator

y sy

stem

.

Asse

ss n

atio

nal d

iagn

ostic

cap

abili

ty, a

nd b

ased

on

the

findi

ngs,

dev

elop

a n

atio

nal p

lan

for a

chie

ving

goa

ls s

tate

d in

the

polic

y.

Cond

uct a

revi

ew o

f exi

stin

g po

int-

of-c

are/

rapi

d di

agno

stic

test

s th

at a

re a

vaila

ble

to th

e co

untr

y fo

r det

ectio

n of

prio

rity

dise

ases

.

Cond

uct a

labo

rato

ry a

nd fi

eld

valid

atio

n of

the

use

of p

oint

-of-

care

/rap

id d

iagn

ostic

test

s fo

r som

e pr

iorit

y di

seas

es.

D

evel

op a

nd im

plem

ent p

oint

-of-

care

dia

gnos

tic te

stin

g st

rate

gies

for p

riorit

y di

seas

es.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd d

isse

min

ate

SOPs

for t

iere

d te

stin

g, in

clud

ing

poin

t-of

-car

e/ra

pid

diag

nosi

s an

d sp

ecim

en re

ferr

al s

yste

ms

to

the

appr

opria

te la

bora

tory

idea

lly w

ithin

the

fram

ewor

k of

a n

atio

nal l

abor

ator

y po

licy,

for e

ach

prio

rity

dise

ase.

D

evel

op in

-ser

vice

trai

ning

pla

ns fo

r all

staf

f tha

t inc

lude

task

-bas

ed tr

aini

ng, r

efre

sher

trai

ning

and

men

torin

g in

thei

r ap

prop

riate

tech

nica

l and

adm

inis

trat

ive

area

s.

Allo

cate

reso

urce

s (h

uman

and

mat

eria

l) to

con

duct

app

ropr

iate

dia

gnos

tic te

stin

g at

the

subn

atio

nal l

evel

in li

ne w

ith th

e na

tiona

l lab

orat

ory

polic

y.


59

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

onito

r im

plem

enta

tion

of th

e tie

red

test

ing

appr

oach

, inc

ludi

ng v

alid

atio

n/qu

ality

ass

uran

ce o

f poi

nt-o

f-ca

re te

stin

g.

Trai

n la

bora

tory

sta

ff on

rele

vant

nov

el d

iagn

ostic

pro

cedu

res

to d

etec

t prio

rity

dise

ases

.

Use

poi

nt-o

f-ca

re d

iagn

ostic

test

ing

for s

ome

of th

e pr

iorit

y di

seas

es a

nd fu

rthe

r con

firm

by

tiere

d te

stin

g ap

proa

ch fr

om

refe

rral

labo

rato

ries.

O

btai

n su

stai

nabl

e fu

ndin

g fo

r lab

orat

ory

proc

urem

ent,

capa

city

bui

ldin

g an

d po

int-

of c

are

diag

nost

ics.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op c

apac

ity to

con

duct

adv

ance

d m

olec

ular

and

ser

olog

ical

test

ing

for c

onfir

mat

ion

of p

riorit

y di

seas

es in

clud

ing

the

abili

ty to

con

duct

mol

ecul

ar s

ubty

ping

.

Dev

elop

and

impl

emen

t a p

lan

to in

crea

se n

atio

nal t

estin

g ca

paci

ty fo

r all

prio

rity

dise

ases

, inc

ludi

ng c

ross

-tra

inin

g of

na

tiona

l lab

orat

ory

staf

f in

diffe

rent

test

ing

met

hodo

logi

es.

D

evel

op q

ualit

y m

anag

emen

t sys

tem

mec

hani

sm fo

r poi

nt-o

f-ca

re te

stin

g, in

clud

ing

qual

ity in

dica

tors

.


60

CAPA

CITY

LEVE

L

Benc

hmar

k 7.

4: L

abor

ator

y qu

ality

sys

tem

is in

pla

ce

Obj

ectiv

e: T

o en

sure

labo

rato

ry q

ualit

y

01N

O C

APAC

ITY

Ther

e ar

e no

nat

iona

l lab

orat

ory

qual

ity s

tand

ards

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

an in

depe

nden

t uni

t at t

he c

entr

al le

vel w

ith a

spe

cific

bud

get l

ine

and

pers

onne

l to

over

see

labo

rato

ry s

ervi

ces

and

deve

lop

natio

nal l

abor

ator

y qu

ality

sta

ndar

ds.

Es

tabl

ish

a qu

ality

ass

essm

ent p

rogr

amm

e fo

r nat

iona

l or c

entr

al la

bora

torie

s fo

r dia

gnos

tics

of d

isea

ses

with

epi

dem

ic

pote

ntia

l.

Dev

elop

a ro

adm

ap fo

r lab

orat

ory

insp

ectio

ns, l

icen

sing

and

acc

redi

tatio

n, in

line

with

the

natio

nal l

abor

ator

y st

rate

gy.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a na

tiona

l qua

lity

asse

ssm

ent p

rogr

amm

e fo

r per

iphe

ral l

abor

ator

ies

for d

iagn

osis

of d

isea

ses

with

epi

dem

ic

pote

ntia

l.

Dev

elop

min

imum

sta

ndar

ds fo

r cer

tifica

tion

or li

cens

ing,

as

a pa

rt o

f the

sys

tem

for r

egul

atio

n of

labo

rato

ries.

Im

plem

ent a

sys

tem

of i

nspe

ctin

g an

d lic

ensi

ng la

bora

torie

s, in

clud

ing

usin

g lo

cal a

dapt

atio

ns o

f int

erna

tiona

l sta

ndar

ds

and

norm

s an

d ob

tain

ing

requ

ired

fund

ing

and

hum

an re

sour

ces.

D

evel

op e

xper

tise

by tr

aini

ng s

elec

ted

labo

rato

ry s

taff

in th

e in

spec

tion

of la

bora

torie

s ba

sed

on th

e st

anda

rds.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

man

dato

ry li

cens

ing

prog

ram

me

for n

atio

nal a

nd s

ubna

tiona

l pub

lic h

ealth

labo

rato

ries.

Es

tabl

ish

natio

nal q

ualit

y st

anda

rds

that

follo

w in

tern

atio

nal n

orm

s an

d st

anda

rds.


61

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

nat

iona

l ext

erna

l qua

lity

assu

ranc

e pr

ogra

mm

e ac

ross

mic

robi

olog

y, vi

rolo

gy, s

erol

ogy

and

para

sito

logy

.

Accr

edit

all n

atio

nal r

efer

ence

labo

rato

ries

to in

tern

atio

nal s

tand

ards

(suc

h as

usi

ng IS

O 1

5189

).

Stre

ngth

en th

e na

tiona

l pla

n fo

r qua

lity

man

agem

ent s

yste

m c

ompl

ianc

e at

the

subn

atio

nal a

nd n

atio

nal l

evel

s th

roug

h co

ntin

uous

qua

lity

impr

ovem

ent b

ased

on

anal

ysis

of a

ctua

l exp

erie

nce

in th

e co

untr

y.

TOO

LS:

La

bora

tory

Qua

lity

Step

wis

e Im

plem

enta

tion

Tool

— W

HO

LQ

SI to

ol in

the

form

of a

web

site

that

pro

vide

s a

step

wis

e pl

an to

gui

de m

edic

al

labo

rato

ries

tow

ard

impl

emen

ting

a qu

ality

man

agem

ent s

yste

m in

com

plia

nce

with

ISO

151

89 o

r nat

iona

l sta

ndar

d w

ith s

imila

r req

uire

men

ts

Met

hodo

logy

for P

riorit

izin

g Se

vere

Em

ergi

ng D

isea

ses

for R

esea

rch

and

Dev

elop

men

t — W

HO

gui

danc

e to

iden

tify

glob

al d

isea

se th

reat

s;

met

hods

can

be

appl

ied

to id

entif

ying

prio

rity

dise

ases

for l

abor

ator

y te

stin

g in

cou

ntrie

s

Stre

ngth

enin

g La

bora

tory

Man

agem

ent T

owar

d Ac

cred

itatio

n –

A s

truc

ture

d qu

ality

impr

ovem

ent p

rogr

am th

at te

ache

s la

bora

tory

man

ager

s ho

w to

impl

emen

t pra

ctic

al q

ualit

y m

anag

emen

t sys

tem

s in

reso

urce

-lim

ited

setti

ngs

La

bora

tory

Qua

lity

Man

agem

ent S

yste

m T

rain

ing

Tool

kit —

WH

O to

olki

t to

trai

n la

bora

tory

man

ager

s, s

enio

r bio

logi

sts

and

tech

nolo

gist

s in

qu

ality

man

agem

ent s

yste

ms

St

epw

ise

impl

emen

tatio

n of

a q

ualit

y m

anag

emen

t sys

tem

for a

hea

lth la

bora

tory

. WH

O E

MRO

pub

licat

ion

adap

ting

the

ISO

151

89 s

tand

ard

to

the

cont

ext a

nd re

aliti

es o

f res

ourc

e-lim

ited

coun

trie

s, w

here

the

requ

irem

ents

of t

he IS

O s

tand

ard

may

be

too

strin

gent

to im

plem

ent.

ht

tp://

apps

.who

.int/

iris/

hand

le/1

0665

/249

570


62

32 L

abor

ator

y bi

osaf

ety

desc

ribes

the

cont

ainm

ent p

rinci

ples

, tec

hnol

ogie

s an

d pr

actic

es th

at a

re im

plem

ente

d to

pre

vent

uni

nten

tiona

l exp

osur

e to

pat

hoge

ns a

nd to

xins

, or t

heir

acci

dent

al re

leas

e.

33 L

abor

ator

y bi

osec

urity

des

crib

es th

e pr

otec

tion,

con

trol a

nd a

ccou

ntab

ility

for v

alua

ble

biol

ogic

al m

ater

ials

with

in la

bora

torie

s, a

s w

ell a

s in

form

atio

n re

late

d to

thes

e m

ater

ials

and

dua

l-us

e re

sear

ch, t

o pr

even

t the

ir un

auth

oriz

ed a

cces

s, lo

ss, t

heft,

mis

use,

div

ersi

on o

r int

entio

nal r

elea

se.

34 L

ist o

f hum

an a

nd a

nim

al p

atho

gens

and

toxi

ns fo

r exp

ort c

ontro

l. 35

Min

imal

/bes

t pra

ctic

es a

s re

ferr

ed in

the

WH

O la

bora

tory

bio

safe

ty m

anua

l. 36

Res

pons

ible

life

sci

ence

s re

sear

ch fo

r glo

bal h

ealth

sec

urity

: a g

uida

nce

docu

men

t. W

HO

/HSE

/GAR

/BD

P/20

10.2

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

010.

37

Bot

h hu

man

and

ani

mal

hea

lth s

ecto

rs.

BIO

SAFE

TY A

ND

BIO

SECU

RITY

08

IMPA

CT:

Impl

emen

tatio

n of

a c

ompr

ehen

sive

, sus

tain

able

and

lega

lly e

mbe

dded

nat

iona

l ove

rsig

ht p

rogr

amm

e fo

r bio

safe

ty a

nd b

iose

curit

y, in

clud

ing

the

safe

and

sec

ure

use,

sto

rage

, dis

posa

l and

con

tain

men

t of p

atho

gens

foun

d in

labo

rato

ries

and

a m

inim

al n

umbe

r of h

oldi

ngs

acro

ss th

e co

untry

, and

invo

lvin

g re

sear

ch, d

iagn

ostic

and

bio

tech

nolo

gy fa

cilit

ies

with

in a

ll sec

tors

.37 S

treng

then

ed, s

usta

inab

le b

iolo

gica

l ris

k m

anag

emen

t be

st p

ract

ices

are

in p

lace

usi

ng c

omm

on e

duca

tiona

l mat

eria

ls. S

afe

and

com

plia

nt tr

ansp

ort o

f inf

ectio

us s

ubst

ance

s is

als

o co

nsid

ered

ac

cord

ing

to n

atio

nal a

nd in

tern

atio

nal r

egul

atio

ns.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Exi

sten

ce o

f a n

atio

nal f

ram

ewor

k fo

r pat

hoge

n bi

osaf

ety

and

bios

ecur

ity, s

trai

n co

llect

ions

and

con

tain

men

t lab

orat

orie

s th

at in

clud

es

iden

tifica

tion

and

stor

age

of n

atio

nal s

trai

n co

llect

ions

in a

min

imal

num

ber o

f fac

ilitie

s fr

om a

ll se

ctor

s. (2

) Exi

sten

ce o

f a c

ompr

ehen

sive

ov

ersi

ght a

nd m

onito

ring

syst

em.

A w

hole

-of-

gove

rnm

ent m

ultis

ecto

ral n

atio

nal b

iosa

fety

32 a

nd b

iose

curit

y33 s

yste

m w

ith d

ange

rous

pat

hoge

ns34

iden

tified

, hel

d, s

ecur

ed a

nd m

onito

red

in

a m

inim

al n

umbe

r of f

acili

ties

acco

rdin

g to

bes

t pra

ctic

es;35

bio

logi

cal r

isk

man

agem

ent t

rain

ing

and

educ

atio

nal o

utre

ach

cond

ucte

d to

pro

mot

e a

shar

ed

cultu

re o

f res

pons

ibili

ty,36

redu

ce d

ual-u

se ri

sks,

miti

gate

bio

logi

cal p

rolif

erat

ion

and

ensu

re s

afe

trans

fer o

f bio

logi

cal a

gent

s; a

nd c

ount

ry-s

peci

fic b

iosa

fety

an

d bi

osec

urity

legi

slat

ion,

labo

rato

ry li

cens

ing

and

path

ogen

con

trol m

easu

res

in p

lace

as

appr

opria

te.


63

CAPA

CITY

LEVE

L

Benc

hmar

k 8.

1: W

hole

-of-

gove

rnm

ent b

iosa

fety

and

bio

secu

rity

syst

em is

in p

lace

for a

ll se

ctor

s (in

clud

ing

hum

an, a

nim

al

(dom

estic

ani

mal

s an

d w

ildlif

e) a

nd e

nviro

nmen

t fac

ilitie

s)

Obj

ectiv

e: T

o de

velo

p an

d im

plem

ent a

bio

safe

ty a

nd b

iose

curit

y sy

stem

for a

ll se

ctor

s (in

clud

ing

hum

an, a

nim

al (d

omes

tic

and

wild

life)

and

env

ironm

ent f

acili

ties)

to m

inim

ize

the

risk

of a

ccid

enta

l or i

nten

tiona

l inf

ectio

n of

labo

rato

ry s

taff

or

rele

ase

of h

azar

dous

pat

hoge

ns

01N

O C

APAC

ITY

Elem

ents

of a

com

preh

ensi

ve n

atio

nal b

iosa

fety

and

bio

secu

rity

syst

em, s

uch

as p

olic

y in

stru

men

ts a

nd p

rope

r fina

ncin

g, a

re

not i

n pl

ace.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d do

cum

ent h

uman

and

ani

mal

hea

lth fa

cilit

ies

that

sto

re/m

aint

ain

dang

erou

s pa

thog

ens

and

toxi

ns in

the

rele

vant

sec

tors

and

hea

lth p

rofe

ssio

nals

resp

onsi

ble

for t

hem

.

Revi

ew a

nd d

evel

op o

r rev

ise

the

natio

nal l

egis

latio

n/re

gula

tions

for b

iosa

fety

and

bio

secu

rity

by th

e hu

man

hea

lth s

ecto

r (o

r oth

er a

ppro

pria

te a

utho

rity)

.

Esta

blis

h a

mec

hani

sm fo

r lab

orat

ory

licen

sing

in h

uman

and

ani

mal

hea

lth s

ecto

rs; e

nsur

e th

at b

iosa

fety

and

bio

secu

rity

requ

irem

ents

are

incl

uded

in g

ener

al li

cens

ing

requ

irem

ents

.

Cond

uct a

sses

smen

ts o

f cur

rent

bio

safe

ty a

nd b

iose

curit

y pr

actic

es, p

roce

dure

s an

d en

gine

erin

g co

ntro

ls a

t the

nat

iona

l le

vel.

D

evel

op p

atho

gen

cont

rol m

easu

res,

incl

udin

g st

anda

rds

for c

onta

inm

ent,

oper

atio

nal h

andl

ing

and

failu

re re

port

ing

syst

ems.


64

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

bio

safe

ty a

nd b

iose

curit

y na

tiona

l fra

mew

ork

incl

udin

g gu

idel

ines

and

reco

rd-k

eepi

ng o

blig

atio

ns a

t all

labo

rato

ries

wor

king

with

haz

ardo

us a

gent

s.

Dev

elop

and

mai

ntai

n in

vent

orie

s fo

r dan

gero

us p

atho

gens

.

Secu

re d

ange

rous

pat

hoge

ns a

nd to

xins

at m

inim

um n

umbe

r of n

atio

nal l

evel

labo

rato

ries.

Im

plem

ent b

iosa

fety

and

bio

secu

rity

best

pra

ctic

es in

all

natio

nal,

inte

rmed

iate

and

loca

l lab

orat

orie

s.

Esta

blis

h an

info

rmat

ion

secu

rity

syst

em fo

r all

sens

itive

doc

umen

tatio

n in

faci

litie

s w

here

dan

gero

us p

atho

gens

and

toxi

ns

are

stor

ed.

Im

plem

ent n

atio

nal b

iosa

fety

and

bio

secu

rity

regu

latio

ns a

nd g

uide

lines

with

all

rele

vant

sec

tors

(suc

h as

hum

an, a

nim

al,

envi

ronm

enta

l hea

lth, d

efen

ce m

inis

try

and

stak

ehol

ders

) with

sta

ndar

dize

d cl

assi

ficat

ion

and

accr

edita

tion

stan

dard

s th

at

cove

r pat

hoge

n co

ntro

l and

per

sonn

el re

liabi

lity

prog

ram

me

requ

irem

ents

.

Dev

elop

an

actio

n pl

an to

repl

ace

dang

erou

s pa

thog

en c

ultu

res

with

saf

er in

vest

igat

ion

met

hods

.

Begi

n de

velo

ping

inci

dent

and

em

erge

ncy

resp

onse

pro

gram

mes

in fa

cilit

ies

stor

ing

dang

erou

s pa

thog

ens.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent t

he b

iosa

fety

and

bio

secu

rity

natio

nal f

ram

ewor

k in

all

labo

rato

ries

at th

e na

tiona

l, in

term

edia

te a

nd lo

cal l

evel

s.

Dev

elop

site

-spe

cific

bio

safe

ty/b

iose

curit

y su

ppor

ting

docu

men

ts th

at in

clud

e in

cide

nt re

spon

se a

nd e

mer

genc

y pl

ans

(suc

h as

in c

ase

of e

xplo

sion

, fire

, flo

od, w

orke

r exp

osur

e, a

ccid

ent o

r illn

ess,

maj

or s

pilla

ge, w

aste

man

agem

ent)

for

labo

rato

ries

at n

atio

nal,

inte

rmed

iate

and

loca

l lev

els.

D

evel

op d

ocum

ents

for d

ual-u

se re

sear

ch a

nd re

spon

sibl

e co

de o

f con

duct

for s

cien

tists

and

sta

ff.

Dev

elop

and

impl

emen

t an

inci

dent

repo

rtin

g sy

stem

that

incl

udes

iden

tifyi

ng in

cide

nts,

repo

rtin

g ac

cord

ing

to re

gula

tions

, an

d ad

dres

sing

act

ion

item

s th

at im

prov

e sa

fety

and

sec

urity

.

Esta

blis

h ex

tern

al m

onito

ring

and

over

sigh

t of b

iosa

fety

and

bio

secu

rity

prac

tices

.

Dev

elop

and

impl

emen

t equ

ipm

ent o

pera

tion

and

mai

nten

ance

pla

ns a

t lab

orat

orie

s st

orin

g pa

thog

ens

of s

ecur

ity c

once

rn.


65

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

sust

aina

ble

fund

ing

and

an o

vers

ight

mec

hani

sm to

sup

port

bio

safe

ty a

nd b

iose

curit

y pr

ogra

mm

es/in

itiat

ives

.

Doc

umen

t im

plem

enta

tion

of th

e na

tiona

l bio

safe

ty a

nd b

iose

curit

y le

gisl

atio

ns, w

hich

are

alig

ned

with

the

inte

rnat

iona

l be

st p

ract

ices

at a

ll le

vels

.

Doc

umen

t and

gen

erat

e in

tern

atio

nal g

ood

prac

tices

for b

iosa

fety

and

bio

secu

rity

arra

ngem

ents

.

Secu

re s

usta

inab

le fu

ndin

g an

d an

ove

rsig

ht a

nd e

nfor

cem

ent m

echa

nism

to s

uppo

rt b

iosa

fety

and

bio

secu

rity

prog

ram

mes

/initi

ativ

es a

t the

min

istr

y le

vel.


66

CAPA

CITY

LEVE

L

Benc

hmar

k 8.

2: B

iosa

fety

and

bio

secu

rity

trai

ning

and

pra

ctic

es in

all

rele

vant

sec

tors

(inc

ludi

ng h

uman

, ani

mal

(dom

estic

an

imal

s an

d w

ildlif

e) a

nd e

nviro

nmen

t)

Obj

ectiv

e: T

o de

velo

p a

publ

ic h

ealth

wor

kfor

ce th

at is

ava

ilabl

e an

d tr

aine

d to

ena

ble

early

det

ectio

n, p

reve

ntio

n,

prep

ared

ness

and

resp

onse

to p

oten

tial e

vent

s of

inte

rnat

iona

l con

cern

at a

ll le

vels

of h

ealth

sys

tem

s to

eff

ectiv

ely

impl

emen

t IH

R

01N

O C

APAC

ITY

No

bios

afet

y an

d bi

osec

urity

trai

ning

or p

lans

are

in p

lace

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

As

sess

bio

safe

ty a

nd b

iose

curit

y tr

aini

ng n

eeds

and

gap

s in

all

rele

vant

sec

tors

.

Cond

uct a

n en

gage

men

t mee

ting

to d

evel

op b

iosa

fety

and

bio

secu

rity

trai

ning

pro

gram

mes

that

alig

n ac

adem

ic c

urric

ulum

w

ith in

tern

atio

nal b

est p

ract

ices

.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ad

apt i

n-se

rvic

e an

d co

ntin

uing

edu

catio

n tr

aini

ng c

urric

ula,

SO

Ps, t

oolk

its, g

ood

mic

robi

olog

ical

pra

ctic

es a

nd p

roce

dure

s to

com

ply

with

bio

safe

ty a

nd b

iose

curit

y ru

les

and

regu

latio

ns a

nd a

ligne

d w

ith in

tern

atio

nal b

est p

ract

ices

.

Trai

n an

d ov

ersi

ght f

acili

ties

that

are

hou

sing

or w

orki

ng w

ith d

ange

rous

pat

hoge

ns a

nd to

xins

to c

ompl

y w

ith b

iosa

fety

and

bi

osec

urity

rule

s an

d re

gula

tions

.

Begi

n de

velo

ping

sus

tain

ed a

cade

mic

and

con

tinui

ng e

duca

tion,

and

trai

ning

pro

gram

mes

for b

iosa

fety

and

bio

secu

rity

alig

ned

with

inte

rnat

iona

l bes

t pra

ctic

es.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent t

rain

ing

prog

ram

mes

and

ove

rsig

ht a

nd a

sses

s th

at th

ey c

ompl

y w

ith b

iosa

fety

and

bio

secu

rity

rule

s an

d re

gula

tions

, and

are

alig

ned

with

inte

rnat

iona

l bes

t pra

ctic

es.

Im

plem

ent s

usta

inab

le tr

aini

ng p

rogr

amm

es, t

hat a

re a

ligne

d w

ith in

tern

atio

nal b

est p

ract

ices

, in

inst

itutio

ns th

at tr

ain

thos

e w

ho m

aint

ain

or w

ork

with

dan

gero

us p

atho

gens

and

toxi

ns.


67

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Al

ign

and

impl

emen

t sus

tain

able

trai

ning

pro

gram

mes

in b

iosa

fety

and

bio

secu

rity

alig

ned

with

inte

rnat

iona

l bes

t pra

ctic

es.

G

uara

ntee

sus

tain

ed fu

ndin

g to

sup

port

trai

ning

pro

gram

mes

from

the

natio

nal g

over

nmen

t.

Incl

ude

bios

afet

y an

d bi

osec

urity

trai

ning

cou

rses

in u

nive

rsity

cur

ricul

a of

pre

trai

ning

edu

catio

n in

bot

h hu

man

and

ani

mal

he

alth

sec

tors

.

Revi

ew tr

aini

ng n

eeds

ass

essm

ents

on

a re

gula

r bas

is a

nd a

djus

t and

upd

ate

trai

ning

pro

gram

mes

acc

ordi

ng to

the

asse

ssm

ent r

esul

ts.

Im

plem

ent p

erio

dic

trai

ning

pro

gram

mes

on

emer

genc

y re

spon

se p

roce

dure

s.

TOO

LS:

W

HO

labo

rato

ry b

iosa

fety

man

ual.

Third

edi

tion.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

004

W

HO

gui

danc

e do

cum

ent:

Step

wis

e im

plem

enta

tion

of re

gula

tory

requ

irem

ents

for e

nsur

ing

bios

afet

y an

d bi

osec

urity

in b

iom

edic

al fa

cilit

ies

(bei

ng fi

naliz

ed w

ith e

xpec

ted

publ

icat

ion

in 2

019)

.

Gui

de to

par

ticip

atin

g in

the

confi

denc

e-bu

ildin

g m

easu

res

of th

e bi

olog

ical

wea

pons

con

vent

ion.

Gen

eva:

Uni

ted

Nat

ions

Offi

ce fo

r Dis

arm

amen

t Af

fairs

; 201

3


68

38 S

urve

illanc

e m

eans

the

syst

emat

ic o

ngoi

ng c

olle

ctio

n, c

olla

tion

and

anal

ysis

of d

ata

for p

ublic

hea

lth p

urpo

ses

and

the

timel

y di

ssem

inat

ion

of p

ublic

hea

lth in

form

atio

n fo

r ass

essm

ent a

nd p

ublic

he

alth

resp

onse

as

nece

ssar

y. 39

Inte

rope

rabl

e, d

escr

ibes

the

exte

nt to

whi

ch s

yste

ms

and

devi

ces

can

exch

ange

dat

a, a

nd in

terp

ret t

hat s

hare

d da

ta. F

or tw

o sy

stem

s to

be

inte

rope

rabl

e, th

ey m

ust b

e ab

le to

exc

hang

e da

ta a

nd

subs

eque

ntly

pre

sent

that

dat

a in

a m

anne

r tha

t can

be

unde

rsto

od b

y th

e us

er (d

efini

tion

by H

ealth

care

Info

rmat

ion

and

Man

agem

ent S

yste

ms

Soci

ety)

. 40

Stro

ng s

urve

illanc

e w

ill su

ppor

t the

tim

ely

reco

gniti

on o

f the

em

erge

nce

of re

lativ

ely

rare

or p

revi

ousl

y un

desc

ribed

pat

hoge

ns in

spe

cific

cou

ntrie

s.

41 E

ach

coun

try h

as to

defi

ne a

“pot

entia

l ris

k to

pub

lic h

ealth

”, pe

rform

risk

map

ping

and

iden

tify

prio

rity

dise

ases

. 42

Cou

ntrie

s w

ill su

ppor

t the

use

of i

nter

oper

able

, inte

rcon

nect

ed s

yste

ms

capa

ble

of lin

king

and

inte

grat

ing

mul

tisec

tora

l sur

veilla

nce

data

and

usi

ng th

e re

sulti

ng in

form

atio

n to

enh

ance

the

capa

city

to

qui

ckly

det

ect a

nd re

spon

d to

dev

elop

ing

biol

ogic

al th

reat

s. F

ound

atio

nal c

apac

ity is

nec

essa

ry fo

r bot

h in

dica

tor-

and

evi

denc

e-ba

sed

surv

eilla

nce,

to s

uppo

rt pr

even

tion

and

cont

rol a

ctiv

ities

, and

in

terv

entio

n ta

rget

ing

for b

oth

esta

blis

hed

infe

ctio

us d

isea

ses

and

new

and

em

ergi

ng p

ublic

hea

lth th

reat

s.

43 In

tern

atio

nally

reco

gniz

ed s

tand

ards

for s

yndr

omic

sur

veilla

nce

are

avai

labl

e fo

r the

follo

win

g fiv

e sy

ndro

mes

: (i)

seve

re a

cute

resp

irato

ry s

yndr

ome,

(ii)

acut

e fla

ccid

par

alys

is, (

iii) a

cute

ha

emor

rhag

ic fe

ver, (

iv) a

cute

wat

ery

diar

rhoe

a w

ith d

ehyd

ratio

n, a

nd (v

) acu

te ja

undi

ce s

yndr

ome.

Thr

ee c

ore

synd

rom

es a

re c

hose

n de

pend

ing

on n

atio

nal d

isea

se c

ontro

l prio

ritie

s. T

he s

urve

illanc

e sy

stem

sho

uld

incl

ude

epid

emio

logi

cal d

ata

and

labo

rato

ry fi

ndin

gs, w

hich

sho

uld

be a

naly

sed

by tr

aine

d ep

idem

iolo

gist

s.

SURV

EILL

ANCE

09

IMPA

CT:

(1) A

func

tioni

ng p

ublic

hea

lth s

urve

illan

ce s

yste

m40

cap

able

of i

dent

ifyin

g po

tent

ial e

vent

s of

con

cern

for p

ublic

hea

lth a

nd h

ealth

sec

urity

.41 (2

) En

hanc

ed n

atio

nal a

nd in

term

edia

te le

vel r

egio

nal c

apac

ity to

ana

lyse

and

link

dat

a fro

m a

nd b

etw

een

the

diffe

rent

leve

ls o

f the

stre

ngth

ened

ea

rly-w

arni

ng s

urve

illan

ce s

yste

m.42

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Sur

veill

ance

for a

t lea

st th

ree

core

syn

drom

es43

indi

cativ

e of

pot

entia

l pub

lic h

ealth

em

erge

ncie

s co

nduc

ted

acco

rdin

g to

inte

rnat

iona

l st

anda

rds.

(2) R

egul

ar a

naly

sis

and

repo

rtin

g of

sur

veill

ance

dat

a.

Stre

ngth

ened

sur

veilla

nce38

sys

tem

s ar

e ab

le to

det

ect e

vent

s of

sig

nific

ance

for p

ublic

hea

lth a

nd h

ealth

sec

urity

; impr

ove

com

mun

icat

ion

and

colla

bora

tion

acro

ss s

ecto

rs a

nd b

etw

een

subn

atio

nal (

loca

l and

inte

rmed

iate

), na

tiona

l and

inte

rnat

iona

l leve

ls o

f aut

horit

y re

gard

ing

surv

eilla

nce

of e

vent

s of

pub

lic h

ealth

si

gnifi

canc

e; a

nd im

prov

e na

tiona

l and

inte

rmed

iate

leve

l reg

iona

l cap

acity

to a

naly

se a

nd lin

k da

ta fr

om a

nd b

etw

een,

stre

ngth

ened

ear

ly-w

arni

ng s

urve

illanc

e,

incl

udin

g in

tero

pera

ble,

39 in

terc

onne

cted

ele

ctro

nic

tool

s. T

his

wou

ld in

corp

orat

e ep

idem

iolo

gica

l, clin

ical

, labo

rato

ry, e

nviro

nmen

tal t

estin

g, p

rodu

ct s

afet

y an

d qu

ality

, and

bio

info

rmat

ics

data

; and

adv

ance

s in

fulfi

lling

core

cap

acity

requ

irem

ents

for s

urve

illanc

e in

acc

orda

nce

with

the

IHR

and

OIE

gui

delin

es.


69

CAPA

CITY

LEVE

L

Benc

hmar

k 9.

1: F

unct

iona

l sur

veill

ance

sys

tem

to id

entif

y po

tent

ial e

vent

s of

con

cern

for p

ublic

hea

lth a

nd h

ealth

sec

urity

is

in p

lace

Th

e su

rvei

llanc

e sy

stem

sho

uld

incl

ude

the:

abili

ty to

con

duct

sur

veill

ance

for a

t lea

st th

ree

core

syn

drom

es in

dica

tive

of a

pub

lic h

ealth

em

erge

ncy

and

ongo

ing,

re

gula

r, sy

stem

atic

and

acc

urat

e su

rvei

llanc

e fo

r dis

ease

s an

d co

nditi

ons

of a

ctua

l or p

oten

tial e

pide

mio

logi

cal i

mpo

rtan

ce

in th

e co

untr

y;

abili

ty to

pro

vide

sys

tem

atic

/rou

tine

repo

rts

and

data

to h

igh-

leve

l pub

lic h

ealth

dec

isio

n-m

aker

s in

the

coun

try,

and

feed

back

to lo

wer

leve

ls im

plem

entin

g th

e co

ntro

l pro

gram

mes

; and

lin

kage

s to

labo

rato

ry a

nd o

ther

info

rmat

ion

syst

ems

to p

rovi

de re

pres

enta

tive,

tim

ely

and

accu

rate

sur

veilla

nce

info

rmat

ion.

Obj

ectiv

e: S

tren

gthe

n su

rvei

llanc

e sy

stem

01N

O C

APAC

ITY

The

coun

try

has

to d

evel

op a

nd im

plem

ent a

ll ac

tiviti

es th

at a

re li

sted

in le

vel 2

to a

chie

ve th

e lim

ited

capa

city

for t

he

surv

eilla

nce

syst

em.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

De

velo

p na

tiona

l com

mun

icab

le

dise

ase

surv

eilla

nce

stra

tegy

bas

ed

on IH

R re

quire

men

ts, w

hich

incl

udes

a

list o

f prio

rity/

epid

emic

-pro

ne

dise

ases

and

syn

drom

es m

ost

rele

vant

to th

e co

untr

y.

Esta

blis

h a

dise

ase

surv

eilla

nce

unit

or d

epar

tmen

t and

fina

lize

the

oper

atio

nal p

lan44

and

pro

cess

.

Des

igna

te s

urve

illan

ce fo

cal p

erso

ns

at s

ubna

tiona

l lev

els.

Es

tabl

ish

indi

cato

r-ba

sed

surv

eilla

nce

D

evel

op g

uide

lines

and

SO

Ps fo

r in

dica

tor-

base

d su

rvei

llanc

e.

Es

tabl

ish

a de

sign

ated

uni

t at a

ll le

vels

, with

ope

ratio

nal p

lan

and

proc

edur

es.

In

clud

e co

untr

y pr

iorit

y di

seas

es in

in

dica

tor-

base

d su

rvei

llanc

e.

Dis

sem

inat

e ca

se d

efini

tions

and

en

sure

that

pro

cess

of d

etec

tion,

Es

tabl

ish

even

t-ba

sed

surv

eilla

nce

D

evel

op g

uide

lines

and

sta

ndar

d op

erat

ing

proc

edur

es fo

r eve

nt-

base

d su

rvei

llanc

e.

Esta

blis

h a

desi

gnat

ed u

nit a

t all

need

ed le

vels

, with

ope

ratio

nal p

lan

and

proc

edur

es.

D

evel

op a

nd p

ut in

pla

ce c

ase

defin

ition

s an

d th

e pr

oces

s of

de

tect

ion,

ass

essm

ent a

nd re

port

ing

of th

e ev

ent (

clus

ters

or o

utbr

eaks

)

44 T

he p

lan

that

cle

arly

defi

nes

actio

ns it

will

take

to s

uppo

rt th

e st

rate

gy.


70

Id

entif

y re

sour

ces

for c

ontro

l of

prio

rity

dise

ases

.

Dev

elop

trai

ning

mat

eria

ls fo

r di

seas

e su

rvei

llanc

e fo

r nat

iona

l and

su

bnat

iona

l lev

els.

D

isse

min

ate

case

defi

nitio

ns a

nd

proc

ess

of d

etec

tion,

ass

essm

ent,

and

repo

rtin

g of

cas

es (u

ser m

anua

l or

gui

delin

es) a

t nat

iona

l and

in

term

edia

te le

vels

.

Dev

elop

and

impl

emen

t ind

icat

or-

base

d su

rvei

llanc

e or

eve

nt-b

ased

su

rvei

llanc

e (re

fer t

o re

spec

tive

colu

mn

for t

heir

benc

hmar

ks).

asse

ssm

ent a

nd re

port

ing

of c

ases

(u

ser m

anua

l or g

uide

lines

) are

in

plac

e at

nat

iona

l and

sub

natio

nal

leve

ls.

for c

ount

ry p

riorit

y di

seas

es

and

diss

emin

ate

to n

atio

nal a

nd

subn

atio

nal l

evel

s.

Esta

blis

h a

proc

ess

to id

entif

y po

tent

ial e

vent

s fro

m c

omm

unity

- ba

sed

repo

rtin

g (p

eopl

e id

entifi

ed

from

the

com

mun

ity, v

erifi

catio

n te

ams

at fa

cilit

ies

iden

tified

, SO

P an

d flo

w o

f inf

orm

atio

n av

aila

ble)

an

d m

ake

the

data

ava

ilabl

e at

all

need

ed le

vels

.

Esta

blis

h sy

stem

s to

iden

tify

pote

ntia

l eve

nts

from

var

ious

oth

er

sour

ces

(suc

h as

med

ia, s

ocia

l m

edia

, priv

ate

sect

or).

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

ctio

ns (d

escr

ibed

abo

ve) f

or b

oth

indi

cato

r- a

nd e

vent

-bas

ed s

urve

illan

ce s

yste

ms

at n

atio

nal a

nd in

term

edia

te

leve

ls (d

istr

ict,

prov

ince

, reg

ion

or s

tate

).

Trai

n 70

% o

f hea

lth w

orke

rs (c

linic

ians

, lab

orat

oria

ns, s

urve

illan

ce o

ffice

rs) i

n de

tect

ion,

mon

itorin

g an

d ev

alua

tion

of

even

ts a

nd c

ases

, with

cle

ar g

uida

nce

for f

ollo

w-u

p di

ssem

inat

ed a

t nat

iona

l and

inte

rmed

iate

leve

ls; d

ocum

ent t

hat h

ealth

w

orke

rs h

ave

rece

ived

trai

ning

.

Esta

blis

h a

proc

ess

of im

med

iate

and

wee

kly

repo

rtin

g fro

m e

very

repo

rtin

g un

it, a

lthou

gh re

port

s m

ay n

ot b

e av

aila

ble

for

ever

y w

eek.

Es

tabl

ish

a pr

oces

s to

ens

ure

that

repo

rted

cas

es o

r eve

nts

with

out

brea

k po

tent

ial a

re in

vest

igat

ed a

nd a

sses

sed

for p

ublic

he

alth

resp

onse

and

link

ed to

the

labo

rato

ry re

sults

, and

that

dat

a fro

m th

e in

vest

igat

ion

are

man

aged

in a

sta

ndar

dize

d tim

efra

me

and

man

ner.

Co

nduc

t reg

ular

trai

ning

for s

urve

illan

ce s

taff

on S

OPs

, gui

delin

es, p

roce

dure

s an

d be

st p

ract

ices

at n

atio

nal a

nd

inte

rmed

iate

leve

ls.


71

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Tr

ain

mor

e th

an 9

0% lo

cal h

ealth

wor

kers

, vol

unte

ers

or b

oth

on d

etec

tion

and

repo

rtin

g of

cas

es, c

lust

ers,

out

brea

ks o

r ev

ents

, and

doc

umen

t tha

t hea

lth w

orke

rs a

re tr

aine

d.

Impl

emen

t the

imm

edia

te a

nd w

eekl

y re

port

ing

mec

hani

sm in

all

heal

th fa

cilit

ies

(pub

lic a

nd p

rivat

e) fr

om a

ll le

vels

, and

en

sure

that

wee

kly

repo

rts

are

rece

ived

.

Trai

n su

rvei

llanc

e st

aff a

t all

leve

ls o

n m

onito

ring

and

eval

uatin

g ev

ents

, and

dev

elop

and

impl

emen

t a c

lear

follo

w-u

p of

the

proc

ess

at n

atio

nal,

inte

rmed

iate

and

loca

l lev

els.

D

evel

op a

mec

hani

sm fo

r cro

ss-b

orde

r sur

veill

ance

by

mea

ns o

f an

agre

ed c

ross

-bor

der s

urve

illan

ce s

yste

m a

t poi

nts

of

entr

y, or

som

e ot

her m

echa

nism

of r

egul

arly

sha

ring

data

and

info

rmat

ion

betw

een

neig

hbou

ring

coun

trie

s.

Cond

uct r

egul

ar tr

aini

ng o

n SO

Ps, g

uide

lines

, pro

cedu

res

and

best

pra

ctic

es a

t all

leve

ls, i

nclu

ding

at t

he lo

cal/h

ealth

faci

lity

leve

l, fo

r sur

veill

ance

sta

ff.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd im

plem

ent a

n op

erat

iona

l pla

n fo

r ong

oing

eva

luat

ion

of th

e su

rvei

llanc

e sy

stem

at a

ll le

vels

.

Esta

blis

h a

mec

hani

sm to

upd

ate

the

surv

eilla

nce

syst

em b

ased

on

eval

uatio

n fin

ding

s at

all

leve

ls.

Se

cure

sus

tain

ed fu

ndin

g fo

r per

sonn

el a

nd m

ater

ials

for t

he s

urve

illan

ce s

yste

m.

D

evel

op a

pla

n an

d pr

oces

s to

sup

port

effo

rts

of o

ther

cou

ntrie

s to

dev

elop

/enh

ance

sur

veill

ance

sys

tem

s, in

clud

ing

cont

ribut

ing

to re

gion

al a

nd/o

r int

erna

tiona

l sur

veill

ance

net

wor

ks.

M

onito

r im

plem

enta

tion

of c

ross

-bor

der s

urve

illan

ce a

nd d

emon

stra

te th

at in

form

atio

n-sh

arin

g pr

otoc

ol is

effe

ctiv

e.

Esta

blis

h a

mec

hani

sm to

con

trib

ute

to re

gion

al o

r int

erna

tiona

l sur

veill

ance

net

wor

ks.


72

CAPA

CITY

LEVE

L

Benc

hmar

k 9.

2: S

urve

illan

ce s

yste

m is

sup

port

ed b

y el

ectr

onic

tool

s O

bjec

tive:

App

licat

ion

of e

letr

onic

tool

s fo

r sur

veill

ance

sys

tem

01N

O C

APAC

ITY

No

syst

em d

evel

oped

; an

asse

ssm

ent o

f the

ele

ctro

nic

syst

em is

pla

nned

or i

s be

ing

cond

ucte

d.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

U

se a

d ho

c el

ectro

nic

tool

s (s

uch

as E

xcel

spr

eads

heet

s) to

repo

rt a

nd a

naly

se s

urve

illan

ce d

ata,

whi

le a

mor

e so

phis

ticat

ed

syst

em is

und

er d

evel

opm

ent.

Pi

lot a

vaila

ble

elec

troni

c to

ols.

D

evel

op a

str

ateg

y fo

r int

egra

ted

elec

troni

c re

al-t

ime

repo

rtin

g sy

stem

for p

ublic

hea

lth s

urve

illan

ce w

ith th

e in

volv

emen

t of

mul

tisec

tora

l sta

keho

lder

s an

d pa

rtne

rs.

D

evel

op o

pera

tiona

l pla

n, s

tand

ards

for d

ata,

and

pla

ns fo

r int

erop

erab

ility

and

dat

a sh

arin

g.

Esta

blis

h a

link

of th

e el

ectro

nic

syst

em u

nder

dev

elop

men

t to

the

exis

ting

heal

th in

form

atio

n m

anag

emen

t sys

tem

.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

n el

ectro

nic

surv

eilla

nce

syst

em a

t the

nat

iona

l lev

el fo

r bot

h in

dica

tor-

and

eve

nt-b

ased

sur

veill

ance

.

Dev

elop

an

elec

troni

c ev

ent m

anag

emen

t sys

tem

at t

he n

atio

nal l

evel

.

Link

ele

ctro

nic

tool

s w

ith th

e la

bora

tory

info

rmat

ion

man

agem

ent s

yste

m a

t the

nat

iona

l lev

el.

D

evel

op a

nd d

isse

min

ate

SOPs

, pro

cedu

res

and

guid

elin

es a

t all

leve

ls.

Tr

ain

80%

of n

atio

nal-

and

inte

rmed

iate

-leve

l sur

veill

ance

sta

ff on

app

licat

ion/

softw

are

for s

urve

illan

ce.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent t

he e

lect

roni

c sy

stem

in 8

0% le

vels

of t

he h

ealth

sys

tem

.

Dev

elop

an

elec

troni

c ev

ent m

anag

emen

t sys

tem

at a

ll le

vels

of t

he h

ealth

sys

tem

.

Link

ele

ctro

nic

tool

s w

ith th

e la

bora

tory

info

rmat

ion

man

agem

ent s

yste

m a

t all

leve

ls.

Co

nduc

t rou

tine

trai

ning

on

appl

icat

ion

or s

oftw

are

for s

urve

illan

ce s

taff

at a

ll le

vels

, inc

ludi

ng 1

00%

of n

atio

nal-

and

inte

rmed

iate

-leve

l sur

veill

ance

sta

ff.


73

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent t

he e

lect

roni

c sy

stem

at a

ll le

vels

of t

he h

ealth

sys

tem

, inc

ludi

ng fr

om p

rivat

e he

alth

care

pro

vide

rs a

nd p

rivat

e la

bora

torie

s.

Secu

re re

sour

ces

for o

pera

tion

of th

e sy

stem

, inc

ludi

ng h

uman

reso

urce

s, h

ardw

are,

sof

twar

e an

d ne

twor

k in

fras

truc

ture

to

run

the

syst

em a

t all

leve

ls.

M

onito

r and

eva

luat

e th

e el

ectro

nic

surv

eilla

nce

syst

em fo

r upd

atio

n as

nee

ded.

Te

st in

tero

pera

bilit

y of

the

elec

troni

c sy

stem

with

oth

er re

leva

nt e

lect

roni

c to

ols

of o

ther

sec

tors

.

Dev

elop

and

dis

sem

inat

e gu

idan

ce to

all

sect

ors

(suc

h as

ani

mal

hea

lth, f

ood

safe

ty) o

n da

ta s

harin

g an

d in

tero

pera

bilit

y.

Trai

n st

aff a

nd d

evel

op p

roto

cols

to s

hare

dat

a w

ith re

gion

al o

r int

erna

tiona

l act

ors

(suc

h as

sha

ring

influ

enza

dat

a in

Glo

bal

Influ

enza

Sur

veill

ance

and

Res

pons

e Sy

stem

and

/or F

luN

ET (a

glo

bal w

eb-b

ased

tool

for i

nflu

enza

viro

logi

cal s

urve

illan

ce))


74

CAPA

CITY

LEVE

L

Benc

hmar

k 9.

3: S

yste

mat

ic a

naly

sis

of s

urve

illan

ce d

ata

for a

ctio

n is

in p

lace

O

bjec

tive:

Con

duct

ana

lysi

s of

dat

a fo

r act

ion

01N

O C

APAC

ITY

No

capa

city

to a

naly

se d

ata.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op s

tand

ards

and

exp

ecta

tions

for a

naly

sis

of s

urve

illan

ce d

ata,

with

an

oper

atio

nal p

lan.

D

evel

op a

trai

ning

pac

kage

for d

ata

man

agem

ent (

data

col

latio

n, a

naly

sis,

tren

d an

alys

is a

nd d

evel

opin

g re

port

s or

su

mm

arie

s).

D

evel

op a

nd d

isse

min

ate

guid

elin

es a

nd p

roce

dure

s to

ass

ess

the

risk

of u

nusu

al c

ase

repo

rts

and

surv

eilla

nce

sign

als

at

all l

evel

s.

Prod

uce

ad h

oc re

port

s of

ana

lyse

d su

rvei

llanc

e da

ta fo

r out

brea

ks o

r oth

er p

ublic

hea

lth e

vent

s an

d di

ssem

inat

e fro

m th

e na

tiona

l lev

el.

D

evel

op a

tool

and

sta

ndar

ds fo

r dat

a qu

ality

ass

essm

ent.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t tra

inin

g on

dat

a an

alys

is a

t nat

iona

l and

inte

rmed

iate

leve

ls.

Pr

oduc

e an

d di

ssem

inat

e an

nual

and

mon

thly

repo

rts

base

d on

som

e an

alys

is (i

.e. n

ot o

nly

num

eric

al c

ase

info

rmat

ion)

fro

m th

e na

tiona

l sur

veill

ance

team

.

Dev

elop

a tr

aini

ng p

acka

ge a

nd tr

ain

staf

f on

the

asse

ssm

ent o

f ris

k of

unu

sual

cas

e re

port

s an

d su

rvei

llanc

e si

gnal

s at

na

tiona

l and

inte

rmed

iate

leve

ls.

D

evel

op a

pro

cess

and

pub

lish

rout

ine

repo

rts

of e

pide

mio

logi

cal i

nfor

mat

ion

for p

riorit

y di

seas

es a

t the

nat

iona

l lev

el.

D

evel

op s

tand

ards

, con

tent

and

form

at o

f an

epid

emio

logi

cal b

ulle

tin fo

r nat

iona

l, in

term

edia

te a

nd lo

cal l

evel

s.

Dev

elop

cap

acity

to c

ondu

ct p

erio

dic

asse

ssm

ent o

f dat

a qu

ality

at t

he n

atio

nal l

evel

.


75

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t tra

inin

g on

dat

a an

alys

is fo

r sur

veill

ance

sta

ff at

all

leve

ls.

Pr

oduc

e w

eekl

y ep

idem

iolo

gica

l rep

orts

with

ana

lyse

d da

ta o

n pr

iorit

y di

seas

es a

nd d

isse

min

ate

to a

ll le

vels

.

Cond

uct a

trai

ning

ass

essm

ent o

f the

risk

of u

nusu

al c

ase

repo

rts

and

surv

eilla

nce

sign

als

at a

ll le

vels

.

Prod

uce

anal

yses

and

dis

sem

inat

e ep

idem

iolo

gic

inte

rpre

tatio

n of

all

maj

or e

vent

s at

all

leve

ls.

O

pera

tiona

lize

a m

echa

nism

for m

onito

ring

data

qua

lity

and

anal

ysis

at n

atio

nal a

nd in

term

edia

te le

vels

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a de

dica

ted

team

for d

ata

anal

ysis

, ris

k as

sess

men

t and

repo

rtin

g at

nat

iona

l and

inte

rmed

iate

leve

ls.

D

evel

op a

mec

hani

sm a

nd tr

ain

staf

f to

shar

e da

ta w

ith o

ther

tool

s th

at a

re u

sed

at re

gion

al o

r int

erna

tiona

l lev

els

(suc

h as

sh

arin

g in

fluen

za d

ata

in G

ISRS

).

Secu

re s

usta

inab

le fu

ndin

g an

d re

sour

ces

for d

ata

anal

ysis

sta

ff an

d w

eekl

y re

port

ing

syst

em.

D

emon

stra

te c

ontin

uous

impr

ovem

ent o

f dat

a qu

ality

at a

ll le

vels

, usi

ng a

sses

smen

t res

ults

.

TOO

LS:

Pu

blic

Hea

lth S

urve

illan

ce –

WH

O re

sour

ces

In

tegr

ated

Dis

ease

Sur

veill

ance

– R

esou

rces

W

HO

reco

mm

ends

sur

veill

ance

sta

ndar

ds –

Sec

ond

Editi

on


76

HU

MAN

RES

OU

RCES

10

IMPA

CT:

Prev

entio

n, d

etec

tion

and

resp

onse

act

iviti

es (i

nclu

ding

hea

lth p

rom

otio

n, o

ccup

atio

nal h

ealth

saf

ety

and

secu

rity,

and

appr

opria

te c

are

of th

ose

affe

cted

) con

duct

ed e

ffect

ivel

y an

d su

stai

nabl

y by

a fu

lly c

ompe

tent

, coo

rdin

ated

, eva

luat

ed a

nd o

ccup

atio

nally

div

erse

mul

tisec

tora

l wor

kfor

ce.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) A tr

aine

d he

alth

wor

kfor

ce th

at in

clud

es n

urse

s an

d m

idw

ives

, phy

sici

ans,

epi

dem

iolo

gist

s an

d ot

her p

ublic

hea

lth a

nd e

nviro

nmen

tal

spec

ialis

ts, s

ocia

l sci

entis

ts, l

abor

ator

y sc

ient

ists

/tec

hnic

ians

, bio

stat

istic

ians

, IT

spec

ialis

ts a

nd b

iom

edic

al te

chni

cian

s. (2

) Exi

sten

ce o

f a

corr

espo

ndin

g w

orkf

orce

in th

e an

imal

sec

tor o

f vet

erin

aria

ns, p

ara-

vete

rinar

ians

, ani

mal

hea

lth p

rofe

ssio

nals

, epi

dem

iolo

gist

s, IT

spe

cial

ists

an

d ot

hers

.

Stat

es P

artie

s w

ith c

ompe

tent

and

wel

l-mot

ivat

ed h

ealth

per

sonn

el fo

r sus

tain

able

and

func

tiona

l pub

lic h

ealth

sur

veill

ance

and

resp

onse

are

ava

ilabl

e at

al

l lev

els

of th

e he

alth

sys

tem

for e

ffect

ive

impl

emen

tatio

n of

IHR.

Hum

an re

sour

ces

incl

ude

nurs

es a

nd m

idw

ives

, phy

sici

ans,

epi

dem

iolo

gist

s an

d ot

her

publ

ic h

ealth

and

env

ironm

enta

l spe

cial

ists

, soc

ial s

cien

tists

, com

mun

icat

ions

per

sonn

el, o

ccup

atio

nal h

ealth

per

sonn

el, la

bora

tory

sci

entis

ts/t

echn

icia

ns,

bios

tatis

ticia

ns, in

form

atio

n te

chno

logy

(IT)

spe

cial

ists

and

bio

med

ical

tech

nici

ans.

The

re is

a c

orre

spon

ding

wor

kfor

ce in

the

anim

al s

ecto

r of v

eter

inar

ians

, an

imal

hea

lth p

rofe

ssio

nals

, par

a-ve

terin

aria

ns, e

pide

mio

logi

sts

and

IT s

peci

alis

ts.

The

reco

mm

ende

d de

nsity

of d

octo

rs, n

urse

s an

d m

idw

ives

per

100

0 po

pula

tion

for o

pera

tiona

l rou

tine

serv

ices

is 4

.45

plus

30%

sur

ge c

apac

ity. T

he o

ptim

al

targ

et fo

r sur

veill

ance

is o

ne tr

aine

d (fi

eld)

epi

dem

iolo

gist

(or e

quiv

alen

t) pe

r 200

000

pop

ulat

ion

who

can

sys

tem

atic

ally

coo

pera

te to

mee

t rel

evan

t IH

R an

d PV

S co

re c

ompe

tenc

ies.

One

trai

ned

epid

emio

logi

st is

nee

ded

per r

apid

resp

onse

team

.


77

CAPA

CITY

LEVE

L

Benc

hmar

k 10

.1: A

n up

-to-

date

, mul

tisec

tora

l wor

kfor

ce s

trat

egy

is in

pla

ce

Obj

ectiv

e: T

o de

velo

p an

d im

plem

ent a

n up

-to-

date

wor

kfor

ce s

trat

egy

for a

func

tiona

l mul

tisec

tora

l hea

lth w

orkf

orce

01N

O C

APAC

ITY

No

mul

tisec

tora

l One

Hea

lth w

orkf

orce

str

ateg

y in

pla

ce.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

As

sess

45 a

nd d

evel

op/d

ocum

ent46

cou

ntry

’s c

urre

nt h

ealth

wor

kfor

ce s

trat

egy.

Bu

ild p

lann

ing

capa

city

to d

evel

op o

r im

prov

e hu

man

reso

urce

s fo

r hea

lth p

olic

y an

d st

rate

gies

that

qua

ntify

hea

lth

wor

kfor

ce n

eeds

, dem

ands

and

sup

ply

unde

r var

ied

futu

re s

cena

rios.

D

evel

op a

mec

hani

sm fo

r mul

tisec

tora

l act

ion

on h

ealth

wor

kfor

ce is

sues

to g

ener

ate

requ

ired

supp

ort f

rom

all

rele

vant

he

alth

sec

tors

, min

istr

ies

of fi

nanc

e, e

duca

tion

and

labo

ur (o

r equ

ival

ent),

col

labo

ratin

g pa

rtne

rs a

nd s

take

hold

ers.

D

evel

op a

pla

n to

fund

and

impl

emen

t the

hea

lth w

orkf

orce

str

ateg

y (a

nim

al a

nd h

uman

hea

lth s

ecto

r), a

nd d

onor

co

ntrib

utio

ns.

D

ocum

ent a

nd d

isse

min

ate

the

publ

ic h

ealth

wor

kfor

ce/h

uman

reso

urce

str

ateg

y.

45 T

his

asse

ssm

ent m

ust d

escr

ibe

whi

ch c

ateg

orie

s of

hea

lth w

orke

rs a

re in

clud

ed in

the

wor

kfor

ce s

trat

egy

(suc

h as

epi

dem

iolo

gist

s, v

eter

inar

ians

, lab

orat

ory

assi

stan

ts a

nd s

peci

alis

ts,

doct

ors,

nur

ses

and

com

mun

ity h

ealth

wor

kers

). 46

Doc

umen

t job

spe

cific

atio

ns fo

r var

ious

cat

egor

ies

of h

ealth

wor

kers

(inc

ludi

ng s

cope

s of

pra

ctic

e, p

erfo

rman

ce a

ppra

isal

, com

pete

ncy

stan

dard

s, c

aree

r lad

der o

ptio

ns).


78

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op p

roto

cols

, SO

Ps, a

nd te

chni

cal g

uide

lines

to e

nsur

e re

gula

r rev

iew

and

upd

ate

of th

e m

ultis

ecto

ral w

orkf

orce

st

rate

gy w

ith fi

nal a

ppro

val f

rom

oth

er re

leva

nt s

ecto

rs o

r oth

er re

leva

nt g

over

nmen

t age

ncie

s.

Dev

elop

min

imum

sta

ndar

ds fo

r ani

mal

(dom

estic

and

wild

life)

, env

ironm

enta

l and

hum

an h

ealth

sta

ffing

leve

ls.

D

ocum

ent a

sep

arat

e w

orkf

orce

str

ateg

y fo

r hum

an re

sour

ces

for t

he a

nim

al a

nd e

nviro

nmen

tal h

ealth

sec

tors

, if n

ot

alre

ady

incl

uded

as

part

of t

he p

ublic

hea

lth w

orkf

orce

str

ateg

y.

Crea

te a

ppro

pria

te jo

b cl

assifi

catio

n an

d jo

b de

scrip

tion

for h

ealth

wor

kers

at a

ll lev

els

of th

e re

levan

t min

istrie

s, an

d cl

ear c

aree

r lad

der.

Es

tabl

ish

a na

tiona

l cas

e fo

r inv

estm

ent i

n hu

man

reso

urce

s fo

r hea

lth a

s a

vita

l com

pone

nt o

f the

Sus

tain

able

Dev

elop

men

t G

oals

, Uni

vers

al H

ealth

Cov

erag

e an

d un

iver

sal a

cces

s to

hea

lthca

re (G

loba

l Stra

tegy

on

HRH

203

0 O

bj3.

59).

Co

nduc

t adv

ocac

y to

impl

emen

t the

stra

tegy

to re

leva

nt s

take

hold

ers,

incl

udin

g m

inis

tries

of h

ealth

, fina

nce,

pla

nnin

g an

d ad

min

istra

tion/

civi

l ser

vice

.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

onito

r and

eva

luat

e th

e im

plem

enta

tion

of th

e m

ultis

ecto

ral w

orkf

orce

str

ateg

y to

trac

k pr

ogre

ss a

nd b

arrie

rs.

D

ocum

ent h

ow th

e na

tiona

l pub

lic h

ealth

wor

kfor

ce is

fina

nced

with

in th

e co

untr

y (G

loba

l Str

ateg

y on

HRH

203

0 O

bj2.

38).

D

evel

op a

str

ateg

ic fr

amew

ork

to n

atio

nally

prio

ritiz

e re

sour

ces

and

inve

stm

ents

in O

ne H

ealth

wor

kfor

ce d

evel

opm

ent.

M

ap a

nd a

lign

inve

stm

ent i

n hu

man

reso

urce

s fo

r hea

lth w

ith th

e cu

rren

t and

futu

re n

eeds

of t

he p

opul

atio

n an

d he

alth

sy

stem

s to

add

ress

sho

rtag

es a

nd e

nhan

ce d

istr

ibut

ion

of h

ealth

wor

kers

, to

enab

le m

axim

um im

prov

emen

ts in

hea

lth

outc

omes

, soc

ial w

elfa

re, e

mpl

oym

ent c

reat

ion

and

econ

omic

gro

wth

(Glo

bal S

trat

egy

on H

RH 2

030

Obj

2).

D

ocum

ent a

nd d

isse

min

ate

annu

al re

port

s of

the

mul

tisec

tora

l wor

kfor

ce s

trat

egic

pla

n w

hich

is c

ompl

eted

and

has

bee

n im

plem

ente

d co

nsis

tent

ly.


79

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ad

opt,

revi

ew a

nd re

vise

str

ateg

y re

gula

rly, r

egar

ding

sus

tain

abili

ty o

f wor

kfor

ce, s

taffi

ng a

nd in

cent

ive

mod

els,

sta

ff re

crui

tmen

t, de

velo

pmen

t/tr

aini

ng a

nd re

tent

ion

mec

hani

sms,

pla

nnin

g an

d m

onito

ring

of h

uman

reso

urce

s, a

nd

impl

emen

tatio

n of

a c

aree

r lad

der.

Es

tabl

ish

natio

nal h

ealth

wor

kfor

ce re

gist

ries

of c

ompe

tent

and

pra

ctic

ing

staf

f, an

d co

llect

key

per

form

ance

indi

cato

rs o

n he

alth

wor

ker s

tock

, dis

trib

utio

n, fl

ow, d

eman

d, s

uppl

y ca

paci

ty a

nd re

mun

erat

ion,

in b

oth

the

publ

ic a

nd p

rivat

e se

ctor

s,

disa

ggre

gate

d by

age

, sex

, eth

nic

or li

ngui

stic

gro

up, a

nd p

lace

of e

mpl

oym

ent (

Glo

bal S

trat

egy

on H

RH 2

030

Obj

4.75

).

Inco

rpor

ate

with

in th

e w

orkf

orce

str

ateg

y ap

prop

riate

ince

ntiv

e pa

ckag

es a

nd s

trat

egie

s to

attr

act,

trai

n an

d re

tain

exp

erts

fo

r any

wor

kfor

ce s

peci

altie

s (m

ay in

clud

e ph

ysic

ians

, nur

ses,

vet

erin

aria

ns, b

iost

atis

ticia

ns la

bora

tory

ass

ista

nts

and

spec

ialis

ts, o

r ani

mal

hea

lth p

rofe

ssio

nals

) to

mee

t nat

iona

l and

sub

natio

nal n

eeds

thro

ugh

dom

estic

ally

trai

ned

heal

th

wor

kers

(Glo

bal S

trat

egy

on H

RH 2

030

Obj

1.25

).

Esta

blis

h a

natio

nal (

and

subn

atio

nal w

here

rele

vant

) con

tinui

ng p

rofe

ssio

nal e

duca

tion

prog

ram

me

for p

rofe

ssio

nals

(G

loba

l Str

ateg

y on

HRH

203

0 O

bj1.

24).


80

CAPA

CITY

LEVE

L

Benc

hmar

k 10

.2: H

uman

reso

urce

s ar

e av

aila

ble

to e

ffec

tivel

y im

plem

ent I

HR

Obj

ectiv

e: T

o de

velo

p a

publ

ic h

ealth

wor

kfor

ce th

at is

ava

ilabl

e an

d tr

aine

d to

pre

vent

, det

ect,

asse

ss, n

otify

, rep

ort a

nd

resp

ond

to p

ublic

hea

lth ri

sks

and

acut

e ev

ents

of d

omes

tic a

nd in

tern

atio

nal c

once

rn a

nd h

ealth

ser

vice

pro

visi

on (i

.e.

epid

emic

pre

pare

dnes

s an

d co

ntro

l) at

all

leve

ls o

f hea

lth s

yste

ms

to e

ffec

tivel

y im

plem

ent I

HR

01N

O C

APAC

ITY

Coun

try

does

not

hav

e ap

prop

riate

hum

an re

sour

ces

capa

city

in re

leva

nt s

ecto

rs re

quire

d fo

r epi

dem

ic p

repa

redn

ess

and

cont

rol.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y a

resp

onsi

ble

unit

and

advi

sory

com

mitt

ee fo

r the

dev

elop

men

t of h

uman

reso

urce

cap

acity

to m

eet I

HR

capa

city

ne

eds.

Co

nduc

t eng

agem

ent m

eetin

gs w

ith th

e hu

man

, ani

mal

and

env

ironm

enta

l hea

lth s

ecto

r wor

kfor

ce a

nd o

ther

sta

keho

lder

s to

exp

and

the

mul

tisec

tora

l pub

lic h

ealth

wor

kfor

ce s

trat

egy

to in

clud

e IH

R ca

paci

ty n

eeds

, suc

h as

pub

lic h

ealth

trai

ning

pr

ogra

mm

es, h

uman

reso

urce

infr

astr

uctu

re, e

xist

ing

and

requ

ired

prof

essi

onal

sta

ffing

leve

ls, a

dmin

istr

ativ

e su

ppor

t and

fu

ndin

g re

quire

men

ts.

Id

entif

y th

e ne

eds

as w

ell a

s cu

rren

t ava

ilabi

lity

and

dist

ribut

ion

of h

uman

reso

urce

s fo

r hea

lth c

apac

ities

: (G

loba

l Str

ateg

y on

HRH

203

0 O

bj1.

28, O

bj4.

75)

Su

rvei

llanc

e of

ficer

s (in

clud

ing

field

epi

dem

iolo

gy s

hort

-cou

rse

trai

ned

and

long

er c

ours

e tr

aine

d) a

nd b

iost

atis

ticia

ns ;

Cl

inic

ians

and

clin

ical

ass

ista

nts

;

Nur

ses

;

Labo

rato

ry s

peci

alis

ts a

nd te

chni

cian

s ;

Ve

terin

aria

ns, v

eter

inar

y te

chni

cian

s an

d pa

ra-v

eter

inar

ians

;

Info

rmat

ion

spec

ialis

ts a

nd a

ssis

tant

s ;

So

cial

sci

entis

ts ;

O

ther

rele

vant

pub

lic h

ealth

per

sonn

el.

Es

tabl

ish

or s

treng

then

nat

iona

l rap

id re

spon

se te

ams

so th

at it

is m

ultid

isci

plin

ary

and

mul

tilev

el.


81

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

hum

an re

sour

ces

for h

ealth

uni

t in

the

hum

an a

nd a

nim

al h

ealth

sec

tors

that

can

mon

itor p

olic

ies

and

plan

s to

in

crea

se th

e m

ultis

ecto

r ani

mal

and

hum

an h

ealth

wor

kfor

ce, a

nd to

pro

mot

e th

e re

crui

tmen

t and

rete

ntio

n of

qua

lified

m

ultid

isci

plin

ary

staf

f.

Dev

elop

a d

atab

ase

of in

-cou

ntry

mul

tidis

cipl

inar

y su

bjec

t mat

ter e

xper

ts re

leva

nt to

IHR.

M

ap re

leva

nt p

ublic

hea

lth m

ultid

isci

plin

ary

wor

kfor

ce a

nd re

view

cur

ricul

um, w

ith u

nive

rsiti

es a

nd p

artn

ers,

for a

ll IH

R hu

man

reso

urce

requ

irem

ents

(suc

h as

for t

he fi

eld

epid

emio

logy

trai

ning

pro

gram

me

curr

icul

um, t

rain

ing

mat

eria

ls,

men

tors

, eva

luat

ion

proc

edur

es, a

ccre

dita

tion)

.

Dev

elop

con

tinui

ng p

rofe

ssio

nal e

duca

tion

prog

ram

mes

, in

prio

rity

One

Hea

lth d

isci

plin

es, a

t the

nat

iona

l and

sub

natio

nal

leve

ls w

ithin

the

stra

tegi

c fr

amew

ork

that

als

o tr

acks

wor

kfor

ce re

tent

ion

and

perf

orm

ance

.

Esta

blis

h te

rms

of re

fere

nce

and

job

desc

riptio

ns fo

r int

erm

edia

te le

vel (

prov

inci

al, d

istr

ict)

rapi

d re

spon

se te

ams

and

publ

ic

heal

th o

ffice

r in-

char

ge o

f out

brea

k pr

epar

edne

ss a

nd re

spon

se.

Tr

ain

or re

crui

t hum

an re

sour

ces

for t

he im

plem

enta

tion

of IH

R ca

paci

ties

for a

ll re

leva

nt s

ecto

rs a

t the

nat

iona

l lev

el.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ex

pand

the

mul

tisec

tora

l str

ateg

ic w

orkf

orce

pla

n na

tionw

ide

to th

e su

bnat

iona

l lev

el.

Im

plem

ent t

he m

ultis

ecto

ral s

trat

egic

wor

kfor

ce p

lan

cons

iste

ntly

at t

he n

atio

nal,

and

subn

atio

nal l

evel

s, w

ith re

gula

r re

view

s to

trac

k pr

ogre

ss a

nd b

arrie

rs, a

nd a

t lea

st a

nnua

l upd

ates

.

Mob

ilize

reso

urce

s to

ens

ure

each

loca

l lev

el h

as s

ome

capa

city

for e

pide

mio

logy

, cas

e m

anag

emen

t, la

bora

tory

ser

vice

s,

One

Hea

lth, a

nd o

ther

s as

nee

ded.

D

evel

op a

nd im

plem

ent S

OPs

on

how

pro

fess

iona

ls a

t the

nat

iona

l and

sub

natio

nal l

evel

s co

mm

unic

ate

durin

g an

in

fect

ious

dis

ease

out

brea

k.

Esta

blis

h a

data

base

of h

uman

reso

urce

s in

all

rele

vant

sec

tors

and

leve

ls o

f the

pub

lic h

ealth

sys

tem

that

can

pro

vide

m

ultid

isci

plin

ary

heal

th p

erso

nnel

dur

ing

publ

ic h

ealth

em

erge

ncie

s w

ith S

OPs

for u

pdat

ing

and

mai

ntai

ning

it.


82

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

nat

iona

l pre

pare

dnes

s an

d re

spon

se p

lans

as

wel

l as

lega

l and

regu

lato

ry fr

amew

orks

and

est

ablis

h pr

otoc

ols,

SO

Ps, t

echn

ical

gui

delin

es a

nd to

olki

ts to

sen

d an

d re

ceiv

e m

ultid

isci

plin

ary

heal

th p

erso

nnel

dur

ing

publ

ic h

ealth

em

erge

ncie

s.

Revi

ew th

e im

plem

enta

tion

plan

of s

endi

ng a

nd re

ceiv

ing

mul

tidis

cipl

inar

y he

alth

per

sonn

el in

at l

east

one

eve

nt re

spon

se.

If th

ere

is n

o re

spon

se in

the

prev

ious

yea

r, th

en d

evel

op a

nd c

ondu

ct a

sim

ulat

ion

exer

cise

to te

st th

e ca

paci

ty.

Id

entif

y re

gion

al a

nd in

tern

atio

nal (

such

as

Glo

bal O

utbr

eak

Aler

t and

Res

pons

e N

etw

ork)

par

tner

s fo

r mul

tidis

cipl

inar

y he

alth

per

sonn

el a

nd e

stab

lish

part

ners

hips

or f

orm

al a

gree

men

ts w

ith th

em.


83

CAPA

CITY

LEVE

L

Benc

hmar

k 10

.3: I

n-se

rvic

e tr

aini

ngs

are

avai

labl

e O

bjec

tive:

To

deve

lop

a fu

nctio

ning

and

acc

redi

ted

cont

inui

ng p

rofe

ssio

nal e

duca

tion

prog

ram

me

thro

ugh

in-s

ervi

ce

trai

ning

s at

nat

iona

l and

sub

natio

nal l

evel

s

01N

O C

APAC

ITY

No

cont

inui

ng p

rofe

ssio

nal e

duca

tion

prog

ram

me

thro

ugh

in-s

ervi

ce tr

aini

ng c

ours

e is

in p

lace

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d ad

dres

s tr

aini

ng n

eeds

for v

ario

us p

rofe

ssio

ns/c

adre

s.

Iden

tify

and

docu

men

t tra

inin

g pr

ogra

mm

es s

peci

fic to

pro

fess

ions

with

in e

ach

pres

ervi

ce tr

aini

ng c

urric

ula

and

join

t tr

aini

ng p

rogr

amm

es.

Pu

blis

h a

natio

nal l

ist o

f in-

serv

ice

trai

ning

ava

ilabl

e in

the

coun

try

incl

udin

g na

tiona

l tra

inin

g in

stitu

tes,

pro

fess

iona

l bod

ies,

sc

hool

s of

pub

lic h

ealth

, nur

sing

, mid

wife

ry, v

eter

inar

y m

edic

al c

olle

ges

and

univ

ersi

ties

that

pro

vide

in-s

ervi

ce tr

aini

ng

cour

ses.

Id

entif

y an

d do

cum

ent a

ll tr

aini

ngs

rela

ted

to c

ontin

genc

y pl

anni

ng, m

anag

emen

t of e

mer

genc

y si

tuat

ions

, ris

k co

mm

unic

atio

ns, a

nd jo

int e

xerc

ises

for m

ultid

isci

plin

ary

team

s.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

nd im

plem

ent a

con

tinui

ng p

rofe

ssio

nal e

duca

tion

prog

ram

me

that

incl

udes

out

brea

k pr

epar

edne

ss a

nd c

ontro

l, fo

r at l

east

one

gro

up o

f pro

fess

iona

ls, s

uch

as p

ublic

hea

lth o

ffice

rs, s

urve

illan

ce o

ffice

rs, n

urse

s, m

idw

ives

, gen

eral

m

edic

al p

ract

ition

ers,

vet

erin

aria

ns, p

ara-

vete

rinar

ians

.

Dev

elop

and

impl

emen

t at l

east

at t

he n

atio

nal l

evel

sho

rt in

-ser

vice

trai

ning

s on

sur

veill

ance

, out

brea

k pr

epar

edne

ss a

nd

resp

onse

for s

peci

fic c

adre

s.


84

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent a

t nat

iona

l and

sub

natio

nal l

evel

s sh

ort-

/long

-ter

m in

-ser

vice

trai

ning

pro

gram

mes

to h

elp

expa

nd th

e nu

mbe

r of

qua

lified

pub

lic h

ealth

pro

fess

iona

ls w

ithin

the

coun

try,

i.e.

Ph

ysic

ians

(pub

lic h

ealth

and

/or c

linic

al c

are)

;

Nur

ses

(pub

lic h

ealth

and

/or c

linic

al c

are)

;

Vete

rinar

ians

(pub

lic h

ealth

, agr

icul

tura

l and

/or p

rivat

e pr

actic

e) a

nd p

ara-

vete

rinar

ians

;

Bios

tatis

ticia

ns ;

O

ther

pub

lic h

ealth

offi

cers

/sur

veill

ance

offi

cers

;

Labo

rato

ry a

ssis

tant

s an

d sp

ecia

lists

;

Live

stoc

k pr

ofes

sion

als.

Im

plem

ent a

t nat

iona

l and

sub

natio

nal l

evel

s sh

ort i

n-se

rvic

e tr

aini

ngs

on s

urve

illan

ce, o

utbr

eak

prep

ared

ness

, res

pons

e,

inci

dent

com

man

d sy

stem

and

risk

com

mun

icat

ion

for s

peci

fic c

adre

s.

Recr

uit s

peci

alis

ts a

s pa

rt o

f IH

R im

plem

enta

tion

at th

e ne

xt re

crui

tmen

t to

stre

ngth

en h

uman

reso

urce

s.

Expl

ore

and

impl

emen

t mea

sure

s to

org

aniz

e an

d fin

ance

spe

cial

izat

ion

and

cont

inuo

us p

rofe

ssio

nal e

duca

tion

in p

ublic

he

alth

, inc

ludi

ng e

pide

mio

logy

, lab

orat

ory,

anim

al a

nd e

nviro

nmen

tal h

ealth

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

ocum

ent t

he re

view

of i

mpl

emen

tatio

n of

sho

rt-/

long

-ter

m in

-ser

vice

trai

ning

pro

gram

mes

.

Gua

rant

ee tr

aine

d st

aff a

nd re

sour

ces

for a

ll IH

R re

leva

nt e

mer

genc

ies/

haza

rds.

Co

ntin

ue a

nd e

xpan

d in

-ser

vice

trai

ning

and

rete

ntio

n pr

ogra

mm

es fo

r spe

cial

ized

hea

lth p

erso

nnel

invo

lved

in IH

R im

plem

enta

tion

in d

ifficu

lt to

acc

ess

area

s.

Mon

itor t

he m

edia

n nu

mbe

r of y

ears

that

pub

lic h

ealth

per

sonn

el h

ave

been

on

staf

f rol

ls w

ithin

the

min

istr

y an

d/or

nat

iona

l in

stitu

tes

and

post

a li

st o

f cur

rent

sta

ff (if

ava

ilabl

e), s

taff

turn

over

and

num

ber o

f sta

ff at

tend

ing

in-s

ervi

ce tr

aini

ng.

Ex

pand

cur

rent

pub

lic h

ealth

and

fiel

d ep

idem

iolo

gy tr

aini

ng p

rogr

amm

es to

incl

ude:

refre

sher

cou

rses

; an

indu

ctio

n pr

ogra

mm

e fo

r fiel

d ep

idem

iolo

gist

s; re

gula

r in-

serv

ice

prog

ram

mes

and

con

tinuo

us p

rofe

ssio

nal d

evel

opm

ent

prog

ram

mes

for a

nim

al h

ealth

sta

ff; a

nd a

sus

tain

able

met

hodo

logy

and

pro

cess

to p

rovi

de c

ontin

uous

and

regu

lar

educ

atio

n fo

r fiel

d ep

idem

iolo

gy s

taff

from

bot

h hu

man

and

ani

mal

hea

lth s

ecto

rs.


85

CAPA

CITY

LEVE

L

Benc

hmar

k 10

.4: F

ield

epi

dem

iolo

gy tr

aini

ng p

rogr

amm

e or

oth

er a

pplie

d ep

idem

iolo

gy tr

aini

ng p

rogr

amm

e is

in p

lace

O

bjec

tive:

To

esta

blis

h a

sust

aina

ble

field

epi

dem

iolo

gy tr

aini

ng p

rogr

amm

e or

oth

er a

pplie

d ep

idem

iolo

gy tr

aini

ng

prog

ram

me

01N

O C

APAC

ITY

No

field

epi

dem

iolo

gy tr

aini

ng p

rogr

amm

e or

app

lied

epid

emio

logy

trai

ning

pro

gram

me

is e

stab

lishe

d.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t eng

agem

ent m

eetin

g w

ith th

e he

alth

min

istr

y, ag

ricul

ture

min

istr

y an

d ot

her r

elev

ant s

take

hold

ers

to d

eter

min

e re

adin

ess

for a

fiel

d or

app

lied

epid

emio

logy

pro

gram

me

and

pote

ntia

l car

eer p

aths

for i

ts g

radu

ates

.

Doc

umen

t the

nee

d fo

r app

lied

epid

emio

logy

com

pete

ncie

s by

revi

ewin

g th

e ed

ucat

iona

l sys

tem

, pub

lic h

ealth

trai

ning

pr

ogra

mm

es, w

orkf

orce

gap

s an

d st

akeh

olde

r int

eres

ts.

Re

view

and

doc

umen

t cur

rent

fiel

d ep

idem

iolo

gy c

apac

ity in

the

coun

try.

Ev

alua

te e

xist

ing

field

or a

pplie

d ep

idem

iolo

gy p

rogr

amm

es in

the

regi

onal

con

text

and

iden

tify

the

host

cou

ntry

whe

re

natio

nal p

ublic

hea

lth p

rofe

ssio

nals

can

be

sent

for t

rain

ing.

Se

cure

an

agre

emen

t with

ano

ther

cou

ntry

to h

ost p

artic

ipan

ts a

nd e

stab

lish

fund

ing

mec

hani

sms

to s

uppo

rt th

e tr

aini

ng.

Co

nduc

t rec

ruitm

ent a

nd s

elec

tion

of p

artic

ipan

ts fo

r fiel

d or

app

lied

epid

emio

logy

trai

ning

in h

ost c

ount

ry.

Tr

ack

the

trai

ning

and

rost

erin

g of

fiel

d or

app

lied

epid

emio

logy

par

ticip

ants

and

gra

duat

es in

hos

t cou

ntry

.

Ensu

re a

vaila

bilit

y of

at l

east

one

trai

ned

epid

emio

logi

st p

er tw

o m

illio

n po

pula

tion.


86

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nven

e a

field

or a

pplie

d ep

idem

iolo

gy te

chni

cal w

orki

ng g

roup

and

est

ablis

h go

als

for p

rogr

amm

e st

affin

g (b

oth

tech

nica

l an

d ad

min

istr

ativ

e), w

ith ro

les

and

resp

onsi

bilit

ies

incl

udin

g le

ader

ship

role

s an

d m

ento

rshi

p of

trai

nees

.

Dev

elop

a s

trat

egic

pla

n fo

r dev

elop

men

t of fi

eld

or a

pplie

d ep

idem

iolo

gy p

rogr

am th

at in

clud

es a

n ad

viso

ry g

roup

and

go

vern

ance

str

uctu

re w

ith s

take

hold

ers,

that

allo

ws

the

deve

lopm

ent o

f goa

ls a

nd o

bjec

tives

of n

atio

nal (

or p

artic

ipat

ion

in

regi

onal

) app

lied

epid

emio

logi

sts.

Es

tabl

ish

an a

dvis

ory

com

mitt

ee to

mai

ntai

n br

oad-

base

d su

ppor

t fro

m s

take

hold

ers

and

part

ners

.

Secu

re a

n ac

cept

able

loca

tion

for fi

eld

or a

pplie

d ep

idem

iolo

gy m

anag

emen

t.

Iden

tify

a su

stai

nabl

e fu

ndin

g m

echa

nism

for fi

eld

or a

pplie

d ep

idem

iolo

gy; c

onsi

der b

asic

leve

l fiel

d or

app

lied

epid

emio

logy

with

a p

lan

for e

xpan

sion

into

inte

rmed

iate

and

adv

ance

d le

vels

of fi

eld

or a

pplie

d ep

idem

iolo

gy, a

s de

term

ined

by

coun

try

need

s.

Dev

elop

cou

rse

curr

icul

um, m

aint

ain

scie

ntifi

c ex

celle

nce

in tr

aini

ng, m

onito

ring

and

eval

uatin

g tr

aine

es, a

nd c

onsu

lt on

ep

idem

iolo

gica

l met

hods

.

Des

igna

te fi

eld

supe

rvis

ors

and

men

tors

for fi

eld

or a

pplie

d ep

idem

iolo

gy a

nd p

repa

re g

uide

lines

for m

ento

rshi

p de

sign

ated

to

mon

itor t

rain

ee a

ctiv

ity, d

evel

opm

ent o

f pro

ject

s, b

arrie

rs to

trai

ning

, am

ong

othe

rs.

D

evel

op tr

aini

ng a

nd S

OPs

for m

ento

rs a

nd s

uper

viso

rs.

D

isse

min

ate

field

or a

pplie

d ep

idem

iolo

gy tr

aini

ng m

ater

ials

, pro

toco

ls, S

OPs

and

tool

kits

.

Esta

blis

h ac

cred

itatio

n m

echa

nism

s fo

r hea

lth tr

aini

ng in

stitu

tes.

Co

nduc

t rec

ruitm

ent a

nd s

elec

tion

of c

andi

date

s fo

r tra

inin

g in

clud

ing

cons

ider

atio

n fo

r par

ticip

atio

n of

vet

erin

aria

ns in

the

epid

emio

logy

trai

ning

pro

gram

me.

Tr

ack

field

or a

pplie

d ep

idem

iolo

gy c

apac

ity in

the

coun

try

incl

udin

g gr

adua

tes

and

posi

tions

afte

r tra

inin

g.

Esta

blis

h a

part

ners

hip

with

oth

er c

ount

ries

in th

e re

gion

to s

hare

epi

dem

iolo

gy tr

aini

ng p

rogr

amm

e gr

adua

tes

durin

g em

erge

ncy

even

ts.

En

sure

ava

ilabi

lity

of a

t lea

st o

ne tr

aine

d ep

idem

iolo

gist

per

one

mill

ion

popu

latio

n.


87

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent t

wo

leve

ls o

f fiel

d or

app

lied

epid

emio

logy

incl

udin

g th

e ba

sic,

inte

rmed

iate

and

/or a

dvan

ced

leve

l at d

esig

nate

d si

tes

that

com

pris

e tr

aine

es fr

om h

uman

and

ani

mal

hea

lth p

rofe

ssio

nals

.

Inte

grat

e a

trai

ned

epid

emio

logi

st in

to c

ore

publ

ic h

ealth

com

pete

ncie

s (fr

ontli

ne s

urve

illan

ce, e

pide

mio

logy

, bio

stat

istic

s,

labo

rato

ry a

nd b

iosa

fety

, vet

erin

ary,

com

mun

icat

ion)

.

Map

fiel

d or

app

lied

epid

emio

logy

cap

acity

at i

nter

med

iate

leve

l/dis

tric

t (or

oth

er s

imila

r adm

inis

trat

ive

divi

sion

) and

trac

k to

info

rm u

pdat

es to

the

natio

nal p

ublic

hea

lth w

orkf

orce

str

ateg

y.

Ensu

re a

vaila

bilit

y of

at l

east

one

trai

ned

epid

emio

logi

st p

er 5

00 0

00 p

opul

atio

n.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

onito

r and

eva

luat

e th

e pe

rfor

man

ce o

f the

epi

dem

iolo

gy w

orkf

orce

with

in h

ealth

care

sys

tem

s in

clud

ing

vete

rinar

y se

rvic

es.

Co

nduc

t eng

agem

ent m

eetin

gs w

ith th

e he

alth

min

istr

y, ag

ricul

ture

min

istr

y, pa

rtne

rs a

nd s

take

hold

ers

to s

treng

then

op

tions

for fi

eld

plac

emen

ts, a

nd to

sus

tain

fund

ing

for e

pide

mio

logy

trai

ning

pro

gram

me

man

agem

ent.

Im

plem

ent e

pide

mio

logy

trai

ning

trac

ks fo

r rel

evan

t car

eer t

rack

s.

Expa

nd e

pide

mio

logy

trai

ning

pro

gram

mes

into

thre

e le

vels

of t

rain

ing

prog

ram

mes

with

car

eer t

rack

s es

tabl

ishe

d fo

r gr

adua

tes

in a

dditi

onal

juris

dict

ions

.

Secu

re s

usta

inab

le fu

ndin

g fo

r epi

dem

iolo

gy tr

aini

ng p

rogr

amm

es a

nd c

aree

r tra

cks

and

purs

ue a

ccre

dita

tion.

En

sure

ava

ilabi

lity

of a

t lea

st o

ne tr

aine

d ep

idem

iolo

gist

per

200

000

pop

ulat

ion.

Es

tabl

ish

alum

ni a

ssoc

iatio

n fo

r epi

dem

iolo

gy g

radu

ates

(all

leve

ls).

TOO

LS:

W

HO

glo

bal s

trat

egy

on h

uman

reso

urce

s fo

r hea

lth: w

orkf

orce

203

0

TEPH

INET

Acc

redi

tatio

n of

FET

Ps a

nd re

sour

ces

for F

ETPs

U

S CD

C Fi

eld

Epid

emio

logy

Tra

inin

g Pr

ogra

m


88

47 “E

mer

genc

y pr

epar

edne

ss” (

defin

ed a

s, th

e kn

owle

dge,

cap

aciti

es a

nd o

rgan

izat

iona

l sys

tem

s de

velo

ped

by g

over

nmen

ts, r

espo

nse

and

reco

very

org

aniz

atio

ns, a

nd c

omm

uniti

es a

nd

indi

vidu

als

to e

ffect

ivel

y an

ticip

ate,

resp

ond

to, a

nd re

cove

r fro

m th

e im

pact

s of

like

ly, i

mm

inen

t, em

ergi

ng o

r cur

rent

em

erge

ncie

s) is

a c

ombi

natio

n of

pla

nnin

g, a

lloca

tion

of re

sour

ces,

tr

aini

ng, e

xerc

isin

g, a

nd o

rgan

izin

g to

bui

ld, s

usta

in a

nd im

prov

e op

erat

iona

l cap

abili

ties

at n

atio

nal,

inte

rmed

iate

and

loca

l or p

rimar

y re

spon

se le

vels

bas

ed o

n st

rate

gic

risk

asse

ssm

ents

. M

ultis

ecto

ral a

ctor

s at

nat

iona

l and

sub

natio

nal (

loca

l and

inte

rmed

iate

) lev

els

have

a c

omm

on u

nder

stan

ding

of t

he p

riorit

y ris

ks a

nd a

re re

ady

for t

imel

y, ef

fect

ive

and

effic

ient

em

erge

ncy

resp

onse

ope

ratio

ns fo

r out

brea

ks a

nd o

ther

em

erge

ncie

s. R

isk

base

d pl

ans

for e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se, r

obus

t em

erge

ncy

man

agem

ent s

truc

ture

s an

d m

obili

zatio

n of

re

sour

ces

durin

g an

em

erge

ncy

are

criti

cal f

or a

tim

ely

resp

onse

to p

ublic

hea

lth e

mer

genc

ies.

EMER

GEN

CY P

REPA

REDN

ESS

11

IMPA

CT:

Mul

tisec

tora

l act

ors

at n

atio

nal a

nd s

ubna

tiona

l (lo

cal a

nd in

term

edia

te) l

evel

s ha

ve a

com

mon

und

erst

andi

ng o

f the

prio

rity

risks

and

are

read

y fo

r tim

ely,

effe

ctiv

e an

d ef

ficie

nt e

mer

genc

y re

spon

se o

pera

tions

for o

utbr

eaks

and

oth

er e

mer

genc

ies.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Exi

sten

ce o

f nat

iona

l str

ateg

ic m

ultih

azar

d em

erge

ncy

risk

asse

ssm

ents

(ris

k pr

ofile

s) a

nd re

sour

ce m

appi

ng. (

2) E

xist

ence

of m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns. (

3) E

vide

nce

from

exe

rcis

es a

s w

ell a

s af

ter-

actio

n an

d ot

her r

evie

ws

of e

ffect

ive

and

effic

ient

mul

tisec

tora

l em

erge

ncy

resp

onse

ope

ratio

ns fo

r out

brea

ks a

nd o

ther

pub

lic h

ealth

em

erge

ncie

s.

Stat

e Pa

rtie

s ar

e in

“em

erge

ncy

prep

ared

ness

” 47 (d

efine

d as

, the

kno

wle

dge,

cap

aciti

es a

nd o

rgan

izat

iona

l sys

tem

s de

velo

ped

by g

over

nmen

ts, r

espo

nse

and

reco

very

org

aniz

atio

ns, c

omm

uniti

es a

nd in

divi

dual

s to

effe

ctiv

ely

antic

ipat

e, re

spon

d to

and

reco

ver f

rom

the

impa

cts

of li

kely

, im

min

ent,

emer

ging

or

cur

rent

em

erge

ncie

s), w

hich

is a

com

bina

tion

of p

lann

ing,

allo

catio

n of

reso

urce

s, tr

aini

ng, e

xerc

isin

g an

d or

gani

zing

to b

uild

, sus

tain

and

impr

ove

oper

atio

nal c

apab

ilitie

s at

nat

iona

l, in

term

edia

te a

nd lo

cal o

r prim

ary

resp

onse

leve

ls b

ased

on

stra

tegi

c ris

k as

sess

men

ts. S

trat

egic

risk

ass

essm

ent

iden

tifies

, ana

lyse

s an

d ev

alua

tes

the

rang

e of

risk

s in

a c

ount

ry a

nd e

nabl

es th

e ris

ks to

be

assi

gned

a le

vel o

f prio

rity.

It in

clud

es a

naly

ses

of p

oten

tial

haza

rds

expo

sure

s an

d vu

lner

abili

ties,

iden

tifica

tion

and

map

ping

of a

vaila

ble

reso

urce

s, a

nd a

naly

ses

of c

apac

ities

(rou

tine

and

surg

e) a

t the

nat

iona

l, in

term

edia

te a

nd lo

cal o

r prim

ary

leve

ls to

man

age

the

risks

of o

utbr

eaks

and

oth

er e

mer

genc

ies.

Em

erge

ncy

prep

ared

ness

app

lies

to a

ny h

azar

d th

at m

ay

caus

e an

em

erge

ncy

and

incl

udes

bio

logi

cal,

chem

ical

, rad

iolo

gica

l and

nuc

lear

, nat

ural

, oth

er te

chno

logi

cal a

nd s

ocie

tal h

azar

ds.


89

CAPA

CITY

LEVE

L

Benc

hmar

k 11

.1: S

trat

egic

em

erge

ncy

risk

asse

ssm

ents

con

duct

ed, a

nd e

mer

genc

y re

sour

ces

iden

tified

, map

ped

and

utili

zed

Obj

ectiv

e: T

o as

sess

and

ass

ign

prio

ritie

s to

risk

s ba

sed

on a

naly

ses

of h

azar

ds e

xpos

ures

and

vul

nera

bilit

ies

and

capa

citie

s, a

nd d

evel

op in

vent

orie

s an

d m

aps

of a

vaila

ble

reso

urce

s fo

r em

erge

ncy

prep

ared

ness

and

resp

onse

.

01N

O C

APAC

ITY

Coun

try

does

not

hav

e ca

paci

ty fo

r em

erge

ncy

risk

asse

ssm

ents

and

reso

urce

map

ping

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

exi

stin

g st

rate

gic

heal

th e

mer

genc

y ris

k as

sess

men

ts, i

nclu

ding

for e

pide

mic

s (i.

e. c

omm

unic

able

dis

ease

s,

zoon

oses

and

em

ergi

ng in

fect

ious

dis

ease

s), n

atur

al a

nd te

chno

logi

cal h

azar

ds a

nd o

ther

eve

nts

that

hav

e th

e po

tent

ial t

o ca

use

heal

th e

mer

genc

ies.

Id

entif

y po

tent

ial g

aps

or a

reas

in s

trat

egic

risk

ass

essm

ents

that

requ

ire u

pdat

ing.

D

evel

op a

mec

hani

sm to

ens

ure

part

icip

atio

n of

the

heal

th s

ecto

r and

oth

er s

take

hold

ers

in th

e ab

ove

proc

esse

s, in

clud

ing

in w

orks

hops

to re

view

and

agr

ee o

n ou

tput

s.

Co

nduc

t a c

ompr

ehen

sive

mul

tihaz

ard

heal

th e

mer

genc

y ris

k as

sess

men

t at t

he n

atio

nal l

evel

; inc

lude

ana

lysi

s of

ge

ogra

phic

are

as a

nd v

ulne

rabl

e su

bpop

ulat

ions

that

may

be

at h

ighe

r ris

k.

Cond

uct a

prio

ritiz

atio

n ex

erci

se to

ass

ign

prio

ritie

s to

thos

e ris

k sc

enar

ios

desc

ribed

in th

e st

rate

gic

heal

th e

mer

genc

y ris

k as

sess

men

ts, i

nclu

ding

thos

e th

at p

ose

the

grea

test

thre

ats

to p

ublic

hea

lth.

M

ap c

urre

nt n

atio

nal l

evel

reso

urce

s to

sup

port

the

emer

genc

y re

spon

se o

f the

hea

lth s

ecto

r at t

he n

atio

nal l

evel

, inc

ludi

ng

hum

an re

sour

ces,

fina

nces

, inf

rast

ruct

ure,

logi

stic

s an

d su

pplie

s (s

uch

as h

ealth

faci

litie

s, e

mer

genc

y op

erat

ion

cent

res,

tr

ansp

ort,

vehi

cles

, col

d ch

ain

capa

city

, tel

ecom

mun

icat

ions

, war

ehou

sing

, sup

ply

rout

es).


90

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

mpl

ete

stra

tegi

c he

alth

em

erge

ncy

risk

asse

ssm

ents

incl

udin

g ha

zard

s, e

xpos

ures

, vul

nera

bilit

ies

and

capa

citie

s, a

nd

risk

prio

ritiz

atio

n ex

erci

ses

in a

ll re

leva

nt s

ecto

rs a

t the

nat

iona

l lev

el.

M

ap c

urre

nt re

sour

ces

to s

uppo

rt e

mer

genc

y re

spon

se in

all

rele

vant

sec

tors

at t

he n

atio

nal l

evel

.

Revi

ew lo

gist

ic a

nd w

areh

ouse

cap

acity

bas

ed o

n th

e na

tiona

l mul

tihaz

ard

resp

onse

pla

n an

d th

e as

sess

ed n

eed

for

stoc

kpili

ng a

nd p

repo

sitio

ning

of s

uppl

ies,

and

iden

tify

gaps

in c

apac

ity th

at re

quire

sup

port

.

Dev

elop

or r

evis

e th

e pl

an fo

r man

agem

ent a

nd d

istr

ibut

ion

of n

atio

nal s

tock

pile

s.

Impl

emen

t mea

sure

s fo

r the

man

agem

ent a

nd d

istr

ibut

ion

of s

tock

pile

s at

the

natio

nal l

evel

.

Dev

elop

a tr

aini

ng p

lan

for r

apid

logi

stic

s ne

eds

ases

smen

ts, a

nd p

lann

ing,

man

agem

ent a

nd d

istr

ibut

ion

of s

tock

pile

s fo

r pu

blic

hea

lth e

vent

s.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

mpl

ete

stra

tegi

c he

alth

em

erge

ncy

risk

asse

ssm

ents

incl

udin

g ha

zard

s, e

xpos

ures

, vul

nera

bilit

ies

and

capa

citie

s, a

nd

risk

prio

ritiz

atio

n ex

erci

ses

in a

ll se

ctor

s at

the

subn

atio

nal l

evel

.

Map

cur

rent

reso

urce

s to

sup

port

em

erge

ncy

resp

onse

in a

ll re

leva

nt s

ecto

rs a

t the

sub

natio

nal l

evel

and

iden

tify

gaps

in

capa

citie

s th

at re

quire

sup

port

.

Impl

emen

t mea

sure

s fo

r the

man

agem

ent a

nd d

istr

ibut

ion

of s

tock

pile

s at

the

subn

atio

nal l

evel

.

Impl

emen

t rap

id n

eeds

ass

essm

ents

, pla

nnin

g, m

anag

emen

t and

dis

trib

utio

n of

sto

ckpi

les

for p

ublic

hea

lth e

vent

s.

Com

plet

e tr

aini

ngs

to s

uppo

rt th

e m

anag

emen

t and

dis

trib

utio

n of

sto

ckpi

les

for p

ublic

hea

lth e

vent

s.

Revi

ew n

atio

nal l

evel

reso

urce

s (c

ritic

al s

tock

leve

ls fo

r prio

rity

risks

) on

an a

nnua

l bas

is o

r whe

n ne

eded

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

and

upd

ate

natio

nal a

nd s

ubna

tiona

l str

ateg

ic h

ealth

em

erge

ncy

risk

asse

ssm

ents

and

reso

urce

map

s re

gula

rly.

Se

cure

fund

ing

to c

ondu

ct ra

pid

need

s as

sess

men

ts in

em

erge

ncy

situ

atio

ns.

Te

st s

tock

pile

man

agem

ent r

egul

arly

and

upd

ate

plan

s an

d st

reng

then

cap

aciti

es a

ccor

ding

ly.

D

ocum

ent a

nd d

isse

min

ate

findi

ngs

on ri

sk a

sses

smen

t and

exp

erie

nce,

add

ress

ing

susp

ecte

d or

con

firm

ed h

ealth

thre

ats.


91

CAPA

CITY

LEVE

L

Benc

hmar

k 11

.2: M

ultis

ecto

ral p

lann

ing

for h

ealth

em

erge

ncy

prep

ared

ness

and

resp

onse

is in

pla

ce

Obj

ectiv

e: D

evel

opm

ent a

nd im

plem

enta

tion

of m

ultis

ecto

ral a

nd m

ultih

azar

d em

erge

ncy

prep

ared

ness

mea

sure

s in

clud

ing

emer

genc

y re

spon

se p

lans

01N

O C

APAC

ITY

The

coun

try

has

to d

evel

op a

nd im

plem

ent a

ll ac

tiviti

es li

sted

in le

vel 2

to a

chie

ve th

e lim

ited

capa

city

for e

ach

func

tion.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

ap k

ey s

take

hold

ers

and

min

istr

ies

invo

lved

in m

ultih

azar

d em

erge

ncy

prep

ared

ness

and

resp

onse

incl

udin

g hu

man

, an

imal

(dom

estic

and

wild

life)

and

env

ironm

enta

l hea

lth s

ecto

rs, m

eteo

rolo

gy, b

orde

r con

trol,

food

and

dru

g ag

ency

, m

ilita

ry, p

rivat

e ag

ricul

tura

l sec

tor,

emer

genc

y se

rvic

es, d

efen

ce, t

rans

port

, med

ia a

nd fi

nanc

e.

Cond

uct c

apac

ity a

sses

smen

ts o

f eac

h st

akeh

olde

r to

supp

ort e

mer

genc

y pr

epar

edne

ss fo

r prio

rity

risks

at t

he n

atio

nal

leve

l, as

app

ropr

iate

.

Iden

tify

key

mea

sure

s fo

r all

sect

ors

to s

treng

then

em

erge

ncy

prep

ared

ness

for p

riorit

y ris

ks a

t the

nat

iona

l lev

el.

Re

view

cur

rent

hea

lth s

ecto

r mul

tihaz

ard

emer

genc

y re

spon

se p

lans

and

oth

er re

spon

se p

lans

for s

peci

fic h

azar

ds.

D

evel

op o

r upd

ate

the

natio

nal h

ealth

sec

tor m

ultih

azar

d em

erge

ncy

resp

onse

pla

n.


92

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent e

mer

genc

y pr

epar

edne

ss m

easu

res

at th

e na

tiona

l lev

el b

y hu

man

hea

lth, a

nim

al h

ealth

and

oth

er re

leva

nt

sect

ions

, inc

ludi

ng fo

r poi

nts

of e

ntry

and

mas

s ga

ther

ing

even

ts.

D

evel

op o

r upd

ate

natio

nal m

ultis

ecto

ral m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns.

Re

view

and

upd

ate

curr

ent m

ultis

ecto

ral m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns a

nd o

ther

resp

onse

pla

ns fo

r spe

cific

ha

zard

s at

the

natio

nal l

evel

.

Cond

uct a

nat

iona

l lev

el s

imul

atio

n ex

erci

se to

test

the

mul

ti ha

zard

resp

onse

pla

n an

d ad

just

the

plan

bas

ed o

n th

e ou

tcom

es o

f the

sim

ulat

ion

or c

ompl

ete

an a

fter-

actio

n re

view

of a

n ac

tual

eve

nt.

As

sess

the

need

for a

dditi

onal

em

erge

ncy

prep

ared

ness

mea

sure

s, in

clud

ing

polic

ies,

pro

cedu

res,

SO

Ps a

nd fi

nanc

ial

mec

hani

sms,

requ

ired

to s

treng

then

em

erge

ncy

prep

ared

ness

.

Impl

emen

t the

mul

ti ha

zard

resp

onse

pla

n at

the

natio

nal l

evel

.

Dev

elop

and

impl

emen

t a tr

aini

ng p

lan

for s

treng

then

ing

emer

genc

y pr

epar

edne

ss m

easu

res

and

the

mul

ti ha

zard

resp

onse

pl

an a

t the

nat

iona

l lev

el.

Se

cure

cap

acity

requ

ired

for e

mer

genc

y pr

epar

edne

ss m

easu

res

for s

peci

fic h

azar

ds o

r ris

k sc

enar

ios,

incl

udin

g co

ntin

genc

y pl

anni

ng, a

dditi

onal

trai

ning

and

equ

ipm

ent.

D

evel

op m

echa

nism

s an

d SO

Ps fo

r im

plem

entin

g do

mes

tic a

nd in

tern

atio

nal s

urge

cap

acity

as

part

of t

he m

ultih

azar

d re

spon

se p

lan.

Es

tabl

ish

a pe

rfor

man

ce-m

onito

ring

fram

ewor

k in

clud

ing

indi

cato

rs, c

riter

ia a

nd ti

mel

ines

for e

mer

genc

y re

spon

se.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Im

plem

ent e

mer

genc

y pr

epar

edne

ss m

easu

res

at n

atio

nal,

subn

atio

nal a

nd lo

cal l

evel

s by

hum

an h

ealth

, ani

mal

hea

lth a

nd

othe

r rel

evan

t sec

tors

, inc

ludi

ng a

t poi

nts

of e

ntry

and

mas

s ga

ther

ing

even

ts.

D

evel

op o

r upd

ate

mul

tisec

tora

l mul

tihaz

ard

subn

atio

nal a

nd lo

cal m

ultih

azar

d re

spon

se p

lans

.

Cond

uct s

imul

atio

ns o

r afte

r-ac

tion

revi

ews

at n

atio

nal a

nd s

ubna

tiona

l lev

els

to te

st th

e m

ultih

azar

d re

spon

se p

lan

with

a

focu

s on

coo

rdin

atio

n an

d co

mm

unic

atio

n be

twee

n th

e na

tiona

l and

sub

natio

nal l

evel

s of

gov

ernm

ent a

nd s

ecto

rs; a

nd

adju

st p

lans

bas

ed o

n ou

tcom

es.

Im

plem

ent t

rain

ing

for e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se a

t sub

natio

nal l

evel

s.

Revi

ew a

nd d

evel

op e

mer

genc

y re

spon

se p

lans

for c

ross

-bor

der a

nd m

ultic

ount

ry e

vent

s w

ith re

gion

al c

ount

erpa

rts

and

inte

rnat

iona

l par

tner

s.


93

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t reg

ular

sim

ulat

ion

exer

cise

s or

afte

r-ac

tion

revi

ews

to te

st m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns a

t nat

iona

l and

su

bnat

iona

l lev

els

and

impl

emen

t mea

sure

s to

bui

ld c

apac

ities

bas

ed o

n ou

tcom

es a

nd re

com

men

datio

ns.

Co

nduc

t int

erna

tiona

l sim

ulat

ion

exer

cise

s to

test

mul

tihaz

ard

emer

genc

y re

spon

se p

lans

for m

ultip

le c

ount

ry e

vent

s.

Adju

st e

mer

genc

y re

spon

se p

lans

and

stre

ngth

en e

mer

genc

y pr

epar

edne

ss b

ased

on

outc

omes

and

reco

mm

enda

tions

.

Assi

gn d

edic

ated

hum

an re

sour

ces

and

allo

cate

regu

lar b

udge

t fun

ding

to s

uppo

rt c

oord

inat

ion

and

impl

emen

tatio

n of

em

erge

ncy

prep

ared

ness

mea

sure

s by

hum

an h

ealth

, ani

mal

hea

lth a

nd o

ther

rele

vant

sec

tors

.

Dev

elop

a m

echa

nism

to e

nsur

e th

at d

edic

ated

reso

urce

s ar

e in

pla

ce fo

r tes

ting

and

impl

emen

tatio

n of

mul

tisec

tora

l, m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns, c

ontin

genc

y pl

ans

and

SOPs

at n

atio

nal a

nd s

ubna

tiona

l lev

els

incl

udin

g an

em

erge

ncy

finan

cing

mec

hani

sm fo

r em

erge

ncy

resp

onse

.

TOO

LS:

A

stra

tegi

c fr

amew

ork

for e

mer

genc

y pr

epar

edne

ss

Emer

genc

y an

d di

sast

er ri

sk m

anag

emen

t for

hea

lth

Emer

genc

ies

prep

ared

ness

and

resp

onse

– R

esou

rces

Pa

ndem

ic p

repa

redn

ess

- Re

sour

ces


94

EMER

GEN

CY R

ESPO

NSE

OPE

RATI

ON

S

12

IMPA

CT:

Effe

ctiv

e co

ordi

natio

n an

d im

prov

ed m

anag

emen

t of t

he re

spon

se to

out

brea

ks a

nd e

mer

genc

ies

as e

vide

nced

by

shor

ter t

imes

from

ear

ly

war

ning

and

det

ectio

n to

act

ivat

ion

and

impl

emen

tatio

n of

a c

oord

inat

ed m

ultis

ecto

ral r

espo

nse

acro

ss a

ll lev

els

resu

lting

in fe

wer

cas

es, d

eath

s an

d ot

her h

ealth

and

soc

ieta

l im

pact

s.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Est

ablis

hmen

t of a

n em

erge

ncy

resp

onse

coo

rdin

atio

n m

echa

nism

or i

ncid

ent m

anag

emen

t sys

tem

. (2)

Dev

elop

men

t of n

atio

nal h

ealth

EO

C pl

ans

and

proc

edur

es. (

3) E

mer

genc

y re

spon

se s

yste

ms

and

deci

sion

-mak

ing

have

bee

n te

sted

and

are

ope

ratin

g ef

ficie

ntly

and

effe

ctiv

ely.

Coun

tries

will

: hav

e a

coor

dina

tion

mec

hani

sm, in

cide

nt m

anag

emen

t sys

tem

s, e

xerc

ise

man

agem

ent p

rogr

amm

es a

nd p

ublic

hea

lth e

mer

genc

y op

erat

ion

cent

res

(EO

Cs) f

unct

ioni

ng a

ccor

ding

to m

inim

um c

omm

on s

tand

ards

; and

mai

ntai

n tr

aine

d, fu

nctio

ning

, mul

tisec

tora

l rap

id re

spon

se te

ams

and

trai

ned

EOC

staf

f cap

able

of a

ctiv

atin

g a

coor

dina

ted

emer

genc

y re

spon

se w

ithin

120

min

utes

of t

he id

entifi

catio

n of

an

emer

genc

y.


95

CAPA

CITY

LEVE

L

Benc

hmar

k 12

.1: F

unct

iona

l em

erge

ncy

resp

onse

coo

rdin

atio

n is

in p

lace

O

bjec

tive:

To

deve

lop

coor

dina

tion

mec

hani

sms

for e

mer

genc

y re

spon

se

01N

O C

APAC

ITY

An e

mer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm is

not

ava

ilabl

e.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a na

tiona

l hea

lth e

mer

genc

y co

ordi

natio

n de

part

men

t or u

nit t

hat m

aint

ains

regu

lar c

onta

ct w

ith e

xper

ts fr

om

hum

an, a

nim

al (d

omes

tic a

nd w

ildlif

e), a

nd e

nviro

nmen

tal h

ealth

as

wel

l as

othe

r sec

tors

.

Prov

ide

key

pote

ntia

l inf

orm

ants

and

resp

onse

par

tner

s fo

r hea

lth e

mer

genc

y op

erat

ions

that

can

hav

e 24

/7 c

over

age

in a

ll m

ajor

hea

lth s

yste

ms.

D

evel

op a

cap

acity

to e

nsur

e th

at th

e IH

R N

FP a

nd o

ther

resp

onsi

ble

part

ies

are

avai

labl

e 24

/7 to

rece

ive

info

rmat

ion

abou

t po

tent

ial h

ealth

thre

ats

and

to re

port

a p

ublic

hea

lth e

mer

genc

y of

inte

rnat

iona

l con

cern

as

outli

ned

in IH

R (2

005)

.

Dev

elop

and

impl

emen

t SO

Ps fo

r an

ad-h

oc e

mer

genc

y co

ordi

natio

n m

echa

nism

dur

ing

the

even

ts.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

an in

cide

nt m

anag

emen

t sys

tem

for m

anag

ing

emer

genc

y re

spon

se a

t the

nat

iona

l lev

el, i

nclu

ding

par

ticip

atio

n

of re

leva

nt s

ecto

rs.

D

evel

op a

pla

n an

d SO

Ps, in

clud

ing

thre

shol

ds a

nd le

vels

for a

ctiv

atin

g th

e em

erge

ncy

resp

onse

coo

rdin

atio

n m

echa

nism

.

Esta

blis

h an

d m

aint

ain

a ro

ster

of e

mer

genc

y op

erat

ions

sta

ff w

ith d

efine

d ro

les

and

func

tions

.

Dev

elop

a tr

aini

ng p

lan

for e

mer

genc

y re

spon

se s

taff,

incl

udin

g on

the

inci

dent

man

agem

ent s

yste

m, a

nd im

plem

ent i

t at

leas

t at t

he n

atio

nal l

evel

.

Fina

lize

SOPs

for c

oord

inat

ion

of k

ey h

ealth

sec

tor a

ctor

s (s

uch

as s

urve

illan

ce, h

ealth

faci

litie

s, e

mer

genc

y m

edic

al te

ams,

m

enta

l hea

lth d

epar

tmen

ts).

Id

entif

y, tr

ain

and

rost

er a

poo

l of s

urge

sta

ff fo

r em

erge

ncy

resp

onse

coo

rdin

atio

n.


96

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a he

alth

sec

tor e

mer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm w

ith p

artic

ipat

ion

from

hea

lth a

nd o

ther

sec

tors

for

man

agin

g em

erge

ncy

resp

onse

at t

he s

ubna

tiona

l and

loca

l lev

els.

Tr

ain

subn

atio

nal a

nd lo

cal l

evel

hea

lth s

ecto

r sta

ff on

the

emer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm.

Co

nduc

t, at

leas

t eve

ry tw

o ye

ars,

an

emer

genc

y re

spon

se e

xerc

ise

or a

fter-

actio

n re

view

with

a fo

cus

on c

oord

inat

ion

betw

een

natio

nal a

nd s

ubna

tiona

l lev

els.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

and

sust

ain

rout

ine

and

emer

genc

y co

mm

unic

atio

ns b

etw

een

natio

nal,

subn

atio

nal a

nd in

tern

atio

nal c

oord

inat

ion

mec

hani

sms

thro

ugh

the

foca

l poi

nts

and

allo

cate

sus

tain

able

fund

ing

for t

hese

act

iviti

es.

Te

st c

oord

inat

ion

mec

hani

sms

at a

ll le

vels

ann

ually

and

doc

umen

t and

impl

emen

t act

iona

ble

impr

ovem

ents

.

Eval

uate

, doc

umen

t and

dis

sem

inat

e in

form

atio

n on

act

ivat

ions

, and

if d

one,

incl

ude

exer

cise

s to

pro

mot

e co

ntin

uous

im

prov

emen

t in

com

mun

icat

ion

and

coor

dina

tion.


97

CAPA

CITY

LEVE

L

Benc

hmar

k 12

.2: E

mer

genc

y op

erat

ions

cen

tre

(EO

C) c

apac

ities

, pro

cedu

res

and

plan

s ar

e in

pla

ce

Obj

ectiv

e: D

evel

op e

mer

genc

y op

erat

ion

capa

citie

s

01N

O C

APAC

ITY

An E

OC

has

not b

een

iden

tified

and

no

EOC

plan

s/pr

oced

ures

are

in p

lace

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t a b

asel

ine

asse

ssm

ent o

f em

erge

ncy

oper

atio

ns c

apac

ity in

clud

ing

infra

stru

ctur

e, s

yste

ms,

wor

kfor

ce a

nd le

gisl

atio

n.

Dev

elop

a h

ealth

EO

C ac

tivat

ion

plan

that

incl

udes

sca

led

leve

l of r

espo

nse

with

hea

lth, c

omm

unic

atio

n an

d ot

her r

esou

rce

requ

irem

ents

at t

he n

atio

nal l

evel

.

Esta

blis

h a

func

tioni

ng h

ealth

EO

C w

ith th

e ca

paci

ty to

coo

rdin

ate

emer

genc

y op

erat

ions

in th

e ev

ent o

f an

emer

genc

y.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Fo

rm a

ste

erin

g co

mm

ittee

or o

ther

man

agem

ent s

truc

ture

to d

evel

op o

bjec

tives

, ess

entia

l fun

ctio

ns a

nd c

ore

com

pone

nts;

ov

erse

e th

e EO

C an

d m

onito

r and

eva

luat

e its

use

.

Dev

elop

an

EOC

impl

emen

tatio

n pl

an th

at in

clud

es b

oth

the

plan

ning

and

dev

elop

men

t of t

he E

OC

(as

outli

ned

in p

ublic

he

alth

em

erge

ncy

oper

atio

ns c

entre

net

wor

k fr

amew

ork)

and

the

cost

ing,

fund

ing

and

sust

aina

bilit

y of

the

EOC.

D

evel

op a

n EO

C ac

tivat

ion

plan

that

incl

udes

sca

led

leve

l of r

espo

nse

with

reso

urce

requ

irem

ents

at e

ach

leve

l.

Dev

elop

a m

echa

nism

to e

nsur

e th

at th

e na

tiona

l em

erge

ncy

resp

onse

pla

n la

ys o

ut th

e co

ncep

t of o

pera

tions

for t

he e

ntire

em

erge

ncy

resp

onse

sys

tem

.

Esta

blis

h a

func

tiona

l nat

iona

l EOC

that

incl

udes

ded

icat

ed p

lan

and

proc

edur

es, a

sec

ure

phys

ical

spa

ce, a

n in

form

atio

n an

d co

mm

unic

atio

n te

chno

logy

infra

stru

ctur

e fo

r inf

orm

atio

n m

anag

emen

t and

sup

port

of e

mer

genc

y op

erat

ions

, and

trai

ned

staf

f.

Deve

lop

and

impl

emen

t a tr

aini

ng p

rogr

amm

e fo

r nat

iona

l EOC

sta

ff in

clud

ing

man

agem

ent,

com

mun

icat

ions

, fina

nce

and

logi

stic

s.

Dev

elop

sta

ndar

dize

d fo

rms

and

tem

plat

es fo

r dat

a/in

form

atio

n m

anag

emen

t, re

port

ing,

brie

fing

and

reco

rd-k

eepi

ng.

D

evel

op a

dat

abas

e of

sub

ject

mat

ter e

xper

ts fo

r con

sulta

tion

on p

riorit

y ha

zard

s.

Iden

tify

criti

cal p

iece

s of

info

rmat

ion

to in

form

em

erge

ncy

resp

onse

, suc

h as

epi

dem

ic in

telli

genc

e, a

nd d

evel

op s

yste

ms

to

capt

ure

and

man

age

this

info

rmat

ion.

D

evel

op p

lans

to li

nk la

bora

tory

and

sur

veill

ance

info

rmat

ion

to th

e em

erge

ncy

resp

onse

com

mun

icat

ions

str

uctu

re.


98

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t a s

imul

ated

exe

rcis

e or

dem

onst

rate

in re

spon

se to

a re

al e

vent

that

the

natio

nal E

OC

can

be a

ctiv

ated

with

in

120

min

utes

of r

ecei

ving

an

early

war

ning

or i

nfor

mat

ion

of a

n em

erge

ncy

requ

iring

EO

C ac

tivat

ion.

D

evel

op E

OCs

at t

he s

ubna

tiona

l lev

el (b

ased

on

the

risks

and

geo

grap

hica

l nee

d) w

ith p

lans

and

SO

Ps.

Tr

ain

EOC

staf

f of s

ubna

tiona

l lev

els

on S

OPs

and

allo

cate

ded

icat

ed re

sour

ces.

D

evel

op a

nd im

plem

ent a

trac

king

of d

ecis

ion-

mak

ing

proc

edur

e fo

r the

act

ivat

atio

n of

an

EOC.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

aint

ain

a ne

twor

k of

fully

func

tiona

l, fu

nded

EO

Cs a

nd tr

aine

d st

aff o

n a

24/7

bas

is.

Te

st o

r upd

ate

EOC

func

tions

regu

larly

at a

ll le

vels

incl

udin

g fo

r lar

ge s

cale

and

con

curr

ent e

mer

genc

ies.

Ac

tivat

e th

e na

tiona

l EO

C ne

twor

k w

ithin

120

min

utes

, whi

ch in

clud

es a

ctiv

atio

n of

nat

iona

l, su

bnat

iona

l or m

ultis

ecto

ral

EOCs

ann

ually

, usi

ng re

al o

r sim

ulat

ed e

vent

s.

Iden

tify

and

secu

re re

sour

ces

for i

mpl

emen

ting

the

EOC

and

rela

ted

activ

ities

.


99

CAPA

CITY

LEVE

L

Benc

hmar

k 12

.3: E

mer

genc

y ex

erci

se m

anag

emen

t pro

gram

me

is in

pla

ce

Obj

ectiv

e: D

evel

op th

e em

erge

ncy

exer

cise

man

agem

ent p

rogr

amm

e

01N

O C

APAC

ITY

No

exer

cise

s ha

ve b

een

com

plet

ed in

the

past

five

yea

rs.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

em

erge

ncy

exer

cise

man

agem

ent c

oord

inat

or a

nd te

am in

the

heal

th s

ecto

r.

Cond

uct e

ither

a s

truct

ured

afte

r-ac

tion

revi

ew fr

om a

n ac

tual

act

ivat

ion

or d

esig

n an

d co

nduc

t a n

atio

nal-l

evel

mul

tisec

tora

l he

alth

em

erge

ncy

tabl

e-to

p ex

erci

se th

at in

clud

es m

ultip

le s

ecto

rs/s

take

hold

ers

that

test

s th

e em

erge

ncy

resp

onse

pla

n an

d cr

itica

l cor

e ca

paci

ties

base

d on

prio

rity

risks

/haz

ards

at l

east

eve

ry fi

ve y

ears

.

Doc

umen

t rec

omm

ende

d ac

tiona

ble

impr

ovem

ents

bas

ed o

n th

e af

ter-

actio

n re

view

or e

xerc

ise.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

esig

n an

d co

nduc

t a n

atio

nal l

evel

mul

tisec

tora

l hea

lth e

mer

genc

y fu

nctio

nal e

xerc

ise

that

incl

udes

mul

tiple

sec

tors

/st

akeh

olde

rs a

nd te

sts

criti

cal c

ore

capa

citie

s ba

sed

on th

e pr

iorit

y ris

ks/h

azar

ds a

t lea

st e

very

two

year

s.

D

ocum

ent r

ecom

men

ded

actio

nabl

e im

prov

emen

ts b

ased

on

the

exer

cise

OR

cond

uct a

fter-

actio

n re

view

of e

vent

s an

d sh

are

the

resu

lts o

f afte

r-ac

tion

revi

ews

with

sta

keho

lder

s at

the

natio

nal l

evel

.

Dev

elop

and

impl

emen

t a c

orre

ctiv

e ac

tion

plan

bas

ed o

n th

e ex

erci

ses

and

afte

r-ac

tion

revi

ew fi

ndin

gs.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

esig

n an

d co

nduc

t var

ious

exe

rcis

es to

test

em

erge

ncy

prep

ared

ness

and

resp

onse

cap

aciti

es a

t nat

iona

l and

sub

natio

nal

leve

ls b

ased

on

prio

rity

risks

/haz

ards

at l

east

eve

ry y

ear.

Co

nduc

t a c

oord

inat

ed e

xerc

ise

at le

ast a

nnua

lly w

ith re

leva

nt s

ecto

rs b

ased

on

prio

rity

risks

/haz

ards

.

Doc

umen

t rec

omm

ende

d ac

tiona

ble

impr

ovem

ents

bas

ed o

n th

e ex

erci

se a

nd m

aint

ain

a re

cord

of r

ecom

men

datio

ns a

nd

the

stat

us o

f the

ir im

plem

enta

tion.

Co

nduc

t afte

r-ac

tion

revie

ws

of e

vent

s an

d sh

are

resu

lts o

f afte

r-ac

tion

revie

ws

with

sta

keho

lder

s at

sub

natio

nal a

nd n

atio

nal le

vels

.

Dev

elop

and

impl

emen

t the

cor

rect

ive

actio

n pl

an b

ased

on

the

exer

cise

s an

d af

ter-

actio

n re

view

find

ings

at n

atio

nal a

nd

subn

atio

nal l

evel

s.


100

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t var

ied

exer

cise

s (o

r in

com

bina

tion)

to te

st e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se c

apac

ities

at n

atio

nal a

nd

subn

atio

nal l

evel

s ev

ery

year

.

Trac

k im

prov

emen

ts id

entifi

ed in

exe

rcis

es a

nd in

corp

orat

e in

to n

atio

nal e

mer

genc

y re

spon

se p

lans

and

pla

ns fo

r st

reng

then

ing

emer

genc

y pr

epar

edne

ss a

nd c

ore

capa

citie

s.

Cond

uct a

fter-

actio

n re

view

s of

any

eve

nts,

and

regu

larly

and

rout

inel

y sh

are

resu

lts o

f the

se re

view

s w

ith s

take

hold

ers

at

all l

evel

s.

Dev

elop

and

impl

emen

t cor

rect

ive

actio

n pl

ans

base

d on

the

exer

cise

s an

d af

ter-

actio

n re

view

find

ings

at a

ll le

vels

.

TOO

LS:

Fr

amew

ork

for a

pub

lic h

ealth

em

erge

ncy

oper

atio

ns c

entre

: thi

s do

cum

ent f

rom

WH

O o

utlin

es th

e ke

y co

ncep

ts a

nd e

ssen

tial r

equi

rem

ents

for

deve

lopi

ng a

nd m

anag

ing

a PH

EOC.

It p

rovi

des

an o

utlin

e fo

r dev

elop

ing

and

man

agin

g a

PHEO

C to

ach

ieve

a g

oal.

Su

stai

nabl

e m

odel

for p

ublic

hea

lth e

mer

genc

y op

erat

ions

cen

tres

for g

loba

l set

tings

: art

icle

from

US

CDC

on P

HEO

Cs w

ith c

ase

stud

ies

from

Vi

etna

m a

nd C

amer

oon

W

HO

Inci

dent

Man

agem

ent S

yste

m: a

trai

ning

cou

rse

from

WH

O th

at is

des

igne

d to

hel

p us

ers

gain

a fo

unda

tiona

l und

erst

andi

ng o

f the

Inci

dent

m

anag

emen

t sys

tem

str

uctu

re a

nd it

s pr

oced

ures

at W

HO.

N

atio

nal I

ncid

ent M

anag

emen

t Sys

tem

: fro

m th

e U

S Fe

dera

l Em

erge

ncy

Man

agem

ent A

genc

y is

a s

erie

s of

free

inte

ract

ive

onlin

e co

urse

s on

in

cide

nt m

anag

emen

t.

Publ

ic H

ealth

Inci

dent

Lea

ders

hip

Trai

ning

: fro

m th

e U

nive

rsity

of M

inne

sota

is a

trai

ning

for p

ublic

hea

lth p

ract

ition

ers

with

lead

ersh

ip

resp

onsi

bilit

ies

durin

g re

spon

ses

to d

isas

ters

and

eve

nts

with

pub

lic h

ealth

impl

icat

ions

.


101

LIN

KIN

G PU

BLIC

HEA

LTH

AN

D SE

CURI

TY A

UTH

ORI

TIES

13

IMPA

CT:

Dev

elop

men

t and

impl

emen

tatio

n of

a m

emor

andu

m o

f und

erst

andi

ng o

r oth

er s

imila

r fra

mew

ork

outli

ning

role

s, re

spon

sibi

litie

s an

d be

st

prac

tices

for s

harin

g re

leva

nt in

form

atio

n am

ong

appr

opria

te h

uman

and

ani

mal

hea

lth, la

w e

nfor

cem

ent a

nd d

efen

se p

erso

nnel

, and

val

idat

ion

of th

e m

emor

andu

m o

f und

erst

andi

ng th

roug

h pe

riodi

c ex

erci

ses

and

sim

ulat

ions

. Cou

ntrie

s ha

ve s

yste

ms

to c

ondu

ct a

nd s

uppo

rt jo

int

epid

emio

logi

cal a

nd c

rimin

al in

vest

igat

ions

to id

entif

y an

d re

spon

d to

sus

pect

ed b

iolo

gica

l, ch

emic

al o

r rad

iolo

gica

l inc

iden

ts o

f sus

pect

ed

delib

erat

e or

igin

in c

olla

bora

tion

with

indi

vidu

al B

iolo

gica

l and

Tox

in W

eapo

ns C

onve

ntio

n (B

TWC)

of S

tate

s Pa

rtie

s, F

AO, I

nter

natio

nal A

tom

ic

Ener

gy A

genc

y (IA

EA),

Inte

rnat

iona

l Crim

inal

Pol

ice

Org

aniz

atio

n (IN

TERP

OL)

, OIE

, Org

anis

atio

n fo

r the

Pro

hibi

tion

of C

hem

ical

Wea

pons

(OPC

W),

the

Uni

ted

Nat

ions

Sec

reta

ry-G

ener

al’s

Mec

hani

sm fo

r Inv

estig

atio

n of

Alle

ged

Use

of C

hem

ical

and

Bio

logi

cal W

eapo

ns, W

HO

and

oth

er re

leva

nt

regi

onal

and

inte

rnat

iona

l org

aniz

atio

ns a

s ap

prop

riate

.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: Ev

iden

ce o

f at l

east

one

resp

onse

in th

e pr

evio

us y

ear t

hat e

ffect

ivel

y lin

ks p

ublic

hea

lth a

nd la

w e

nfor

cem

ent,

or a

form

al e

xerc

ise

or s

imul

atio

n in

volv

ing

lead

ersh

ip fr

om th

e co

untr

y’s

publ

ic h

ealth

and

law

enf

orce

men

t com

mun

ities

.

Coun

try

cond

ucts

a ra

pid,

mul

tisec

tora

l res

pons

e fo

r any

eve

nt o

f sus

pect

ed o

r con

firm

ed d

elib

erat

e or

igin

, incl

udin

g th

e ca

paci

ty to

link

pub

lic h

ealth

and

la

w e

nfor

cem

ent,

and

to p

rovi

de ti

mel

y in

tern

atio

nal a

ssis

tanc

e.


102

CAPA

CITY

LEVE

L

Benc

hmar

k 13

.1: P

ublic

hea

lth a

nd s

ecur

ity a

utho

ritie

s (la

w e

nfor

cem

ent,

bord

er c

ontr

ol, c

usto

ms)

link

ed d

urin

g a

susp

ect

or c

onfir

med

bio

logi

cal,

chem

ical

or r

adio

logi

cal e

vent

O

bjec

tive:

Str

engt

heni

ng th

e lin

kage

bet

wee

n pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s du

ring

pote

ntia

l eve

nts

of n

atio

nal

conc

ern

01N

O C

APAC

ITY

No

legi

slat

ion,

rela

tions

hips

, pro

toco

ls, m

emor

anda

of u

nder

stan

ding

or o

ther

agr

eem

ents

exi

st b

etw

een

publ

ic h

ealth

, ani

mal

he

alth

, rad

iolo

gica

l saf

ety,

chem

ical

saf

ety

and

secu

rity

auth

oriti

es to

add

ress

all

haza

rds.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y se

ctor

s re

spon

sibl

e fo

r res

pons

e to

pot

entia

l IH

R re

late

d ha

zard

s (b

iolo

gica

l, che

mic

al a

nd ra

diat

ion)

.

Iden

tify

poin

ts-o

f-co

ntac

t to

assi

st w

ith th

e im

plem

enta

tion

of p

reve

ntio

n, d

etec

tion

and

resp

onse

act

iviti

es a

t gov

ernm

ent

agen

cies

acr

oss

mul

tiple

sec

tors

(suc

h as

pub

lic h

ealth

, ani

mal

hea

lth, s

ecur

ity a

utho

ritie

s, a

gric

ultu

re, c

hem

ical

, rad

iatio

n).

D

eter

min

e ro

les

and

resp

onsi

bilit

ies

for r

espo

ndin

g to

var

ious

thre

ats

and

othe

r inc

iden

ts o

f con

cern

thro

ugh

a re

view

of

natio

nal r

espo

nse

plan

s, p

olic

ies

and

proc

edur

es, o

r oth

er m

eans

, thr

ough

an

enga

gem

ent m

eetin

g or

oth

er m

eans

.

Asse

ss ri

sk o

f sig

nific

ant b

iolo

gica

l (an

d ch

emic

al o

r rad

iolo

gica

l) in

cide

nts

of c

once

rn to

the

coun

try.

D

evel

op tr

igge

rs fo

r sha

ring

info

rmat

ion

on b

iolo

gica

l thr

eats

or o

ther

inci

dent

s of

con

cern

(suc

h as

che

mic

al, r

adio

logi

cal)

with

rele

vant

mul

tisec

tora

l age

ncie

s.

Esta

blis

h an

info

rmal

or f

orm

al c

omm

unic

atio

ns p

roce

ss to

sha

re in

form

atio

n, b

ased

on

iden

tified

trig

gers

, rel

ated

to b

iolo

gica

l th

reat

s or

oth

er in

cide

nts

of c

once

rn (s

uch

as c

hem

ical

, rad

iolo

gica

l) am

ong

rele

vant

mul

tisec

tora

l age

ncie

s (s

uch

as p

ublic

he

alth

, ani

mal

hea

lth a

nd s

ecur

ity a

utho

ritie

s).

Tr

ain

staf

f on

join

t ris

k as

sess

men

t and

app

licat

ion

of tr

igge

rs, a

nd s

harin

g of

info

rmat

ion

amon

g al

l sec

tors

rele

vant

to

haza

rds.


103

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

com

mun

icat

ion

amon

g pu

blic

hea

lth, a

nim

al h

ealth

and

sec

urity

/law

enf

orce

men

t poi

nts

of c

onta

ct w

ho w

ould

ne

ed to

col

labo

rate

in c

ase

of a

sus

pect

ed in

tent

iona

l eve

nt.

Id

entif

y ap

prop

riate

act

iviti

es (s

uch

as n

otifi

catio

ns, a

sses

smen

ts, i

nves

tigat

ion,

labo

rato

ry te

stin

g) fo

r res

pons

e to

bi

olog

ical

thre

ats

or o

ther

inci

dent

s of

con

cern

(suc

h as

che

mic

al, r

adio

logi

cal),

whi

ch w

ill b

e co

vere

d by

a w

ritte

n pr

otoc

ol

or m

emor

andu

m o

f und

erst

andi

ng b

etw

een

sect

ors.

D

evel

op lo

gist

ical

pla

ns to

incl

ude

mul

tisec

tora

l age

ncie

s, in

clud

ing

if ap

prop

riate

, law

enf

orce

men

t, in

the

publ

ic h

ealth

EO

C.

Det

erm

ine

sam

ple

colle

ctio

n, tr

ansp

ort,

stor

age,

sec

urity

and

test

ing

requ

irem

ents

am

ong

rele

vant

sec

tors

(i.e

. pub

lic

heal

th, s

ecur

ity a

utho

ritie

s, a

gric

ultu

re) f

or b

iolo

gica

l thr

eats

and

oth

er in

cide

nts

of c

once

rn (s

uch

as c

hem

ical

, rad

iolo

gica

l).

Fina

lize

a w

ritte

n pr

otoc

ol o

r mem

oran

dum

of u

nder

stan

ding

that

form

aliz

es a

nd in

stitu

tiona

lizes

inte

ract

ions

bet

wee

n re

leva

nt m

ultis

ecto

ral a

genc

ies

(pub

lic h

ealth

, ani

mal

hea

lth a

nd s

ecur

ity a

utho

ritie

s).

D

evel

op S

OPs

defi

ning

the

proc

ess

and

com

mun

icat

ion

mec

hani

sms

for a

sses

sing

and

resp

ondi

ng to

sus

pect

ed

inte

rnat

iona

l eve

nts.

D

evel

op tr

aini

ng c

urric

ulum

usi

ng c

ount

ry-s

peci

fic c

onte

nt (s

uch

as re

gula

tions

/aut

horit

ies,

age

ncy

role

s/re

spon

sibi

litie

s an

d ca

se s

tudi

es).

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t reg

ular

trai

ning

in re

leva

nt s

ecto

rs.

Co

nduc

t at l

east

one

pub

lic h

ealth

em

erge

ncy

resp

onse

or e

xerc

ise

per y

ear t

hat i

nclu

des

appr

opria

te in

form

atio

n sh

arin

g be

twee

n pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s us

ing

the

form

al p

roto

col o

r mem

oran

dum

of u

nder

stan

ding

.

Doc

umen

t find

ings

of t

he re

spon

se o

r exe

rcis

e, h

ighl

ight

the

gaps

and

bes

t pra

ctic

es, a

nd a

djus

t pro

toco

ls a

s ap

prop

riate

.

Cond

uct j

oint

trai

ning

of p

ublic

hea

lth, a

nim

al h

ealth

and

sec

urity

aut

horit

ies

to o

rient

, exe

rcis

e an

d in

stitu

tiona

lize

know

ledg

e of

mem

oran

dum

of u

nder

stan

ding

and

oth

er a

gree

men

ts re

late

d to

all

haza

rds.


104

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

ocum

ent c

ondu

ctio

n of

regu

lar j

oint

trai

ning

/exe

rcis

e pr

ogra

mm

es a

t nat

iona

l, in

term

edia

te a

nd lo

cal l

evel

s fo

r pub

lic

heal

th, a

nim

al h

ealth

and

sec

urity

aut

horit

ies

to o

rient

, exe

rcis

e an

d in

stitu

tiona

lize

the

know

ledg

e of

mem

oran

dum

of

unde

rsta

ndin

g an

d ot

her a

gree

men

ts re

late

d to

all

haza

rds.

Ex

pand

the

join

t ris

k as

sess

men

t, ex

chan

ge o

f inf

orm

atio

n an

d re

port

ing

to a

ll le

vels

(nat

iona

l, in

term

edia

te a

nd lo

cal

leve

ls).

Co

nduc

t an

eval

uatio

n to

det

erm

ine

whe

ther

info

rmat

ion

abou

t eve

nts

of jo

int c

once

rn is

sha

red

in a

tim

ely

and

effe

ctiv

e m

anne

r at n

atio

nal,

inte

rmed

iate

and

loca

l lev

els

as o

utlin

ed in

form

al m

emor

anda

of u

nder

stan

ding

or o

ther

agr

eem

ents

/pr

otoc

ols,

and

that

the

resp

onse

is a

ppro

pria

te a

nd e

ffect

ive,

and

cor

rect

ive

actio

n is

take

n ba

sed

on th

is e

valu

atio

n.

TOO

LS:

W

HO

–O

IE o

pera

tiona

l fra

mew

ork

for g

ood

gove

rnan

ce a

t the

hum

an¬–

anim

al in

terf

ace:

Brid

ging

WH

O a

nd O

IE to

ols

for t

he a

sses

smen

t of

natio

nal c

apac

ities

. WH

O a

nd O

IE; 2

014.

Te

rres

tria

l ani

mal

hea

lth c

ode.

Cha

pter

3.4

Vet

erin

ary

legi

slat

ion.

Wor

ld O

rgan

isat

ion

for A

nim

al H

ealth

; 201

6

Conv

entio

n on

the

proh

ibiti

on o

f the

dev

elop

men

t, pr

oduc

tion,

sto

ckpi

ling

and

use

of c

hem

ical

wea

pons

and

on

thei

r des

truc

tion.

The

Hag

ue:

Org

anis

atio

n fo

r the

Pro

hibi

tion

of C

hem

ical

Wea

pons

Tr

eaty

on

the

non-

prol

ifera

tion

of n

ucle

ar w

eapo

ns. I

nter

natio

nal A

tom

ic E

nerg

y Ag

ency

[inf

orm

atio

n ci

rcul

ar] I

NFC

IRC/

140,

22

April

197

0

Join

t Crim

inal

and

Epi

dem

iolo

gica

l Inv

estig

atio

ns H

andb

ook

2016

. Int

erna

tiona

l Edi

tion


105

MED

ICAL

CO

UN

TERM

EASU

RES

AND

PERS

ON

NEL

DEP

LOYM

ENT

14

IMPA

CT:

Coun

tries

will

hav

e th

e ne

cess

ary

lega

l and

regu

lato

ry p

roce

sses

and

logi

stic

al p

lans

to a

llow

for r

apid

nat

iona

l or c

ross

-bor

der d

eplo

ymen

t and

re

ceip

t of p

ublic

hea

lth a

nd m

edic

al p

erso

nnel

dur

ing

emer

genc

ies.

Reg

iona

l (in

tern

atio

nal)

colla

bora

tion

will

ass

ist c

ount

ries

in o

verc

omin

g th

e lo

gist

ical

and

regu

lato

ry c

halle

nges

to d

eplo

ymen

t of p

ublic

hea

lth a

nd m

edic

al p

erso

nnel

from

one

cou

ntry

to a

noth

er.

Coun

try

has

deve

lope

d ca

se m

anag

emen

t pro

cedu

res

and

impl

emen

ted

it du

ring

heal

th e

mer

genc

ies

due

to IH

R re

leva

nt h

azar

ds.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Evi

denc

e of

at l

east

one

resp

onse

to a

pub

lic h

ealth

em

erge

ncy

with

in th

e pr

evio

us y

ear t

hat d

emon

stra

tes

that

the

coun

try

sent

or r

ecei

ved

med

ical

cou

nter

mea

sure

s an

d pe

rson

nel a

ccor

ding

to w

ritte

n na

tiona

l or i

nter

natio

nal p

roto

cols

, or a

form

al e

xerc

ise

or s

imul

atio

n th

at

dem

onst

rate

s th

ese

mea

sure

s. (2

) Evi

denc

e of

dem

onst

ratin

g ap

plic

atio

n of

cas

e m

anag

emen

t pro

cedu

res

for e

vent

s du

e to

IHR

-rel

evan

t ha

zard

s. (3

) Evi

denc

e of

a s

tron

g na

tiona

l res

pons

e te

am/e

mer

genc

y m

edic

al te

am (E

MT)

str

uctu

res,

exe

rcis

es, t

rain

ings

, am

ong

othe

rs.

Nat

iona

l fra

mew

ork

for t

rans

ferr

ing

(sen

ding

and

rece

ivin

g) m

edic

al c

ount

erm

easu

res,

pub

lic h

ealth

and

med

ical

per

sonn

el fr

om u

naffe

cted

regi

ons

(rapi

d re

spon

se te

ams/

natio

nal e

mer

genc

y m

edic

al te

ams)

, and

inte

rnat

iona

l par

tner

s du

ring

publ

ic h

ealth

em

erge

ncie

s; a

nd p

roce

dure

s fo

r cas

e m

anag

emen

t of

eve

nts

due

to IH

R re

leva

nt h

azar

ds.


106

CAPA

CITY

LEVE

L

Benc

hmar

k 14

.1: S

yste

m is

in p

lace

for a

ctiv

atin

g an

d co

ordi

natin

g m

edic

al c

ount

erm

easu

res

durin

g a

publ

ic h

ealth

em

erge

ncy

Obj

ectiv

e: T

o de

velo

p a

func

tiona

l sys

tem

for a

ctiv

atin

g an

d co

ordi

natin

g he

alth

per

sonn

el d

urin

g a

publ

ic h

ealth

em

erge

ncy

01N

O C

APAC

ITY

No

natio

nal c

ount

erm

easu

res

plan

has

bee

n dr

afte

d.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

nat

iona

l pre

pare

dnes

s an

d re

spon

se p

lans

, lega

l and

regu

lato

ry fr

amew

orks

, and

bas

elin

e ca

paci

ty fo

r sto

ckpi

ling

and

depl

oyin

g m

edic

al c

ount

erm

easu

res,

incl

udin

g se

ctor

role

s an

d re

spon

sibi

litie

s, in

volv

ing

all k

ey s

take

hold

ers.

Re

view

nat

iona

l law

s an

d re

gula

tions

for t

he re

gist

ratio

n, p

rocu

rem

ent a

nd u

se o

f med

ical

dev

ices

, vac

cine

s, d

rugs

, bio

logi

cals

an

d m

edic

al s

uppl

ies

from

nat

iona

l and

/or i

nter

natio

nal s

ourc

es d

urin

g pu

blic

hea

lth e

mer

genc

ies.

Co

mpl

ete

feas

ibilit

y as

sess

men

t for

est

ablis

hing

a m

edic

al c

ount

erm

easu

res

stoc

kpile

, incl

udin

g se

cure

and

func

tiona

l fa

cilit

ies

to s

tock

pile

med

ical

cou

nter

mea

sure

s at

all

leve

ls.

D

raft

a na

tiona

l pla

n to

sen

d, re

ceiv

e, s

tock

pile

and

dep

loy

med

ical

cou

nter

mea

sure

s.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ad

opt t

he n

atio

nal p

lan

to s

end,

rece

ive,

sto

ckpi

le a

nd d

eplo

y m

edic

al c

ount

erm

easu

res,

incl

udin

g m

appi

ng re

sour

ces

with

in th

e co

untr

y an

d w

ith p

artn

ers.

D

evel

op s

tand

ardi

zed

prot

ocol

s, p

lans

for s

tora

ge, d

eplo

ymen

t and

logi

stic

al a

nd a

dmin

istr

ativ

e su

ppor

t at a

ll le

vels

.

Esta

blis

h re

gula

tory

pat

hway

s fo

r use

of m

edic

al c

ount

erm

easu

res

incl

udin

g ap

prop

riate

aut

horiz

atio

ns, c

lear

ance

s, e

thic

al

norm

s, a

nd p

erm

issi

ons

durin

g in

vest

igat

ions

and

resp

onse

s.

Crea

te d

eplo

ymen

t pro

toco

ls, S

OPs

, tec

hnic

al g

uide

lines

and

tool

kits

incl

udin

g co

mm

unic

atio

n m

ater

ials

, tra

inin

gs a

nd

educ

atio

nal i

nfor

mat

ion

to in

form

sta

ff, th

e co

mm

unity

and

sta

keho

lder

s.

Trai

n ea

rly re

spon

ders

in th

e ap

prop

riate

use

and

man

agem

ent o

f cou

nter

mea

sure

s.

Dev

elop

and

con

duct

a ta

ble-

top

exer

cise

, if c

ount

erm

easu

res

(whi

ch in

clud

es s

endi

ng a

nd re

ceiv

ing

med

ical

co

unte

rmea

sure

s) h

ave

not b

een

depl

oyed

in th

e pr

evio

us y

ear.


107

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

the

impl

emen

tatio

n pl

an o

f sen

ding

, rec

eivi

ng, s

tock

pilin

g an

d de

ploy

ing

med

ical

cou

nter

mea

sure

s in

at l

east

one

re

spon

se.

In

clud

e pr

ocur

emen

t of a

nim

al c

ount

erm

easu

res

in th

e co

untr

y pl

ans,

pro

cedu

res

or le

gal p

rovi

sion

s.

If th

ere

is n

o re

spon

se in

the

prev

ious

yea

r, th

en d

evel

op a

nd c

ondu

ct a

sim

ulat

ion

exer

cise

that

test

s th

e im

plem

enta

tion

plan

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

part

ners

hips

with

cou

ntrie

s, a

nd re

gion

al a

nd in

tern

atio

nal p

artn

ers,

that

incl

ude

proc

urem

ent,

shar

ing

and

dist

ribut

ion

of m

edic

al c

ount

erm

easu

res.

D

evel

op a

nd ro

utin

ely

appl

y cr

iteria

to d

ocum

ent p

rogr

ess

of s

endi

ng a

nd re

ceiv

ing

med

ical

cou

nter

mea

sure

s du

ring

a re

spon

se.

Ro

utin

ely

test

and

eva

luat

e th

e ca

paci

ty o

f em

erge

ncy

depl

oym

ent o

f med

ical

cou

nter

mea

sure

s an

d up

date

the

plan

.

Dev

elop

a ra

tiona

l and

evi

denc

e-ba

sed

stra

tegy

to p

riorit

ize

reso

urce

s an

d in

vest

men

ts in

med

ical

cou

nter

mea

sure

s at

the

natio

nal l

evel

.


108

CAPA

CITY

LEVE

L

Benc

hmar

k 14

.2: S

yste

m is

in p

lace

for a

ctiv

atin

g an

d co

ordi

natin

g he

alth

per

sonn

el d

urin

g a

publ

ic h

ealth

em

erge

ncy

Obj

ectiv

e: T

o de

velo

p a

func

tiona

l sys

tem

for a

ctiv

atin

g an

d co

ordi

natin

g he

alth

per

sonn

el d

urin

g a

publ

ic h

ealth

em

erge

ncy

01N

O C

APAC

ITY

No

natio

nal p

erso

nnel

dep

loym

ent p

lan

has

been

dra

fted.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

nat

iona

l pre

pare

dnes

s an

d re

spon

se p

lans

, and

lega

l and

regu

lato

ry fr

amew

orks

for s

endi

ng a

nd re

ceiv

ing

heal

th

pers

onne

l with

key

sta

keho

lder

s.

Revi

ew n

atio

nal l

aws

and

regu

latio

ns fo

r the

regi

stra

tion

of E

MTs

.48

Co

nduc

t a s

take

hold

er m

eetin

g to

det

erm

ine

base

line

capa

city

/cap

abilit

ies

of re

leva

nt m

inis

tries

and

par

tner

ing

agen

cies

for

depl

oym

ent o

f EM

Ts.

Id

entif

y po

ints

of c

onta

ct a

t rel

evan

t mul

tisec

tora

l org

aniz

atio

ns.

D

evel

op p

roto

cols

, SO

Ps, t

echn

ical

gui

delin

es a

nd to

olki

ts fo

r sen

ding

and

rece

ivin

g he

alth

per

sonn

el, a

nd fo

r sha

ring

info

rmat

ion

as a

ppro

pria

te.

Id

entif

y an

d do

cum

ent b

arrie

rs to

regi

ster

ing,

as

wel

l as

rece

ivin

g an

d de

ploy

ing

natio

nal/i

nter

natio

nal h

ealth

per

sonn

el a

nd

team

s, in

clud

ing

safe

ty a

nd li

abilit

y gu

idan

ce fo

r per

sonn

el d

eplo

ymen

t.

Dev

elop

SO

Ps a

nd tr

aini

ng fo

r the

org

aniz

atio

n, tr

ansp

orta

tion

and

dist

ribut

ion

of p

erso

nal p

rote

ctiv

e eq

uipm

ent,

med

icat

ions

an

d su

pplie

s to

hea

lth p

erso

nnel

.

Dev

elop

sta

ndar

dize

d pl

ans

for t

reat

men

t cen

tres

for t

riage

, IPC

and

trea

tmen

t dur

ing

emer

genc

y in

cide

nts.

Es

tabl

ish

a co

mm

unic

atio

n ne

twor

k fo

r hea

lth p

erso

nnel

dur

ing

emer

genc

ies.

D

evel

op to

ols

for e

mer

genc

y he

alth

dis

aste

r edu

catio

n of

the

publ

ic fo

r com

mun

ity a

ccep

tanc

e of

dep

loye

d he

alth

per

sonn

el.

D

raft

a na

tiona

l pla

n to

sen

d an

d re

ceiv

e he

alth

per

sonn

el.

Ap

ply

to W

HO

EM

T se

cret

aria

t for

ass

ista

nce

in d

evel

opin

g na

tiona

l EM

Ts.

48 E

MTs

con

sist

of h

ealth

pro

fess

iona

ls p

rovi

ding

dire

ct c

linic

al c

are

to p

opul

atio

ns a

ffect

ed b

y ou

tbre

aks,

dis

aste

rs a

nd e

mer

genc

ies

as a

sur

ge c

apac

ity to

sup

port

the

loca

l hea

lth s

yste

m.

They

cou

ld b

e ci

vilia

n or

mili

tary

or n

ongo

vern

men

tal t

eam

s an

d in

clud

e bo

th n

atio

nal a

nd in

tern

atio

nal p

erso

nnel

.


109

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ad

opt t

he n

atio

nal p

lan

on p

erso

nnel

dep

loym

ent a

nd d

evel

op p

roce

dure

s or

lega

l pro

visi

ons.

Co

nduc

t a ta

ble-

top

exer

cise

, if n

o re

spon

se h

as o

ccur

red

in th

e pa

st y

ear,

whi

ch in

clud

es s

endi

ng a

nd re

ceiv

ing

heal

th

pers

onne

l and

team

s, a

nd c

ompr

isin

g th

e cr

eatio

n of

an

EMT

coor

dina

tion

cell

and/

or c

ase

man

agem

ent p

illar

in th

e na

tiona

l hea

lth E

OC.

D

evel

op a

nd c

ondu

ct a

tabl

e-to

p ex

erci

se w

hich

incl

udes

sen

ding

and

rece

ivin

g he

alth

per

sonn

el in

an

emer

genc

y an

d re

view

the

pers

onne

l dep

loym

ent p

lan.

Ap

ply

to th

e W

HO

EM

T se

cret

aria

t for

men

tors

hip

and

verifi

catio

n as

an

inte

rnat

iona

lly c

lass

ified

EM

T.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

the

impl

emen

tatio

n pl

an o

f sen

ding

and

rece

ivin

g he

alth

per

sonn

el in

at l

east

one

eve

nt re

spon

se.

Co

nduc

t a s

imul

atio

n ex

erci

se, i

f no

resp

onse

has

occ

urre

d in

pas

t yea

r, to

test

the

send

ing

and

rece

ivin

g of

hea

lth

pers

onne

l.

Esta

blis

h an

d tr

ain

a ro

ster

of q

ualifi

ed p

erso

nnel

to b

e ac

tivat

ed in

a p

ublic

hea

lth e

mer

genc

y.

Achi

eve

cert

ifica

tion

as a

nat

iona

l or i

nter

natio

nal E

MT

from

WH

O to

sup

port

the

natio

nal r

espo

nse.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y an

d pa

rtne

r with

regi

onal

and

inte

rnat

iona

l (su

ch a

s G

loba

l Out

brea

k Al

ert a

nd R

espo

nse

Net

wor

k) p

artn

ers

for

mob

ilizi

ng h

ealth

per

sonn

el.

D

evel

op a

nd m

aint

ain

a ro

ster

of t

rain

ed a

nd c

ertifi

ed h

ealth

per

sonn

el.

Ro

utin

ely

test

and

eva

luat

e ca

paci

ty o

f em

erge

ncy

depl

oym

ent o

f hea

lth p

erso

nnel

(sen

ding

and

rece

ivin

g) in

clud

ing

the

set

up a

nd ru

nnin

g of

an

EMT

coor

dina

tion

cell

and/

or c

ase

man

agem

ent p

illar

with

in th

e na

tiona

l hea

lth E

OC.


110

CAPA

CITY

LEVE

L

Benc

hmar

k 14

.3: C

ase

man

agem

ent p

roce

dure

s im

plem

ente

d fo

r rel

evan

t IH

R ha

zard

s O

bjec

tive:

Dev

elop

and

impl

emen

t cas

e m

anag

emen

t pro

cedu

res

for a

ll re

leva

nt IH

R ha

zard

s

01N

O C

APAC

ITY

No

case

man

agem

ent g

uide

lines

are

ava

ilabl

e fo

r prio

rity

epid

emic

-pro

ne d

isea

ses.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op s

tand

ardi

zed

case

man

agem

ent g

uide

lines

for p

riorit

y di

seas

es a

nd IH

R-re

leva

nt h

azar

ds.

D

evel

op tr

igge

rs fo

r sha

ring

info

rmat

ion

on d

isea

ses,

con

ditio

ns a

nd e

vent

s of

pub

lic h

ealth

em

erge

ncy

of in

tern

atio

nal

conc

ern

with

rele

vant

mul

tisec

tora

l age

ncie

s.

Dev

elop

the

diss

emin

atio

n pl

an (i

nclu

ding

trai

ning

pac

kage

) for

cas

e m

anag

emen

t gui

delin

es fo

r all

leve

ls.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

isse

min

ate

case

man

agem

ent g

uide

lines

to s

ubna

tiona

l lev

el a

nd p

oint

s of

ent

ry.

D

evel

op a

nd d

isse

min

ate

SOPs

for t

he m

anag

emen

t and

tran

spor

t of p

oten

tially

infe

ctio

us p

atie

nts,

incl

udin

g pa

tient

re

ferr

al a

nd tr

ansp

orta

tion

mec

hani

sms.

Id

entif

y th

e tr

ansp

orta

tion

mec

hani

sm a

nd re

ferr

al c

entre

s ba

sed

on p

riorit

y ris

ks.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

view

cas

e m

anag

emen

t, pa

tient

refe

rral a

nd tr

ansp

orta

tion,

and

man

agem

ent a

nd tr

ansp

orta

tion

of p

oten

tially

infe

ctio

us

patie

nts

in a

ccor

danc

e w

ith g

uide

lines

and

SOP

s ba

sed

on a

ctua

l exp

erie

nce

or a

spe

cific

exe

rcis

e to

eva

luat

e th

ese

proc

edur

es.

D

ocum

ent t

he re

view

of t

he im

plem

enta

tion

of th

ese

guid

elin

es a

nd S

OPs

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a m

echa

nism

to e

nsur

e co

ntin

uous

pre

senc

e of

trai

ned

staf

f and

reso

urce

s fo

r cas

e m

anag

emen

t, pa

tient

refe

rral

an

d tr

ansp

orta

tion

for a

ll IH

R re

leva

nt e

mer

genc

ies/

haza

rds.

Re

view

cas

e m

anag

emen

t, pa

tient

refe

rral

and

tran

spor

tatio

n of

IHR

rele

vant

em

erge

ncie

s, if

it o

ccur

red

in th

e pa

st tw

o ye

ars.

D

ocum

ent a

nd d

isse

min

ate

less

ons

lear

ned

from

the

man

agem

ent o

f IH

R-re

leva

nt e

mer

genc

ies.


111

TOO

LS:

W

hat a

re m

edic

al c

ount

erm

easu

res?

Med

ical

cou

nter

mea

sure

s ar

e pr

oduc

ts (d

rugs

, bio

logi

cs, d

rugs

, dev

ices

) tha

t may

be

used

in th

e ev

ent o

f a

pote

ntia

l pub

lic h

ealth

em

erge

ncy

due

to IH

R ha

zard

s (li

ke in

fect

ious

, foo

d sa

fety

rela

ted

even

ts, c

hem

ical

eve

nts

and

radi

atio

n ev

ents

). Th

ese

can

be u

sed

to p

reve

nt, d

etec

t and

resp

ond

to e

vent

s as

soci

ated

with

abo

ve m

entio

ned

thre

ats

and

dise

ases

.

Inte

rnat

iona

l Coo

rdin

atin

g G

roup

on

Vacc

ine

Prov

isio

n fro

m In

tern

atio

nal F

eder

atio

n of

Red

Cro

ss a

nd R

ed C

resc

ent S

ocie

ties,

Méd

ecin

s Sa

ns

Fron

tière

s, U

nite

d N

atio

ns In

tern

atio

nal C

hild

ren’

s Em

erge

ncy

Fund

and

WH

O, h

as in

form

atio

n on

mec

hani

sms

to m

anag

e an

d co

ordi

nate

the

prov

isio

n of

em

erge

ncy

vacc

ine

supp

lies

and

antib

iotic

s to

cou

ntrie

s du

ring

maj

or o

utbr

eaks

. Thi

s in

clud

es v

acci

nes

for c

hole

ra, m

enin

gitis

and

ye

llow

feve

r.

Gui

ding

Prin

cipl

es fo

r Int

erna

tiona

l Out

brea

k Al

ert a

nd R

espo

nse

– fr

om th

e G

loba

l Out

brea

k Al

ert a

nd R

espo

nse

Net

wor

k (G

OAR

N),

prov

ides

in

form

atio

n on

how

to p

repa

re fo

r fiel

d ac

tivity

, to

activ

ate

inte

rnat

iona

l sup

port

, to

coor

dina

te re

spon

se in

the

field

, to

eval

uate

and

follo

w u

p ou

tbre

aks

of in

tern

atio

nal i

mpo

rtan

ce. C

lass

ifica

tion

and

min

imum

sta

ndar

ds fo

r for

eign

med

ical

team

s in

sud

den

onse

t dis

aste

rs-

from

th

e EM

T se

cret

aria

t WH

O, a

nd u

nder

goin

g re

-writ

e to

incl

ude

outb

reak

resp

onse

by

clin

ical

team

s an

d co

ordi

natio

n as

pect

s an

d av

aila

ble

in th

e “B

lue

Book

”

Emer

genc

y M

edic

al T

eam

s In

itiat

ive:

Sur

ge c

apac

ity in

hea

lth c

are

durin

g em

erge

ncie

s. 2

8–29

Nov

embe

r 201

7 Ba

ngko

k, T

haila

nd. T

he re

gula

tion

and

man

agem

ent o

f int

erna

tiona

l em

erge

ncy

med

ical

team

s: fr

om W

HO

and

IFRC

201

7, p

rovi

des

an o

verv

iew

of t

he is

sues

in re

gula

ting

and

man

agin

g in

tern

atio

nal e

mer

genc

y m

edic

al te

ams

in a

sel

ectio

n of

larg

e an

d sm

all-s

cale

sud

den

onse

t dis

aste

rs.


112

RISK

CO

MM

UN

ICAT

ION

15

IMPA

CT:

Effe

ctiv

e ris

k co

mm

unic

atio

n al

low

s pe

ople

at r

isk

to u

nder

stan

d an

d ad

opt p

rote

ctiv

e be

havi

ours

. It a

llow

s au

thor

ities

and

exp

erts

to li

sten

to

and

addr

ess

peop

le’s

con

cern

s an

d ne

eds

so th

at th

e ad

vice

they

pro

vide

is re

leva

nt a

nd tr

uste

d. F

eedb

ack

from

at-

risk

com

mun

ity m

embe

rs

is u

sed

to tw

eak

broa

der r

espo

nse

mea

sure

s, m

akin

g th

em m

ore

likel

y to

be

acce

pted

.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) For

mal

gov

ernm

ent r

isk

com

mun

icat

ions

pla

ns, a

rran

gem

ents

and

sys

tem

s in

pla

ce. (

2) E

xist

ence

of r

isk

com

mun

icat

ion

coor

dina

tion

mec

hani

sms

for i

nter

nal a

nd p

artn

er c

omm

unic

atio

n. (3

) Evi

denc

e th

at th

e pu

blic

com

mun

icat

ion

unit

or te

am o

pera

tes

effic

ient

ly a

nd e

ffect

ivel

y.

(4) E

vide

nce

that

risk

com

mun

icat

ion

units

sys

tem

atic

ally

eng

age

popu

latio

ns a

t the

com

mun

ity le

vel d

urin

g em

erge

ncie

s. (5

) Exi

sten

ce o

f a

syst

em to

gat

her i

nfor

mat

ion

on p

erce

ptio

ns, r

isky

beh

avio

urs

and

mis

info

rmat

ion

to a

naly

se p

ublic

con

cern

s an

d fe

ars.

Ris

k co

mm

unic

atio

n ca

paci

ty a

t the

nat

iona

l and

sub

natio

nal l

evel

s sh

ould

ens

ure

timel

y an

d ef

fect

ive

two-

way

com

mun

icat

ion

betw

een

conc

erne

d au

thor

ities

and

the

popu

latio

n at

risk

. Thi

s in

clud

es b

oth

proa

ctiv

e di

ssem

inat

ion

of in

form

atio

n an

d ac

tive

liste

ning

. The

exc

hang

e of

info

rmat

ion,

adv

ice

and

opin

ion

shou

ld b

e do

ne th

roug

h ch

anne

ls a

nd p

latfo

rms

that

are

acc

esse

d an

d m

ost t

rust

ed b

y th

e at

-ris

k po

pula

tion

(suc

h as

the

med

ia, s

ocia

l med

ia,

mas

s aw

aren

ess

cam

paig

ns, h

ealth

pro

mot

ion,

soc

ial m

obili

zatio

n, s

take

hold

er o

r via

trus

ted

com

mun

ity le

ader

s).


113

CAPA

CITY

LEVE

L

Benc

hmar

k 15

.1: R

isk

com

mun

icat

ion

syst

ems

for u

nusu

al e

vent

s an

d em

erge

ncie

s is

in p

lace

O

bjec

tive:

To

deve

lop

a sy

stem

for r

isk

com

mun

icat

ion

for u

nusu

al e

vent

s an

d em

erge

ncie

s

01N

O C

APAC

ITY

Coun

try

has

not y

et d

evel

oped

a s

yste

m fo

r ris

k co

mm

unic

atio

n fo

r unu

sual

eve

nts

and

emer

genc

ies.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y pe

ople

or u

nits

resp

onsi

ble

for r

isk

com

mun

icat

ion

with

in e

ach

rele

vant

min

istr

y an

d re

leva

nt s

ecto

rs, w

ith d

efine

d te

rms

of re

fere

nce

to w

ork

toge

ther

dur

ing

a pu

blic

hea

lth e

mer

genc

y.

Iden

tify

and

assi

gn s

poke

sper

sons

(hol

ding

a c

erta

in jo

b po

sitio

n) fo

r pub

lic h

ealth

em

erge

ncy.

Es

tabl

ish

a lis

t of k

ey s

take

hold

ers

in g

over

nmen

t min

istr

ies

and

amon

g im

plem

entin

g pa

rtne

rs. I

dent

ify p

oint

s of

con

tact

fo

r com

mun

icat

ion

incl

udin

g di

ffere

nt m

eans

for i

nter

nal i

nfor

mat

ion

shar

ing

(suc

h as

by

emai

l, SM

S or

pho

ne o

r clo

sed

grou

p so

cial

med

ia p

latfo

rms)

.

Esta

blis

h a

dedi

cate

d ris

k co

mm

unic

atio

n un

it or

team

to w

ork

on tw

o-w

ay c

omm

unic

atio

n w

ith th

e pu

blic

(inc

ludi

ng

affe

cted

at-

risk

com

mun

ities

) usi

ng S

OPs

, prio

rity

task

s an

d de

dica

ted

resp

onsi

bilit

ies

for c

omm

unic

atio

n an

d de

cisi

on-

mak

ing

auth

ority

dur

ing

a pu

blic

hea

lth e

vent

at t

he n

atio

nal l

evel

.

Dev

elop

a n

atio

nal m

ultih

azar

d, m

ultis

ecto

ral e

mer

genc

y ris

k co

mm

unic

atio

n pl

an.

As

sess

exi

stin

g ca

paci

ties

and

need

s w

ithin

gov

ernm

ent m

inis

trie

s an

d ke

y pa

rtne

r age

ncie

s, a

nd d

evel

op tr

aini

ng p

lans

for

prio

rity

skill

s id

entifi

ed fo

r car

ryin

g ou

t effe

ctiv

e ris

k co

mm

unic

atio

n.


114

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Te

st th

e ex

istin

g sy

stem

and

pla

n th

roug

h ac

tual

exp

erie

nce

and/

or ta

ble-

top

or s

imul

atio

n ex

erci

ses.

D

evel

op ri

sk c

omm

unic

atio

n ca

paci

ties

thro

ugh

casc

ade

trai

ning

and

/or m

ento

rshi

p at

the

subn

atio

nal l

evel

on

info

rmat

ion

shar

ing

amon

g ke

y st

akeh

olde

rs, i

nclu

ding

thro

ugh

the

med

ia, s

ocia

l med

ia a

nd d

irect

inte

ract

ion

with

affe

cted

co

mm

uniti

es.

Co

mm

unic

ate

in lo

cal l

angu

ages

and

use

app

ropr

iate

tech

nolo

gy fo

r inf

orm

atio

n ex

chan

ge (d

isse

min

atio

n an

d re

ceiv

ing

feed

back

from

the

publ

ic).

D

evel

op a

mec

hani

sm fo

r sys

tem

atic

ally

col

lect

ing

feed

back

from

the

com

mun

ity (s

uch

as th

roug

h te

leph

one

hotli

ne, s

ocia

l m

edia

foru

ms,

dire

ct e

ngag

emen

t).

Dev

elop

a m

echa

nism

to c

ondu

ct b

asel

ine

surv

eys

on k

now

ledg

e, a

ttitu

des

and

prac

tices

on

prio

rity

heal

th th

reat

s an

d on

he

alth

see

king

pra

ctic

es.

Es

tabl

ish

a m

echa

nism

to e

nsur

e re

gula

r col

labo

ratio

n am

ong

staf

f res

pons

ible

for s

urve

illan

ce, r

isk

asse

ssm

ent a

nd ri

sk

com

mun

icat

ion.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a de

dica

ted,

ade

quat

ely

reso

urce

d co

re ri

sk c

omm

unic

atio

n te

am a

nd a

sur

ge m

echa

nism

to e

nsur

e th

at h

uman

re

sour

ces

capa

city

for r

isk

com

mun

icat

ion

is a

vaila

ble

befo

re, d

urin

g an

d af

ter a

n ev

ent/

emer

genc

y.

Allo

cate

requ

ired

reso

urce

s to

sup

port

the

core

risk

com

mun

icat

ion

team

bef

ore,

dur

ing

and

afte

r an

emer

genc

y.

Cond

uct a

n af

ter-

actio

n re

view

of r

isk

com

mun

icat

ion

follo

win

g a

real

eve

nt o

r a s

imul

atio

n ex

erci

se.

Im

plem

ent r

isk

com

mun

icat

ion

trai

ning

acr

oss

sect

ors

and

at s

ubna

tiona

l lev

els.

D

evel

op a

mec

hani

sm fo

r sys

tem

atic

exc

hang

e of

info

rmat

ion

amon

g di

ffere

nt fu

nctio

ns o

f an

emer

genc

y re

spon

se (s

uch

as s

urve

illan

ce, l

abor

ator

y, pa

tient

car

e, in

fect

ion

prev

entio

n an

d co

ntro

l, lo

gist

ics,

risk

com

mun

icat

ion,

hum

an re

sour

ces,

pl

anni

ng, b

udge

t and

fina

nce)

.

Esta

blis

h m

onito

ring

and

eval

uatio

n to

ols

to e

valu

ate

the

impl

emen

tatio

n of

risk

com

mun

icat

ion

activ

ities

dur

ing

publ

ic

heal

th e

mer

genc

ies.

Tr

ain

front

line

heal

thca

re s

taff

on e

ffect

ive

risk

com

mun

icat

ion.


115

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

vise

the

risk

com

mun

icat

ion

plan

bas

ed o

n fin

ding

s or

resu

lts fr

om e

valu

atio

n of

the

real

eve

nt.

Es

tabl

ish

a m

echa

nism

with

ded

icat

ed re

sour

ces

for t

he fu

nctio

ning

of a

n ef

fect

ive

risk

com

mun

icat

ion

syst

em, i

nclu

ding

hu

man

and

fina

ncia

l res

ourc

es fo

r a d

edic

ated

team

with

bud

get f

or im

plem

entin

g ac

tiviti

es a

t the

nat

iona

l and

sub

natio

nal

leve

ls.

D

ocum

ent,

inco

rpor

ate

findi

ngs,

and

dis

sem

inat

e le

sson

s le

arne

d fro

m ri

sk c

omm

unic

atio

n ac

tiviti

es o

f an

even

t or

exer

cise

.


116

CAPA

CITY

LEVE

L

Benc

hmar

k 15

.2: C

oord

inat

ion

of ri

sk c

omm

unic

atio

n is

eff

ectiv

e O

bjec

tive:

Str

engt

hen

coor

dina

tion

for r

isk

com

mun

icat

ion

01N

O C

APAC

ITY

Coun

try

does

not

hav

e ef

fect

ive

coor

dina

tion

for r

isk

com

mun

icat

ion.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y m

inis

tries

, org

aniz

atio

ns a

nd k

ey s

take

hold

ers

invo

lved

in ri

sk c

omm

unic

atio

n an

d co

mm

unity

eng

agem

ent.

Co

nsul

t with

and

con

duct

initi

al m

eetin

g w

ith id

entifi

ed o

rgan

izat

ions

and

min

istri

es to

defi

ne c

oord

inat

ion

mec

hani

sms

and

plat

form

s at

nat

iona

l and

sub

natio

nal l

evel

s.

Esta

blis

h ob

ject

ives

, com

mun

icat

ion

flow

cha

rts, S

OPs

and

way

s of

wor

king

bet

wee

n un

its, a

genc

ies/

orga

niza

tions

, for

risk

co

mm

unic

atio

n an

d co

mm

unity

eng

agem

ent.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

pla

tform

or m

echa

nism

for r

egul

ar in

form

atio

n sh

arin

g w

ith re

leva

nt s

ecto

rs in

clud

ing

min

istr

ies,

par

tner

s an

d ot

her s

take

hold

ers.

Es

tabl

ish

a re

gula

r ris

k co

mm

unic

atio

n co

ordi

natio

n m

echa

nism

bet

wee

n re

leva

nt k

ey s

take

hold

ers

at n

atio

nal a

nd

subn

atio

nal l

evel

s.

Dev

elop

app

ropr

iate

act

ion

plan

s th

at id

entif

y pr

iorit

y in

terv

entio

ns, l

angu

ages

and

com

mun

icat

ion

of p

refe

renc

e to

key

po

pula

tions

at r

isk.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Ex

pand

info

rmat

ion

shar

ing

mec

hani

sm w

ith o

ther

sec

tors

incl

udin

g m

edia

, civ

il soc

iety

and

the

priv

ate

sect

or.

Co

nduc

t reg

ular

risk

com

mun

icat

ion

coor

dina

tion

mee

tings

at n

atio

nal a

nd s

ubna

tiona

l leve

ls. D

ocum

ent a

nd s

hare

out

com

es o

f th

e m

eetin

gs.

Im

plem

ent r

egul

ar ri

sk c

omm

unic

atio

n co

ordi

natio

n am

ong

rele

vant

key

sta

keho

lder

s at

nat

iona

l and

sub

natio

nal le

vels

.

Eval

uate

the

effe

ctiv

enes

s of

the

coor

dina

tion

mec

hani

sm a

mon

g al

l par

tner

s ei

ther

thro

ugh

a re

al e

vent

or s

imul

atio

n ex

erci

se.


117

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

M

aint

ain

a re

gula

r coo

rdin

atio

n m

echa

nism

.

Asse

ss p

erfo

rman

ce o

f the

coo

rdin

atio

n m

echa

nism

regu

larly

thro

ugh

sim

ulat

ion

exer

cise

s or

afte

r-ac

tion

revi

ews

and

shar

e re

sults

with

par

tner

s.

Upd

ate

actio

n pl

ans

with

rele

vant

sta

keho

lder

s w

ith c

lear

ly d

efine

d ro

les

and

prov

isio

n of

reso

urce

s.


118

CAPA

CITY

LEVE

L

Benc

hmar

k 15

.3: E

ffec

tive

com

mun

icat

ion

with

com

mun

ites

Obj

ectiv

e: S

tren

gthe

n co

mm

unic

atio

n en

gage

men

t with

com

mun

ities

01N

O C

APAC

ITY

Coun

try

does

not

hav

e ef

fect

ive

com

mun

icat

ion

with

com

mun

ities

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

a lis

t of k

ey s

take

hold

ers

– c

ivil

soci

ety

grou

ps, k

ey n

ongo

vern

men

tal o

rgan

izat

ions

, key

relig

ious

and

trad

ition

al

lead

ers

– a

t the

nat

iona

l lev

el.

Co

nduc

t a n

eeds

ana

lysi

s fo

r effe

ctiv

ely

enga

ging

with

civ

il so

ciet

y gr

oups

and

key

non

gove

rnm

enta

l org

aniz

atio

ns (i

nclu

ding

fe

mal

e-or

ient

ed o

rgan

izat

ions

), an

d re

ligio

us a

nd tr

aditi

onal

lead

ers

at th

e na

tiona

l lev

el.

Id

entif

y ke

y in

tern

al re

sour

ces

with

in a

ll re

leva

nt m

inis

tries

to h

elp

enga

ge w

ith k

ey s

take

hold

ers

at th

e na

tiona

l lev

el.

D

evel

op a

pla

n to

eng

age

key

stak

ehol

ders

at t

he n

atio

nal l

evel

.

Iden

tify

foca

l poi

nts

for c

omm

unity

eng

agem

ent a

t the

nat

iona

l and

sub

natio

nal l

evel

s.

Dev

elop

and

dis

sem

inat

e tra

inin

g on

com

mun

ity e

ngag

emen

t at t

he n

atio

nal a

nd s

ubna

tiona

l lev

els.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y tr

uste

d co

mm

unity

lead

ers

and

cham

pion

s at

the

subn

atio

nal l

evel

to s

uppo

rt c

omm

unity

eng

agem

ent (

such

as

relig

ious

lead

ers,

trad

ition

al h

eale

rs, c

omm

unity

net

wor

ks).

Id

entif

y fo

cal p

oint

s fro

m th

e m

inis

try

and

part

ners

for c

omm

unity

eng

agem

ent a

t the

sub

natio

nal l

evel

.

Dev

elop

and

dis

sem

inat

e tr

aini

ng o

n co

mm

unity

eng

agem

ent a

t the

sub

natio

nal l

evel

.

Dev

elop

tool

s, p

roce

dure

s an

d m

etho

ds fo

r com

mun

ity e

ngag

emen

t to

obta

in c

omm

unity

feed

back

thro

ugh

surv

eys,

ho

tline

s, c

omm

unity

dia

logu

e or

oth

er m

eans

.

Iden

tify

and

trai

n co

mm

unity

out

reac

h gr

oups

, inc

ludi

ng v

olun

teer

s.


119

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

mec

hani

sms

for s

yste

mat

ical

ly re

ceiv

ing

com

mun

ity fe

edba

ck th

roug

h m

ultip

le c

hann

els

incl

udin

g so

cial

med

ia

and

dire

ct d

ialo

gue.

Co

nduc

t reg

ular

refre

sher

trai

ning

, brie

fing,

sup

ervi

sion

and

eng

agem

ent o

f soc

ial m

obili

zers

and

com

mun

ity e

ngag

ers.

D

evel

op m

echa

nism

s to

sys

tem

atic

ally

inte

grat

e fe

edba

ck o

n co

mm

unity

con

cern

s an

d is

sues

of i

nter

est i

nto

com

mun

ity

enga

gem

ent a

ctiv

ities

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

dedi

cate

d hu

man

and

fina

ncia

l res

ourc

es fo

r com

mun

ity e

ngag

emen

t inc

ludi

ng c

ore

staf

f and

impl

emen

tatio

n bu

dget

at n

atio

nal a

nd s

ubna

tiona

l lev

els.

Re

gula

rly a

sses

s pe

rfor

man

ce o

f com

mun

ity e

ngag

emen

t and

sha

re re

sults

obt

aine

d th

roug

h af

ter-

actio

n re

view

s or

si

mul

atio

n ex

erci

ses.

TOO

LS:

W

HO

gui

danc

e on

Ris

k Co

mm

unic

atio

n

Com

mun

icat

ing

Risk

in P

ublic

Hea

lth E

mer

genc

ies

Ri

sk c

omm

unic

atio

n tr

aini

ng c

ours

es

Risk

com

mun

icat

ion

reso

urce

s –

WH

O w

ebsi

te


120

POIN

TS O

F EN

TRY

16

IMPA

CT:

Tim

ely

dete

ctio

n of

and

effe

ctiv

e re

spon

se to

any

pot

entia

l haz

ards

that

occ

ur a

t or m

ay b

e sp

read

via

poi

nts

of e

ntry

.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Pub

lic h

ealth

em

erge

ncy

cont

inge

ncy

plan

for e

ach

desi

gnat

ed p

oint

s of

ent

ry in

an

all-h

azar

d an

d m

ultis

ecto

ral a

ppro

ach.

(2) E

vide

nce

confi

rms

core

cap

aciti

es p

resc

ribed

in th

e IH

R An

nex

1B a

re e

stab

lishe

d fo

r res

pond

ing

to e

vent

s th

at m

ay c

onst

itute

a p

ublic

hea

lth e

mer

genc

y of

inte

rnat

iona

l con

cern

, and

func

tioni

ng in

an

all-h

azar

d an

d m

ultis

ecto

ral a

ppro

ach.

Stat

es P

artie

s de

sign

ate

and

mai

ntai

n co

re c

apac

ities

at i

nter

natio

nal a

irpor

ts a

nd p

orts

(and

whe

re ju

stifi

ed fo

r pub

lic h

ealth

reas

ons,

a S

tate

Par

ty m

ay

desi

gnat

e gr

ound

cro

ssin

gs) t

hat i

mpl

emen

t pub

lic h

ealth

mea

sure

s re

quire

d to

pre

vent

, det

ect a

nd m

anag

e a

varie

ty o

f pub

lic h

ealth

risk

s in

a m

ultis

ecto

ral

appr

oach

(IH

R An

nex

1b).


121

CAPA

CITY

LEVE

L

Benc

hmar

k 16

.1: R

outin

e ca

paci

ties

at p

oint

s of

ent

ry a

re in

pla

ce

Obj

ectiv

e: E

stab

lishm

ent o

f rou

tine

capa

citie

s at

des

igna

ted

poin

ts o

f ent

ry

01N

O C

APAC

ITY

Coun

try

does

not

hav

e ca

paci

ty fo

r app

ropr

iate

sur

veill

ance

or m

edic

al s

ervi

ces

at d

esig

nate

d po

ints

of e

ntry

.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t cap

acity

ass

essm

ent a

t key

poi

nts

of e

ntry

to in

form

sel

ectio

n fo

r IH

R de

sign

atio

n.

Des

igna

te p

oint

s of

ent

ry a

ccor

ding

to th

e re

quire

men

ts o

f IH

R.

Iden

tify

key

rele

vant

sta

keho

lder

s th

at a

re re

late

d to

est

ablis

h ca

paci

ties

at e

ach

desi

gnat

ed p

oint

of e

ntry

.

Iden

tify

com

pete

nt a

utho

ritie

s at

eac

h de

sign

ated

poi

nt o

f ent

ry.

Co

nduc

t rev

iew

of a

ppro

pria

te m

edic

al s

ervi

ces

incl

udin

g di

agno

stic

faci

litie

s fo

r the

pro

mpt

ass

essm

ent a

nd c

are

of s

ick

trave

llers

as

per A

nnex

1B,

1(a

), an

d id

entif

y ga

ps a

nd c

orre

ctiv

e ac

tions

.

Dev

elop

SO

Ps fo

r med

ical

ser

vice

s (id

entifi

catio

n of

dia

gnos

tic fa

cilit

ies

to c

olla

bora

te w

ith c

are

of s

ick

trave

llers

and

refe

rral

).

Trai

n st

aff o

n m

edic

al s

ervi

ces

SOPs

and

ens

ure

the

prov

isio

n of

ade

quat

e re

sour

ces

incl

udin

g sp

ace,

equ

ipm

ent a

nd

prem

ises

as

per A

nnex

1B,

1(a

), 1(

b).

Es

tabl

ish

capa

citie

s at

des

igna

ted

poin

ts o

f ent

ry o

f app

ropr

iate

med

ical

ser

vice

s as

per

IHR

Anne

x 1B

, 1(a

).

Dev

elop

a s

trate

gy to

est

ablis

h al

l the

rout

ine

capa

citie

s pr

escr

ibed

in th

e IH

R An

nex

1B, 1

.

Dev

elop

a s

trate

gy to

inte

grat

e de

sign

ated

poi

nts

of e

ntry

into

nat

iona

l sur

veilla

nce

syst

ems.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op S

OPs

as

per A

nnex

1B,

1 a

nd tr

ain

staf

f of d

esig

nate

d po

ints

of e

ntry

.

Allo

cate

ade

quat

e re

sour

ces

to d

esig

nate

d po

ints

of e

ntry

to e

stab

lish

rout

ine

capa

citie

s fo

r bio

logi

cal h

azar

ds a

t all

desi

gnat

ed p

oint

s of

ent

ry.

Im

plem

ent t

he s

trat

egy

to h

ave

all t

he ro

utin

e ca

paci

ties

pres

crib

ed in

IHR

Anne

x 1B

, in

plac

e an

d fu

nctio

ning

, for

bio

logi

cal

haza

rds.

Im

plem

ent t

he s

trat

egy

with

ade

quat

e re

sour

ces

to in

tegr

ate

desi

gnat

ed p

oint

s of

ent

ry in

to n

atio

nal s

urve

illan

ce s

yste

ms.


122

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Re

gula

rly tr

ain

staf

f on

guid

elin

es a

nd S

OPs

as

per A

nnex

1B,

1 a

t all

desi

gnat

ed p

oint

s of

ent

ry.

Al

loca

te a

dequ

ate

reso

urce

s to

des

igna

ted

poin

ts o

f ent

ry to

est

ablis

h ro

utin

e ca

paci

ties

for a

ll-ha

zard

pre

vent

ion,

det

ectio

n an

d re

spon

se.

Im

plem

ent t

he s

trat

egy

to h

ave

all r

outin

e ca

paci

ties

pres

crib

ed in

IHR

Anne

x 1B

in p

lace

and

func

tioni

ng, f

or a

ll-ha

zard

s su

ch a

s ac

cess

to a

ppro

pria

te m

edic

al s

ervi

ces

and

tran

spor

tatio

n of

sic

k tr

avel

lers

to a

n ap

prop

riate

med

ical

faci

lity

for

biol

ogic

al, c

hem

ical

and

radi

atio

n su

spec

ted

or c

onfir

med

eve

nts.

In

tegr

ate

desi

gnat

ed p

oint

s of

ent

ry in

to n

atio

nal s

urve

illan

ce s

yste

ms

for a

ll-ha

zard

s w

ith th

e in

volv

emen

t of a

ll re

leva

nt

sect

ors.

D

evel

op a

str

ateg

y fo

r con

tinuo

us im

prov

emen

t and

regu

larly

mon

itor a

nd e

valu

ate

rout

ine

capa

citie

s at

poi

nts

of e

ntry

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Al

loca

te s

usta

inab

le fu

nds

and

mob

ilize

sta

ff fo

r all

key

func

tions

.

Dem

onst

rate

bes

t pra

ctic

es o

f fun

ctio

ning

of a

ll ro

utin

e ca

paci

ties

for a

ll-ha

zard

s an

d di

ssem

inat

e to

key

sta

keho

lder

s.

Doc

umen

t con

tinuo

us im

prov

emen

ts e

ither

thro

ugh

self-

eval

uatio

n or

ext

erna

l eva

luat

ion.


123

CAPA

CITY

LEVE

L

Benc

hmar

k 16

.2: E

ffec

tive

publ

ic h

ealth

resp

onse

at p

oint

s of

ent

ry

Obj

ectiv

e: S

tren

gthe

n ca

paci

ty fo

r eff

ectiv

e pu

blic

hea

lth re

spon

se a

t poi

nts

of e

ntry

01N

O C

APAC

ITY

Publ

ic h

ealth

em

erge

ncy

cont

inge

ncy

plan

for e

ach

desi

gnat

ed p

oint

of e

ntry

for r

espo

ndin

g to

pub

lic h

ealth

em

erge

ncie

s is

no

t in

plac

e.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y ke

y st

akeh

olde

rs fo

r eac

h de

sign

ated

poi

nt o

f ent

ry fo

r all-

haza

rds.

Re

view

the

stat

us o

f the

em

erge

ncy

resp

onse

pla

n at

eac

h de

sign

ated

poi

nt o

f ent

ry.

D

evel

op a

pub

lic h

ealth

em

erge

ncy

cont

inge

ncy

plan

, incl

udin

g SO

Ps a

nd g

uida

nce

in s

ome

of th

e de

sign

ated

poi

nts

of e

ntry

, pr

iorit

ized

by

volu

me

and

frequ

ency

of i

nter

natio

nal t

raffi

c, p

ublic

hea

lth ri

sks

exis

ting

in a

reas

in w

hich

the

inte

rnat

iona

l tra

ffic

orig

inat

es, o

r thr

ough

whi

ch it

pas

ses,

acc

ordi

ng to

Ann

ex 1

B.2.

Tr

ain

staf

f of a

ll de

sign

ated

poi

nts

of e

ntry

on

guid

ance

and

SO

Ps fo

r res

pond

ing

to a

t lea

st e

vent

s du

e to

bio

logi

cal h

azar

ds.

Al

loca

te re

sour

ces

incl

udin

g fu

nds

to a

ll de

sign

ated

poi

nts

of e

ntry

for i

mpl

emen

tatio

n of

the

plan

dur

ing

the

even

ts.

In

tegr

ate

all d

esig

nate

d po

ints

of e

ntry

into

the

natio

nal e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se p

lan

with

the

invo

lvem

ent o

f re

leva

nt s

ecto

rs a

nd s

ervi

ces.

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

pub

lic h

ealth

em

erge

ncy

cont

inge

ncy

plan

for b

iolo

gica

l haz

ards

in a

ll th

e de

sign

ated

poi

nts

of e

ntry

.

Trai

n st

aff o

f all

desi

gnat

ed p

oint

s of

ent

ry o

n gu

idan

ce a

nd S

OPs

for r

espo

ndin

g to

eve

nts

due

to b

iolo

gica

l haz

ards

.

Allo

cate

reso

urce

s in

clud

ing

fund

s to

all

desi

gnat

ed p

oint

s of

ent

ry fo

r im

plem

enta

tion

of th

e pl

an d

urin

g th

e ev

ents

.

Dem

onst

rate

cap

acity

to a

pply

ad

hoc

mea

sure

s re

late

d to

trav

elle

rs a

t poi

nts

of e

ntry

(suc

h as

med

ical

refe

rral

, tra

nspo

rt)

for e

arly

det

ectio

n, a

sses

smen

t and

saf

e tr

ansf

er o

f sic

k tr

avel

lers

to a

ppro

pria

te m

edic

al fa

cilit

ies

at a

ll de

sign

ated

poi

nts

of e

ntry

.

Inte

grat

e al

l des

igna

ted

poin

ts o

f ent

ry in

to th

e na

tiona

l em

erge

ncy

prep

ared

ness

and

resp

onse

pla

n.


124

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

pub

lic h

ealth

em

erge

ncy

cont

inge

ncy

plan

for a

ll-ha

zard

s in

all

the

desi

gnat

ed p

oint

s of

ent

ry.

Tr

ain

staf

f of a

ll de

sign

ated

poi

nts

of e

ntry

on

guid

ance

and

SO

Ps fo

r res

pond

ing

to e

vent

s du

e to

any

type

of h

azar

d,

incl

udin

g ca

re o

f affe

cted

ani

mal

s an

d re

ferr

al m

echa

nism

in c

olla

bora

tion

with

the

anim

al s

ecto

r.

Allo

cate

reso

urce

s in

clud

ing

fund

s to

all

desi

gnat

ed p

oint

s of

ent

ry fo

r im

plem

enta

tion

of th

e pl

an d

urin

g th

e ev

ent,

incl

udin

g ca

re o

f affe

cted

ani

mal

s an

d re

ferr

al m

echa

nism

to v

eter

inar

y se

rvic

es.

D

emon

stra

te c

apac

ity to

app

ly re

com

men

ded

mea

sure

s to

dis

infe

ct, d

e-ra

t, di

sins

ect,

deco

ntam

inat

e or

oth

erw

ise

treat

ba

ggag

e, c

argo

, con

tain

ers,

con

veya

nces

, goo

ds a

nd p

osta

l par

cels

.

Regu

larly

mon

itor o

r eva

luat

e th

e ca

paci

ty fo

r pre

pare

dnes

s an

d re

spon

se m

easu

res

at p

oint

s of

ent

ry e

ither

dur

ing

real

ev

ents

or t

hrou

gh s

imul

atio

n ex

erci

ses

and

upda

te th

e co

ntin

genc

y pl

an a

nd re

spon

se m

echa

nism

.

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t afte

r-ac

tion

revi

ew o

r a s

imul

atio

n ex

erci

se to

test

and

revi

ew re

spon

se c

apac

ities

of a

ll de

sign

ated

poi

nts

of e

ntry

.

Doc

umen

t the

resu

lts o

f the

afte

r-ac

tion

revi

ew/s

imul

atio

n ex

erci

se, a

nd d

emon

stra

te a

ctio

n to

add

ress

reco

mm

enda

tions

fo

r im

prov

emen

t.

Upd

ate

the

mec

hani

sms,

gui

danc

e, S

OPs

and

pla

n, b

ased

on

the

findi

ngs

of th

ese

eval

uatio

ns a

nd te

sts.

Sh

are

best

pra

ctic

es fo

r con

tinuo

us im

prov

emen

t with

all

rele

vant

sta

keho

lder

s.

TOO

LS:

As

sess

men

t too

l for

cor

e ca

paci

ty re

quire

men

ts a

t des

igna

ted

airp

orts

, por

ts a

nd g

roun

d cr

ossi

ngs.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

009.

Th

is d

ocum

ent w

as d

evel

oped

to s

uppo

rt S

tate

s Pa

rtie

s in

ass

essi

ng e

xist

ing

capa

citie

s an

d ca

paci

ty n

eeds

at p

oint

s of

ent

ry w

hen

deci

ding

w

hich

airp

orts

, por

ts a

nd g

roun

d cr

ossi

ngs

to d

esig

nate

und

er A

rtic

le 2

0.1

and

Anne

x 1B

. It i

nclu

des

an E

xcel

spr

eads

heet

file

mod

el fo

r IH

R co

re

capa

citie

s as

sess

men

t at p

orts

, airp

orts

and

gro

und

cros

sing

s.

Coor

dina

ted

publ

ic h

ealth

sur

veill

ance

bet

wee

n po

ints

of e

ntry

and

nat

iona

l hea

lth s

urve

illan

ce s

yste

ms:

adv

isin

g pr

inci

ples

. Ist

edi

tion.

Gen

eva:

W

orld

Hea

lth O

rgan

izat

ion;

201

4. T

his

docu

men

t pro

vide

s st

eps

for i

mpl

emen

ting/

stre

ngth

enin

g co

mm

unic

atio

n m

echa

nism

s an

d de

fines

crit

eria

fo

r dec

idin

g w

hat a

nd h

ow e

vent

s sh

ould

be

repo

rted

bet

wee

n po

ints

of e

ntry

and

the

natio

nal h

ealth

sur

veill

ance

sys

tem

.


125

H

andb

ook

for t

he m

anag

emen

t of p

ublic

hea

lth e

vent

s in

air

tran

spor

t. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

5. T

his

docu

men

t is

com

plem

enta

ry to

oth

er W

HO

pub

licat

ions

add

ress

ing

risk

asse

ssm

ent a

t a n

atio

nal l

evel

, con

tinge

ncy

plan

ning

at p

oint

s of

ent

ry, e

stab

lishm

ent

of c

apac

ities

and

app

licat

ion

of e

mer

genc

y pl

ans

at th

e ai

rpor

t lev

el.

H

andb

ook

for m

anag

emen

t of p

ublic

hea

lth e

vent

s on

boa

rd s

hips

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

016.

Thi

s do

cum

ent a

ims

to p

rovi

de

tech

nica

l adv

ice

to c

ompe

tent

aut

horit

ies

at th

e po

rt le

vel f

or m

anag

emen

t of p

ublic

hea

lth e

vent

s on

boa

rd s

hips

. It c

ompl

emen

ts o

ther

WH

O

publ

icat

ions

add

ress

ing

risk

asse

ssm

ent a

t the

nat

iona

l lev

el, c

ontin

genc

y pl

anni

ng a

t por

ts, a

irpor

ts a

nd g

roun

d cr

ossi

ngs,

and

est

ablis

hmen

t of

capa

citie

s an

d ap

plic

atio

n of

em

erge

ncy

plan

s at

the

port

leve

l.

Han

dboo

k fo

r ins

pect

ion

of s

hips

and

issu

ance

of s

hip

sani

tatio

n ce

rtifi

cate

s. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

1. T

his

hand

book

is

base

d on

the

IHR

(200

5) p

rovi

sion

s re

gard

ing

ship

insp

ectio

ns a

nd is

sue

of S

hip

Sani

tatio

n Ce

rtifi

cate

s. It

pro

vide

s gu

idan

ce fo

r pre

parin

g an

d pe

rfor

min

g in

spec

tion,

com

plet

ing

the

cert

ifica

tes

and

appl

ying

pub

lic h

ealth

mea

sure

s w

ithin

the

fram

ewor

k of

the

IHR

(200

5).

Ve

ctor

sur

veill

ance

and

con

trol a

t por

ts, a

irpor

ts, a

nd g

roun

d cr

ossi

ngs.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

016.

Thi

s ha

ndbo

ok p

rovi

des

tech

nica

l adv

ice

for d

evel

opin

g a

com

preh

ensi

ve p

rogr

amm

e fo

r sys

tem

atic

mon

itorin

g of

dis

ease

vec

tors

and

inte

grat

ed v

ecto

r con

trol a

t poi

nts

of e

ntry

, bas

ed o

n IH

R re

quire

men

ts.

Eb

ola

publ

icat

ions

: Tra

vel a

nd p

oint

s of

ent

ry. [

WH

O w

ebsi

te] T

echn

ical

gui

danc

e se

t on

Ebol

a vi

rus

dise

ase

prep

ared

ness

and

resp

onse

aim

s to

: (i)

pro

vide

ear

ly d

etec

tion

of p

oten

tially

infe

cted

per

sons

; (ii)

ass

ist i

n im

plem

entin

g W

HO

reco

mm

enda

tions

rela

ted

to E

bola

man

agem

ent;

and

(iii)

prev

ent t

he in

tern

atio

nal s

prea

d of

the

dise

ase

whi

le a

llow

ing

auth

oriti

es to

avo

id u

nnec

essa

ry re

stric

tions

and

del

ays

at p

oint

s of

ent

ry.

G

uide

to s

hip

sani

tatio

n: G

loba

l ref

eren

ce o

n he

alth

requ

irem

ents

for s

hip

cons

truc

tion

and

oper

atio

n. T

hird

edi

tion.

Gen

eva:

Wor

ld H

ealth

O

rgan

izat

ion;

201

1. T

he p

rimar

y ai

m o

f the

revi

sed

guid

e to

shi

p sa

nita

tion

is to

pre

sent

the

publ

ic h

ealth

sig

nific

ance

of s

hips

in te

rms

of d

isea

se

and

to h

ighl

ight

the

impo

rtan

ce o

f app

lyin

g ap

prop

riate

con

trol m

easu

res.

G

uide

to h

ygie

ne a

nd s

anita

tion

in a

viat

ion.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

009.

Thi

s do

cum

ent a

ddre

sses

wat

er, a

nd c

lean

ing

and

disi

nfec

tion

of fa

cilit

ies

with

gui

delin

es th

at p

rovi

de p

roce

dure

s an

d qu

ality

spe

cific

atio

ns th

at a

re to

be

achi

eved

.

Gui

de fo

r pub

lic h

ealth

em

erge

ncy

cont

inge

ncy

plan

ning

at d

esig

nate

d po

ints

of e

ntry

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

012.

Thi

s gu

ide

was

de

sign

ed to

ass

ist W

HO

Mem

ber S

tate

s, b

oth

larg

e an

d sm

all,

to b

ridge

the

gap

betw

een

the

lega

l req

uire

men

ts o

f IH

R (2

005)

, and

the

prag

mat

ic

read

ines

s an

d re

spon

se c

apac

ity fo

r pub

lic h

ealth

em

erge

ncie

s at

des

igna

ted

poin

ts o

f ent

ry.


126

CHEM

ICAL

EVE

NTS

17

IMPA

CT:

Tim

ely

dete

ctio

n of

and

effe

ctiv

e re

spon

se to

pot

entia

l che

mic

al ri

sks

and/

or e

vent

s in

col

labo

ratio

n w

ith o

ther

sec

tors

resp

onsi

ble

for c

hem

ical

sa

fety

, indu

strie

s, tr

ansp

orta

tion

and

safe

was

te d

ispo

sal.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: M

echa

nism

s an

d an

ena

blin

g en

viro

nmen

t est

ablis

hed

and

func

tioni

ng fo

r det

ectin

g an

d re

spon

ding

to c

hem

ical

eve

nts

or e

mer

genc

ies.

Stat

es P

artie

s ha

ve in

pla

ce s

urve

illan

ce a

nd re

spon

se c

apac

ity fo

r che

mic

al ri

sks

or e

vent

s. T

his

requ

ires

effe

ctiv

e co

mm

unic

atio

n an

d co

llabo

ratio

n am

ong

the

sect

ors

resp

onsi

ble

for c

hem

ical

saf

ety,

incl

udin

g he

alth

, ind

ustr

y, tr

ansp

orta

tion,

was

te d

ispo

sal,

anim

al h

ealth

and

the

envi

ronm

ent.


127

CAPA

CITY

LEVE

L

Benc

hmar

k 17

.1: M

echa

nism

s ar

e in

pla

ce fo

r sur

veill

ance

, ale

rt a

nd re

spon

se to

che

mic

al e

vent

s or

em

erge

ncie

s O

bjec

tive:

Est

ablis

h po

licie

s, le

gisl

atio

n, p

lans

and

cap

aciti

es fo

r sur

veill

ance

, ale

rt a

nd re

spon

se to

che

mic

al e

vent

s or

em

erge

ncie

s

01N

O C

APAC

ITY

No

mec

hani

sm to

det

ect a

nd re

spon

d to

che

mic

al e

vent

s, p

oiso

ning

s or

em

erge

ncie

s.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

As

sess

exi

stin

g po

licie

s, le

gisl

atio

n an

d pl

ans

for c

hem

ical

eve

nt s

urve

illanc

e, a

lert

and

resp

onse

.

Dev

elop

a s

trate

gy to

fill

gaps

.

Iden

tify

key

stak

ehol

ders

in a

ll se

ctor

s an

d es

tabl

ish

foca

l poi

nts

for c

oord

inat

ion

and

colla

bora

tion

for c

hem

ical

eve

nt

surv

eilla

nce,

ale

rt an

d re

spon

se.

Id

entif

y an

d de

scrib

e pr

iorit

y ch

emic

al e

vent

s49 to

info

rm p

lann

ing,

a p

roce

ss w

hich

can

incl

ude

cond

uctin

g an

inve

ntor

y of

po

tent

ially

haz

ardo

us c

hem

ical

site

s an

d m

anuf

actu

ring

faci

litie

s an

d a

revi

ew o

f pas

t che

mic

al e

vent

s.

Asse

ss c

apac

ities

for c

hem

ical

eve

nt s

urve

illanc

e, a

lert

and

resp

onse

at a

ll le

vels

(nat

iona

l, sub

natio

nal).

Dev

elop

a s

trate

gy a

nd a

ctio

n pl

an to

incr

ease

cap

aciti

es.

D

evel

op g

uide

lines

and

SO

Ps fo

r sur

veilla

nce,

ale

rt an

d re

spon

se to

che

mic

al e

vent

s an

d em

erge

ncie

s in

clud

ing

for

labo

rato

ries,

and

dev

elop

trai

ning

pac

kage

s on

thes

e gu

idel

ines

and

SO

Ps.

D

evel

op c

apac

ities

for d

iagn

osis

and

trea

tmen

t of c

hem

ical

poi

soni

ngs

and

esta

blis

h a

pois

on in

form

atio

n se

rvic

e th

at

oper

ates

at l

east

dur

ing

offic

e ho

urs.

As

sess

exi

stin

g la

bora

tory

cap

aciti

es fo

r the

ana

lysi

s of

hum

an a

nd e

nviro

nmen

tal s

ampl

es to

info

rm th

e as

sess

men

t and

m

anag

emen

t inv

estig

atio

n of

che

mic

al e

vent

s an

d po

ison

ings

.

49 T

his

proc

ess

can

incl

ude

carr

ying

out

an

inve

ntor

y of

haz

ardo

us c

hem

ical

site

s an

d a

revi

ew o

f pas

t che

mic

al e

vent

s.


128

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

evel

op a

ll th

e ne

cess

ary

polic

ies

and

legi

slat

ion

for c

hem

ical

eve

nt s

urve

illan

ce, a

lert

and

resp

onse

.

Dev

elop

eve

nt re

spon

se p

lans

at a

ll le

vels

(nat

iona

l, su

bnat

iona

l, lo

cal)

with

the

invo

lvem

ent o

f rel

evan

t sta

keho

lder

s an

d en

sure

the

follo

win

g:

Map

and

revi

ew a

ll ha

zard

ous

site

s an

d fa

cilit

ies

;

Defi

ne ro

les

and

resp

onsi

bilit

ies

of re

leva

nt a

genc

ies

for r

espo

nse

durin

g ev

ents

;

Prep

are

prot

ocol

s fo

r the

inve

stig

atio

n an

d ve

rifica

tion

of c

hem

ical

eve

nts

and

pois

onin

g, in

clud

ing

thro

ugh

labo

rato

ry

test

ing

;

Asse

ss tr

aini

ng n

eeds

and

dev

elop

a tr

aini

ng p

lan

;

Cond

uct t

rain

ing

of p

erso

nnel

at r

elev

ant a

genc

ies

and

faci

litie

s ;

Im

plem

ent S

OPs

for c

oord

inat

ion

and

colla

bora

tion

durin

g ch

emic

al e

vent

s.

Esta

blis

h a

surv

eilla

nce

syst

em b

ased

on

the

abov

e st

rate

gy a

nd g

uide

lines

for s

urve

illan

ce a

nd a

lert

.

Prov

ide

adeq

uate

reso

urce

s to

the

natio

nal p

oiso

n in

form

atio

n se

rvic

e50 to

ope

rate

on

a 24

/7 b

asis

, and

inte

grat

e th

e po

ison

s in

form

atio

n se

rvic

e in

to th

e pu

blic

hea

lth s

urve

illan

ce s

yste

m.

Pu

t in

plac

e ag

reem

ents

with

des

igna

ted

qual

ity a

ssur

ed la

bora

torie

s (n

atio

nal o

r lab

orat

orie

s in

oth

er c

ount

ries)

for t

imel

y an

alys

is o

f bio

logi

cal a

nd e

nviro

nmen

tal s

ampl

es w

ith s

uspe

cted

che

mic

al e

xpos

ure.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Es

tabl

ish

links

with

key

inte

rnat

iona

l che

mic

al/t

oxic

olog

y ne

twor

ks51

for s

uppo

rt in

the

man

agem

ent o

f che

mic

al e

vent

s an

d po

ison

ings

.

Ensu

re a

ll re

leva

nt p

erso

nnel

rece

ive

regu

lar t

rain

ing

on s

urve

illan

ce, a

lert

and

resp

onse

to c

hem

ical

eve

nts

and

pois

onin

gs.

Sh

are

on a

rout

ine

basi

s, in

form

atio

n on

che

mic

al e

vent

s, c

hem

ical

eve

nt ri

sk a

sses

smen

ts a

nd re

spon

se a

ctio

n w

ith

rele

vant

age

ncie

s.

Mon

itor o

n a

rout

ine

basi

s, th

e tim

elin

ess

of th

e in

form

atio

n sh

arin

g m

echa

nism

abo

ut e

vent

s an

d po

tent

ial r

isk.

50 T

he p

oiso

ns c

entre

sho

uld

be s

uffic

ient

ly s

taffe

d an

d re

sour

ced

to p

rovi

de a

robu

st a

nd re

liabl

e 24

/7 s

ervi

ce. T

he p

oiso

ns c

entre

sho

uld

be w

ell u

sed

by th

e po

pula

tion

it se

rves

(che

ck

num

ber o

f cal

ls p

er d

ay).

Refe

r to

Gui

delin

es fo

r poi

sons

con

trol.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 1

997.

51

Exa

mpl

es in

clud

e th

e W

HO

glo

bal a

nd re

gion

al to

xico

logy

net

wor

ks a

nd o

ther

regi

onal

net

wor

ks, s

uch

as in

the

Euro

pean

Uni

on, p

rofe

ssio

nal t

oxic

olog

y as

soci

atio

ns.


129

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t afte

r-ac

tion

revi

ews

follo

win

g de

tect

ion

and

resp

onse

to c

hem

ical

eve

nts,

or i

n th

e ab

senc

e of

real

eve

nts,

con

duct

ex

erci

ses.

D

ocum

ent a

nd u

se th

e fin

ding

s to

ass

ess,

revi

ew a

nd s

treng

then

sur

veill

ance

, ale

rt a

nd re

spon

se in

clud

ing

coor

dina

tion

and

com

mun

icat

ion.

Al

loca

te a

dequ

ate

reso

urce

s in

clud

ing

fund

s to

poi

son

cent

re(s

).

Dev

elop

a m

echa

nism

to in

tegr

ate

the

syst

ems

of p

ublic

hea

lth s

urve

illan

ce a

nd e

nviro

nmen

tal m

onito

ring

that

cap

ture

s an

d as

sess

es c

hem

ical

exp

osur

es fr

om d

iffer

ent s

ourc

es.

Su

stai

n a

mec

hani

sm to

ens

ure

resp

onse

cap

acity

52 a

t nat

iona

l, su

bnat

iona

l and

loca

l lev

els.

52 T

his

incl

udes

set

ting

min

imum

requ

irem

ents

for:

loca

l em

erge

ncy

plan

ning

and

resp

onse

act

iviti

es (i

.e. a

rran

gem

ents

for s

calin

g up

cap

abili

ties

of lo

cal e

mer

genc

y re

spon

se, n

atio

nal

supp

ort m

echa

nism

s, a

nd in

fras

truc

ture

and

ale

rtin

g m

echa

nism

s); i

nspe

ctio

n of

haz

ardo

us s

ites

and

asse

ssm

ent o

f em

erge

ncy

plan

s; a

nd o

pera

tors

to c

ompl

y an

d lia

ison

with

loca

l go

vern

men

ts (s

ee a

lso:

WH

O m

anua

l: Th

e pu

blic

hea

lth m

anag

emen

t of c

hem

ical

inci

dent

s. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

9 (a

cces

sed

30 J

anua

ry 2

019)

).

TOO

LS:

Th

e pu

blic

hea

lth m

anag

emen

t of c

hem

ical

inci

dent

s. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

9

Chem

ical

rele

ases

cau

sed

by n

atur

al h

azar

d ev

ents

and

dis

aste

rs: i

nfor

mat

ion

for p

ublic

hea

lth a

utho

ritie

s. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

20

18 a

cces

sed

8 O

ctob

er 2

018)

.

Gui

delin

es fo

r poi

sons

con

trol.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 1

997.


130

RADI

ATIO

N E

MER

GEN

CIES

18

IMPA

CT:

Tim

ely

dete

ctio

n an

d ef

fect

ive

resp

onse

to p

oten

tial r

adio

logi

cal e

mer

genc

ies

and

nucl

ear i

ncid

ents

with

cro

ss-s

ecto

ral c

oord

inat

ion.

MO

NIT

ORI

NG

AN

D E

VALU

ATI

ON

: (1

) Mec

hani

sms

esta

blis

hed

and

func

tioni

ng fo

r det

ectin

g an

d re

spon

ding

to ra

diol

ogic

al e

mer

genc

ies.

Stat

es P

artie

s sh

ould

hav

e su

rvei

llanc

e an

d re

spon

se c

apac

ity fo

r rad

iolo

gica

l em

erge

ncie

s an

d nu

clea

r inc

iden

ts. T

his

requ

ires

effe

ctiv

e co

ordi

natio

n am

ong

all s

ecto

rs in

volv

ed in

radi

atio

n em

erge

ncy

prep

ared

ness

and

resp

onse

.


131

CAPA

CITY

LEVE

L

Benc

hmar

k 18

.1: M

echa

nism

is in

pla

ce fo

r det

ectin

g an

d re

spon

ding

to ra

diol

ogic

al a

nd n

ucle

ar e

mer

genc

ies

emer

genc

ies

Obj

ectiv

e: E

stab

lish

a m

echa

nism

to d

etec

t and

resp

ond

to ra

diol

ogic

al a

nd n

ucle

ar e

mer

genc

ies

01N

O C

APAC

ITY

No

mec

hani

sm (s

uch

as p

olic

ies,

pla

ns a

nd c

oord

inat

ion

proc

ess)

is in

pla

ce fo

r the

det

ectio

n, a

sses

smen

t and

resp

onse

to

radi

atio

n em

erge

ncie

s.

02 LIM

ITED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y ke

y st

akeh

olde

rs a

nd d

esig

nate

foca

l poi

nts

resp

onsi

ble

for r

adia

tion-

rela

ted

haza

rds

and

emer

genc

ies,

esp

ecia

lly

from

radi

atio

n au

thor

ities

and

pub

lic h

ealth

uni

ts.

D

evel

op S

OPs

or p

roto

cols

for c

oord

inat

ion

and

com

mun

icat

ion

with

nat

iona

l aut

horit

ies,

cle

arly

indi

catin

g ro

les

and

resp

onsi

bilit

ies,

incl

udin

g fo

r the

hea

lth m

inis

try a

nd IH

R fo

cal p

oint

s.

Conv

ene

a m

eetin

g w

ith k

ey s

take

hold

ers

to re

view

, ass

ess,

map

and

dev

elop

pol

icie

s, s

trate

gies

and

pla

ns fo

r det

ectio

n,

asse

ssm

ent a

nd re

spon

se to

radi

atio

n em

erge

ncie

s.

Dis

sem

inat

e th

ese

polic

ies,

pla

ns a

nd le

gisl

atio

n fo

r rad

iolo

gica

l eve

nt s

urve

illanc

e, a

lert

and

resp

onse

to re

leva

nt

stak

ehol

ders

.

Cond

uct a

risk

ass

essm

ent f

or ra

diat

ion

haza

rds.

D

evel

op a

radi

atio

n m

onito

ring

mec

hani

sm w

ith re

quire

d SO

Ps a

nd g

uide

lines

, and

est

ablis

h a

mec

hani

sm to

sha

re

info

rmat

ion

amon

g th

e re

leva

nt s

take

hold

ers.

Tr

ain

rele

vant

sta

ff on

thes

e SO

Ps, g

uide

lines

and

info

rmat

ion

shar

ing.

Pr

ocur

e lo

gist

ics

for r

obus

t rad

iatio

n m

onito

ring

syst

ems.

D

esig

nate

or s

ecur

e ac

cess

to la

bora

tory

cap

acity

to m

onito

r, id

entif

y an

d as

sess

exp

osur

e.


132

03DE

VELO

PED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Id

entif

y ke

y te

chni

cal e

xper

ts fr

om re

leva

nt s

ecto

rs to

dev

elop

tech

nica

l gui

delin

es o

r SO

Ps fo

r the

man

agem

ent o

f rad

iatio

n em

erge

ncie

s (in

clud

ing

risk

asse

ssm

ent,

repo

rtin

g, e

vent

con

firm

atio

n, n

otifi

catio

n an

d in

vest

igat

ion)

.

Dev

elop

trai

ning

pac

kage

(s) o

n th

ese

guid

elin

es/S

OPs

for t

he m

anag

emen

t of r

adia

tion

emer

genc

ies

and

trai

n re

leva

nt s

taff

at le

ast a

t the

nat

iona

l lev

el.

D

evel

op p

olic

ies,

pro

toco

ls a

nd s

trat

egie

s fo

r nat

iona

l and

inte

rnat

iona

l tra

nspo

rt o

f rad

ioac

tive

mat

eria

ls, s

ampl

es a

nd

was

te m

anag

emen

t, an

d en

sure

logi

stic

requ

irem

ents

for t

rans

port

atio

n.

Proc

ure

or e

nsur

e ac

cess

to s

tock

pile

to s

uppo

rt ra

diat

ion

emer

genc

y pr

epar

edne

ss a

nd re

spon

se, a

nd d

evel

op a

di

strib

utio

n pl

an fo

r the

eve

nt o

f an

emer

genc

y.

Dev

elop

gui

delin

es fo

r man

agem

ent o

f rad

iolo

gica

l was

te in

clud

ing

that

from

the

hosp

itals

and

med

ical

ser

vice

s.

Esta

blis

h a

was

te m

anag

emen

t site

with

the

requ

ired

capa

city

for m

onito

ring

it.

Dev

elop

cas

e m

anag

emen

t gui

delin

es to

man

age

case

s of

radi

atio

n em

erge

ncie

s (e

ither

as

a st

and-

alon

e gu

idel

ine

or a

s pa

rt o

f the

cas

e m

anag

emen

t gui

delin

es fo

r all

haza

rds

(refe

r to

Benc

hmar

k 14

.3)).

Id

entif

y he

alth

faci

litie

s th

at c

an m

anag

e pa

tient

s in

the

even

t of a

radi

atio

n em

erge

ncy.

Tr

ain

rele

vant

hea

lthca

re w

orke

rs o

n th

ese

prot

ocol

s an

d gu

idel

ines

.

Dev

elop

a m

echa

nism

for s

yste

mat

ic in

form

atio

n ex

chan

ge b

etw

een

com

pete

nt ra

diol

ogic

al a

utho

ritie

s an

d hu

man

hea

lth

surv

eilla

nce

units

abo

ut ra

diol

ogic

al e

vent

s an

d po

tent

ial r

isks

.

04DE

MON

STRA

TED

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

Co

nduc

t afte

r-ac

tion

revi

ews

or s

imul

atio

n ex

erci

ses

in th

e ab

senc

e of

real

eve

nts

to:

ev

alua

te/t

est t

he g

uide

lines

/SO

Ps (c

ondu

ct jo

intly

with

the

com

pete

nt ra

diat

ion

auth

oriti

es a

nd th

e pu

blic

hea

lth u

nit);

te

st c

oord

inat

ion

and

com

mun

icat

ion

mec

hani

sms

betw

een

rele

vant

nat

iona

l com

pete

nt a

utho

rity

for n

ucle

ar

regu

lato

ry c

ontro

l/saf

ety

and

rele

vant

sec

tors

;

test

cas

e m

anag

emen

t cap

acity

; and

up

date

gui

delin

es/S

OPs

and

coo

rdin

atio

n an

d co

mm

unic

atio

n m

echa

nism

s ba

sed

on th

e fin

ding

s.

Resp

ond

to a

ny ra

diol

ogic

al th

reat

s w

ith jo

int r

isk

asse

ssm

ent,

inve

stig

atio

n an

d im

plem

enta

tion

of th

e re

spon

se p

lan.

En

sure

that

if S

OPs

cal

l for

pre

posi

tioni

ng o

f log

istic

s to

add

ress

a ra

diat

ion

emer

genc

y, di

strib

ute

thes

e lo

gist

ics

in a

ll de

sign

ated

pla

ces

at a

ll tim

es.

Sh

are

info

rmat

ion

with

rele

vant

sta

keho

lder

s re

gula

rly o

n th

e ris

k an

d th

reat

s th

at a

re p

oten

tial f

or e

mer

genc

ies.


133

05SU

STAI

NAB

LE

CAPA

CITY

ACTI

ON

S TO

ACH

IEVE

TH

IS L

EVEL

:

D

ocum

ent a

nd d

isse

min

ate

best

pra

ctic

es o

f tes

t res

ults

and

revi

ews.

Co

nduc

t reg

ular

trai

ning

of s

taff

of h

ealth

faci

litie

s to

man

age

patie

nts

in th

e ev

ent o

f a ra

diat

ion

emer

genc

y.

Dev

elop

and

con

duct

em

erge

ncy

resp

onse

dril

ls a

nd o

ther

exe

rcis

es o

n ra

diat

ion

emer

genc

y an

d up

date

the

resp

onse

pla

n,

mec

hani

sms

and

guid

elin

es a

ccor

ding

ly.

Su

stai

n a

mec

hani

sm to

ens

ure

resp

onse

cap

acity

at n

atio

nal,

subn

atio

nal a

nd lo

cal l

evel

s.

TOO

LS:

H

ealth

Em

erge

ncy

and

Dis

aste

r Ris

k M

anag

emen

t - R

adia

tion

Emer

genc

ies

D

evel

opm

ent o

f WH

O G

uide

lines

on

Publ

ic H

ealth

Res

pons

e to

Rad

iolo

gica

l and

Nuc

lear

Em

erge

ncie

s (2

012-

2016

)

Med

ical

Rad

iatio

n ex

posu

re

Radi

atio

n Em

erge

ncie

s -

WH

O W

ebpa

ge

Inci

dent

and

Em

erge

ncy

Cent

er –

Inte

rnat

iona

l Ato

mic

Ene

rgy

Agen

cy

Reso

urce

s fro

m In

tern

atio

nal A

tom

ic E

nerg

y Ag

ency


134

ANNEX 1: GLOSSARY

Biosafety. Laboratory biosafety describes the containment principles, technologies and practices that are implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release.

Biosecurity. Laboratory biosecurity describes the protection, control and accountability for valuable biological materials within laboratories as well as information related to these materials and dual-use research, to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release.

Case. A person who has the particular disease, health disorder or condition that meets the case definitions for surveillance and outbreak investigation purposes. The definition of a case for surveillance and outbreak investigation purpose is not necessarily the same as the ordinary clinical definition (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Case definition. A set of diagnostic criteria that must be fulfilled for an individual to be regarded as a case of a particular disease for surveillance and outbreak investigation purposes. Case definitions can be based on clinical criteria, laboratory criteria or a combination of the two with the elements of time, place and person. (In the IHR, case definitions are published on the WHO website53 for the four diseases for which all cases must be notified by States Parties to WHO, regardless of circumstances, under the IHR as provided in Annex 2.)

Chemical event. A manifestation of a disease or an occurrence, which creates a potential for a disease as a result of exposure to or contamination by a chemical agent.

Cluster. An aggregation of relatively uncommon events or diseases in space and/or time in amounts that are believed or perceived to be greater than that expected by chance (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Communicable disease (infectious disease). An illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal or reservoir to a susceptible host, either directly or indirectly through an intermediate plant or animal host, vector or the inanimate environment (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Competent authority. An authority responsible for the implementation and application of health measures under the IHR.

Note: These terms and definitions have been provided for use within the context of this tool and may differ from those used in other documents. The purpose is to clarify key terms that are NAPHS relevant.

53 http://www.who.int/ihr/survellance_response/case_definitions/en/


135

Contamination. The presence of an infectious or toxic agent or matter on the body surface of a human or animal, in or on a product prepared for consumption or on other inanimate objects, including conveyances that may constitute a public health risk.

Dangerous pathogens and toxins. These are biological agents and toxins that have the potential to pose a severe threat to both human and animal health. While some select agents are normally found in the environment and don’t cause human disease, many of them – if manipulated or released in large quantities – can cause serious health threats. The informal Australia Group provides a List of human and animal pathogens and toxins for export control (http://www.australiagroup.net/en/human_animal_pathogens.html, accessed 28 August 2016).

Designated laboratories. These are laboratories designated to perform specific laboratory services by national, WHO or other authorities because of their proven capacities and capabilities, such as for AMR testing.

Designated points of entry. These refer to a port, airport and potentially a ground crossing that is designated by a State Party to strengthen, develop and maintain the capacities as per main IHR articles 19, 20 and 21, and as described in Annex 1 of the IHR:

the capacities at all times concerning access to medical services for prompt assessment and care of ill travellers, a safe environment for travellers (e.g. water, food, waste), personnel for inspection and vector control functions; and

the capacities to respond specifically to events that may constitute a public health emergency of international concern.

Disease. An illness or medical condition, irrespective of origin or source, that presents or could present significant harm to humans.

Early warning system. A specific procedure in disease surveillance to detect any abnormal occurrence, or departure from the usual or normally observed frequency of phenomena (such as one case of Ebola fever), as early as possible. An early warning system is only useful if it is linked to mechanisms for early response (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Epidemic. The occurrence in a community or region of cases of an illness, specific health-related behaviours, or other health-related events clearly in excess of normal expectancy. The community or region and the period in which the cases occur are specified precisely. The number of cases indicating the presence of an epidemic varies according to the agent, size and type of population exposed, previous experience or lack of exposure to the disease, and time and place of occurrence (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Event. A manifestation of disease or an occurrence that creates a potential for disease.

Event-based surveillance. The organized and rapid capture of information about events that are a potential risk to public health. This information can be rumours and other ad hoc reports transmitted through formal channels (i.e. established routine reporting systems) and informal channels (i.e. the media, health workers and reports from nongovernmental organizations), including events related to the occurrence of disease in humans and events related to potential human exposure.


136

Feedback. The regular process of sending analyses and reports about surveillance data back through all levels of the surveillance system so that all participants can be informed of trends and performance.

Field Epidemiology Training Program

FETP Basic Level Training is for local health staff and consists of limited classroom hours interspersed throughout as a three-to-five month on-the-job field assignment to build capacity in conducting timely outbreak detection, public health response and public health surveillance.

FETP Intermediate Level Training is for district/region/state-level epidemiologists, and consists of limited classroom hours interspersed throughout as a six-to-nine month on-the-job mentored field assignment to build capacity in conducting outbreak investigations, planned epidemiologic studies, and public health surveillance analyses and evaluations.

FETP Advanced Level Training is for advanced epidemiologists and consists of limited classroom hours interspersed throughout the 24 months of mentored field assignments to build capacity in outbreak investigations, planned epidemiologic studies, public health surveillance analyses and evaluations, scientific communication, and evidence-based decision making for development of effective public health programming with a national focus. Animal health professionals can be engaged in these FETP trainings.

Functional exercise. A fully simulated interactive exercise that tests the capability of an organization to respond to a simulated event. The exercise tests multiple functions of the organization’s operational plan. It is a coordinated response to a situation in a time pressured realistic situation as described in WHO Simulation Exercise Manual 5. A functional exercise focuses on the coordination, integration and interaction of an organization’s policies, procedures, roles and responsibilities before, during or after the simulated event (WHO Simulation Exercise Manual. HO-WHE-CPI-2017.10 (http://apps.who.int/iris/bitstream/10665/254741/1/WHO-WHE-CPI-2017.10-eng.pdf?ua=1, accessed 13 August 2017).

Ground crossing. A point of land entry into a State Party, including those utilized by road vehicles and trains.

Hazard. The inherent capability of an agent or situation to have an adverse effect; a factor or exposure that may adversely affect health (similar concept to risk factor).

Health care worker. Any employee in a health care facility who has close contact with patients, patient-care areas or patient-care items; also referred to as “health care personnel”.

Health event. Any event relating to the health of an individual, such as the occurrence of a case of a specific disease or syndrome, the administration of a vaccine or an admission to hospital.

Health measure. A procedure applied to prevent the spread of disease or contamination; it does not include law enforcement or security measures.

Incidence. The number of instances of illness commencing, or of persons falling ill, during a given period in a specified population (Prevalence and incidence. WHO Bulletin 1966;35:783-784).

Indicator-based surveillance. The routine reporting of cases of disease, including from notifiable diseases surveillance, sentinel surveillance, laboratory based surveillance. This routine reporting is commonly health care facility based with reporting done on a weekly or monthly basis.

Infection. The entry and development or multiplication of an infectious agent in the body of humans and animals that may constitute a public health risk.


137

Infectious disease. see Communicable disease.

International Health Regulations (2005) (IHR or the Regulations). This is a legally-binding instrument of international law which has its origin in the International Sanitary Conventions of 1851, concluded in response to increasing concern about the links between international trade and spread of diseases (cross-border health risks).

Legislation. The range of legal, administrative or other governmental instruments that may be available for States Parties to implement the IHR. This includes legally binding instruments, such as state constitutions, laws, acts, decrees, orders, regulations and ordinances; legally non-binding instruments, such as guidelines, standards, operating rules, administrative procedures or rules; and other types of instruments, such as protocols, resolutions and inter-sectoral or inter-ministerial agreements. This encompasses legislation in all sectors, such as health, agriculture, transportation, environment, ports and airports, and at all applicable governmental levels (national, intermediate, local and other).

Logistics. Pharmaceuticals, medical and surgical supplies, medical devices and equipment, and other products needed to support healthcare providers.

Multisectoral. A holistic approach involving the efforts of multiple organizations, institutes and agencies. It encourages interdisciplinary participation, collaboration and coordination of people of concern and resources from these key organizations for promoting health security, to achieve a specific goal.

National legislation. see Legislation.

National IHR Focal Point. The national centre designated by each State Party, which shall be accessible at all times for communications with WHO IHR contact points under the IHR.

Notifiable disease. A disease that, by statutory/legal requirements, must be reported to a public health or other competent authority in the pertinent jurisdiction when the diagnosis is made (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Notification. The processes by which cases or outbreaks are brought to the knowledge of the health authorities. In the context of the IHR, notification is the official communication of a disease/health event to the WHO by the health administration of the Member State affected by the disease/health event.

One Health. Defined by WHO as an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes (http://www.who.int/features/qa/one-health/en/, accessed 28 November 2017)

In the context of the WHO IHR monitoring and evaluation framework, taking a One Health approach means including, from all relevant sectors, national information, expertise, perspectives and experience necessary to conduct assessments, evaluations and reporting for the implementation of the IHR.

Other governmental instruments. Agreements, protocols and resolutions of any government authority or body.

Outbreak. An epidemic limited to localized increase in the incidence of a disease, such as in a village, town or closed institution (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Point of entry. A passage for international entry or exit of travellers, baggage, cargo, containers, conveyances,


138

goods and postal parcels, and the agencies and areas providing services to them upon entry or exit.

Port. A seaport or a port on an inland body of water where ships on an international voyage arrive or depart.

Public health emergency of international concern (PHEIC). An extraordinary event (as provided in the IHR) that: (i) constitutes a public health risk to other states through the international spread of disease; and (ii) potentially requires a coordinated international response.

Public health risk. The likelihood of an event that may adversely affect the health of human populations, with an emphasis on whether it may spread internationally or present a serious and direct danger.

Rapid response team. A group of trained individuals that is ready to respond quickly to an event. The composition and terms of reference are determined by the concerned country.

Readiness. It is the ability to quickly and appropriately respond when required to any emergencies.

Regulations or administrative requirements. All regulations, procedures, rules and standards.

Relevant sectors. Private and public sectors: such as all levels of the health care system (national, subnational and community/primary public health); NGOs; ministries of agriculture (zoonosis, veterinary laboratory), transport (transport policy, civil aviation, ports and maritime transport), trade and/or industry (food safety and quality control), foreign trade (consumer protection, control of compulsory standard enforcement), communication, defence, treasury or finance (customs), environment, interior, health, tourism; the home office; media; and regulatory bodies.

Risk communication. For public health emergencies includes the range of communication capacities required through the preparedness, response and recovery phases of a serious public health event to encourage informed decision making, positive behaviour change and the maintenance of trust.

Surveillance. The systematic ongoing collection, collation and analysis of data for public health purposes and the timely dissemination of public health information for assessment and public health response, as necessary.

Syndrome. A symptom complex in which the symptoms and/or signs coexist more frequently than would be expected by chance independently (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).

Table top exercise. A facilitated discussion of an emergency situation, generally in an informal, low-stress environment. It is designed to elicit constructive discussion between participants; to identify and resolve problems; and to refine existing operational plans. This is the only type of simulation exercise that does not require an existing response plan in place. (WHO Simulation Exercise Manual. HO-WHE-CPI-2017.10 (http://apps.who.int/iris/bitstream/10665/254741/1/WHO-WHE-CPI-2017.10-eng.pdf?ua=1, accessed 30 November 2017).

Trained staff. Individuals that have educational credentials and/or received specific instruction that is applicable to a task or situation.

Vector. An insect or other animal that normally transports an infectious agent that constitutes a public health risk.

Verification. The provision of information by a State Party to WHO confirming the status of an event within the territory or territories of that State Party.


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WHO IHR contact point. The unit within WHO that is accessible at all times for communications with the National IHR Focal Point.

Zoonotic diseases (or zoonoses). Any infection or infectious disease that is naturally transmissible from vertebrate animals to humans (http://www.who.int/topics/zoonoses/en, accessed 28 November 2017).

Zoonotic event. A manifestation of a disease in animals that creates a potential for a disease in humans as a result of human exposure to the animal source.


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