WHO HEALTH ACTION IN CRISESWHO HEALTH ACTION IN CRISESINDUCTION BRIEFING INDUCTION BRIEFING GENEVA APRIL, 26 TO 30 2004GENEVA APRIL, 26 TO 30 2004

THREE YEAR PROGRAMMETHREE YEAR PROGRAMMEGENERAL PRESENTATIONGENERAL PRESENTATIONByBy

EmilienneEmilienne AnikpoAnikpo N'TameN'TameHAC HAC –– WHO WHO -- GENEVAGENEVA

OUTLINEOUTLINE

1. INTRODUCTION1. INTRODUCTION2. THE ROLE OF WHO IN CRISES AND 2. THE ROLE OF WHO IN CRISES AND EMERGENCIESEMERGENCIES3. WHO STRENGHS AND WEAKNESES3. WHO STRENGHS AND WEAKNESES4. DEVELOPING A PROGRAMME TO ENHANCE 4. DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCEWHO PERFORMANCE5. OBJECTIVE OF THE TYP5. OBJECTIVE OF THE TYP6. PRIORITY PROGRAMME OUTCOMES6. PRIORITY PROGRAMME OUTCOMES7. BUDGET7. BUDGET8. PROGRAMME INPLEMENTATION FRAMEWORK8. PROGRAMME INPLEMENTATION FRAMEWORK9. CONCLUSION9. CONCLUSION

THE ROLE OF WHO IN THE ROLE OF WHO IN CRISES AND EMERGENCIESCRISES AND EMERGENCIES11

WHO action in emergencies and WHO action in emergencies and crisis situations aims at reducing the crisis situations aims at reducing the avoidable death, illness and avoidable death, illness and disabilities that result from all types disabilities that result from all types of crisesof crises

THE ROLE OF WHO IN THE ROLE OF WHO IN CRISES AND EMERGENCIESCRISES AND EMERGENCIES22

Identifying and ensuring that health Identifying and ensuring that health and nutrition related issues are and nutrition related issues are properly addressedproperly addressedStrengthening health and nutrition Strengthening health and nutrition surveillance systemsurveillance systemEnsuring control CD and VPDEnsuring control CD and VPDEnsuring that risks related to the Ensuring that risks related to the environment are recognised and environment are recognised and properly managedproperly managedEnsuring good quality and access to Ensuring good quality and access to basic preventive and curative carebasic preventive and curative care

Ensuring that Humanitarian Health Ensuring that Humanitarian Health assistance is in line with international assistance is in line with international standards, local priorities and does standards, local priorities and does not compromise future health not compromise future health developmentdevelopmentAdvocating and negotiating for Advocating and negotiating for secure access, neutrality and secure access, neutrality and protection of health workers and protection of health workers and services services Ensuring that lessons learnt in a Ensuring that lessons learnt in a crisis are used to improve health crisis are used to improve health sector preparedness for future crises sector preparedness for future crises and disaster reductionand disaster reductionDefining an integrated health policy Defining an integrated health policy for preparedness, response, recovery for preparedness, response, recovery and mitigationand mitigation

WHO STRENGTHS AND WHO STRENGTHS AND CAPACITYCAPACITY

Resolutions 46.6 and 48.2 of the WHA define the scope of the Resolutions 46.6 and 48.2 of the WHA define the scope of the Organisation work in terms of humanitarian action, emergency Organisation work in terms of humanitarian action, emergency preparedness, national capacity building and advocacy for preparedness, national capacity building and advocacy for humanitarian principles;humanitarian principles;Technical and institutional knowledge accumulated and assessed Technical and institutional knowledge accumulated and assessed over timeover timeKnowKnow--how, analytic support, technical advice and how, analytic support, technical advice and sectoralsectoralcoordination help local, national and international health coordination help local, national and international health stakeholders respond best and together to health challenges in stakeholders respond best and together to health challenges in crisescrisesRDG for HAC tasked to ensure direction & leadership and involve RDG for HAC tasked to ensure direction & leadership and involve the whole organization in the whole organization in cisiscisis related work, in close partnership related work, in close partnership with UN agencies and NGOs. with UN agencies and NGOs.

WHO WEAKNESSES AS WHO WEAKNESSES AS PERCEIVED FROM OUTSIDEPERCEIVED FROM OUTSIDE11

"WHO is not seen as a overall priority partner in "WHO is not seen as a overall priority partner in emergencies, not by itself and not by ECHO.emergencies, not by itself and not by ECHO.WHO is primarily oriented towards middle and long WHO is primarily oriented towards middle and long term approach and has not organised its tools, funds, term approach and has not organised its tools, funds, personnel and corporate philosophy to tackle personnel and corporate philosophy to tackle emergencies. emergencies. Traditionally WHO is working closely with the MOH Traditionally WHO is working closely with the MOH which is sometimes an advantage but may be a liability which is sometimes an advantage but may be a liability in some cases to respond to emergencies.in some cases to respond to emergencies.Not at all WHO staff show a genuine interest in Not at all WHO staff show a genuine interest in participating in emergency operations"participating in emergency operations"

Source: ECHO, Brussels, April, 21Source: ECHO, Brussels, April, 21, 2004, 2004

WHO WEAKNESSES AS WHO WEAKNESSES AS PERCEIVED FROM OUTSIDEPERCEIVED FROM OUTSIDE22

""……Major bottlenecks identified: Major bottlenecks identified: link to MOH too strong, link to MOH too strong, wrong people recruited for the job at hand,wrong people recruited for the job at hand,no funding, no field orientation, no funding, no field orientation, no interest in emergencies, no interest in emergencies, not enough in frontline of emergenciesnot enough in frontline of emergencies

No direct established link between the HAC No direct established link between the HAC focal point and ECHO focal point and ECHO office"office"______________________________________________________ECHO people do recognize that the kind ECHO people do recognize that the kind of backof back--up WHO is capable to provideup WHO is capable to provide

DEVELOPING A PROGRAMME TO DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCE:ENHANCE WHO PERFORMANCE:New leadership, new focusNew leadership, new focus

WHO Senior management acknowledged in WHO Senior management acknowledged in 2002 the need to strengthen its capacity 2002 the need to strengthen its capacity A joint evaluation revealed the potential impact A joint evaluation revealed the potential impact of the increased WHO technical capacity at of the increased WHO technical capacity at country, subcountry, sub-- regional and Regional levelsregional and Regional levelsRealistic timeframe (3 years)Realistic timeframe (3 years)WHO HAC strategy available since last quarter WHO HAC strategy available since last quarter of 2003 pins down key ideas and provides of 2003 pins down key ideas and provides basis for broader and intensive consultationsbasis for broader and intensive consultations

DEVELOPING A PROGRAMME TO DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCE: ENHANCE WHO PERFORMANCE: Strategic thinkingStrategic thinking

Over 300 key WHO staff and partners consulted:Over 300 key WHO staff and partners consulted:-- WHO country RepresentativesWHO country Representatives-- Senior Management Senior Management ADG'sADG's, Directors of , Directors of

Technical departments, Technical departments, DPMsDPMs, , RDsRDs-- HAC staff in Geneva and all 6 regional HAC staff in Geneva and all 6 regional

EHA/HAC/PED focal points (EHA/HAC/PED focal points (VersoixVersoix))………… reshaping the strategy and starting a reshaping the strategy and starting a

process of internal review of support functions process of internal review of support functions with other departmentswith other departments

DEVELOPING A PROGRAMME TO DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCE: ENHANCE WHO PERFORMANCE: Strategic thinkingStrategic thinking ((cntcnt))

Over 40 Missions and Donors consulted:Over 40 Missions and Donors consulted:general support for the strategic general support for the strategic direction and proposaldirection and proposalKey areas in the draft proposal that need Key areas in the draft proposal that need more clarification identifiedmore clarification identified

DEVELOPING A PROGRAMME TO DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCE : ENHANCE WHO PERFORMANCE : Planning process Planning process

Step 1Step 1: each Region and Geneva outline plan of work and budgets : each Region and Geneva outline plan of work and budgets for next three yearsfor next three years

Step 2Step 2: HAC Geneva consolidates all seven plans in line with HAC : HAC Geneva consolidates all seven plans in line with HAC strategystrategy

Step 3Step 3: All six WHO regions and Geneva gather in Cairo to : All six WHO regions and Geneva gather in Cairo to develop a common programme framework, leading to a develop a common programme framework, leading to a consolidated and unified global HAC programme, reflecting consolidated and unified global HAC programme, reflecting regional prioritiesregional priorities

Step 4Step 4: Regional and HQ HAC teams in the Cairo meeting agree : Regional and HQ HAC teams in the Cairo meeting agree on key issues: levels of services, objectives per crisis phases,on key issues: levels of services, objectives per crisis phases, key key products and activities and indicators, as well as monitoring anproducts and activities and indicators, as well as monitoring and d evaluation system, programme supervision, human resource evaluation system, programme supervision, human resource management, etc.management, etc.

DEVELOPING A PROGRAMME TO DEVELOPING A PROGRAMME TO ENHANCE WHO PERFORMANCE: ENHANCE WHO PERFORMANCE: Searching for fundsSearching for funds

Extensive consultations with partnersExtensive consultations with partners-- IASC in RomeIASC in Rome-- DfiDDfiD in Londonin London-- US Govt and USAIDUS Govt and USAID-- IFRC, UNICEF and other key partner agenciesIFRC, UNICEF and other key partner agencies-- EU and other Humanitarian partners in EU and other Humanitarian partners in

MontreuxMontreux-- Donors 2Donors 2ndnd meeting, March 24, 2004meeting, March 24, 2004-- ECHO, in Brussels, April 21, 2004ECHO, in Brussels, April 21, 2004

DEVELOPING A PROGRAMME DEVELOPING A PROGRAMME TO ENHANCE WHO TO ENHANCE WHO PERFORMANCE PERFORMANCE 22

Need for high level technical and Need for high level technical and managerial competence managerial competence ("Plans do not work, ("Plans do not work, people work")people work")

Strong capacities and operational performance in Strong capacities and operational performance in project planning monitoring and reportingproject planning monitoring and reportingTechnical capacity and experience in the specifics Technical capacity and experience in the specifics of emergency preparedness and disaster mitigationof emergency preparedness and disaster mitigationExcellent working relationships with technical Excellent working relationships with technical departments in WHOdepartments in WHOSkills at communication, and advocacy, including Skills at communication, and advocacy, including tact and diplomacytact and diplomacy

THE THREE YEAR THE THREE YEAR PROGRAMME OBJECTIVEPROGRAMME OBJECTIVE

To improve the performance of the World To improve the performance of the World Health Organisation for better support to Health Organisation for better support to Member states to prepare for, respond to and Member states to prepare for, respond to and recover from crises______________________recover from crises______________________Systematic investment in effective WHO Systematic investment in effective WHO capacity within countries, in subcapacity within countries, in sub--regions and in regions and in Regions in order to provide sufficient support Regions in order to provide sufficient support for health action before, during and after crisesfor health action before, during and after crises

PRIORITY OUTCOMES OF PRIORITY OUTCOMES OF THE PROGRAMMETHE PROGRAMME

Outcome 1: Effective WHO country Outcome 1: Effective WHO country capacitycapacity

Outcome 2: Global synergyOutcome 2: Global synergy

Outcome 3: WHO Surge capacity for Outcome 3: WHO Surge capacity for Rapid response Rapid response

OUTCOME 1: EFFECTIVE OUTCOME 1: EFFECTIVE WHO COUNTRY CAPACITYWHO COUNTRY CAPACITY

Capacity to support crisis preparedness in 50 Capacity to support crisis preparedness in 50 countriescountries

Standards of preparedness for health Standards of preparedness for health aspects of crises proposedaspects of crises proposedInternational and regional preparedness International and regional preparedness training programme developedtraining programme developedDisaster riskDisaster risk--reduction planning underway reduction planning underway for 20 countriesfor 20 countriesNetwork of skilled persons set up in at Network of skilled persons set up in at least 2 regionsleast 2 regions

OUTCOME 1OUTCOME 1

Capacity to support crisis response in 90% of crisis situations,Capacity to support crisis response in 90% of crisis situations,through:through:

functioning health coordination mechanisms focused functioning health coordination mechanisms focused on agreed outcomes, strategies and procedures for on agreed outcomes, strategies and procedures for their executiontheir executionroutine and systematic provision of an agreed standard routine and systematic provision of an agreed standard of health information and intelligence updated at of health information and intelligence updated at regular intervalsregular intervalshuman and financial resources, logistics available as human and financial resources, logistics available as requested from the field within a monthrequested from the field within a monththe human resources are available when neededthe human resources are available when neededthe supplies needed for effective response to health the supplies needed for effective response to health aspects are available when needed; aspects are available when needed;

OUTCOME 1OUTCOME 1

Capacity to support repair and Capacity to support repair and recovery/rehabilitationrecovery/rehabilitation

Recovery and rehabilitation planning are Recovery and rehabilitation planning are incorporated into early needs assessmentsincorporated into early needs assessmentsResource mobilised for urgent repair actions for Resource mobilised for urgent repair actions for damaged system within the context of peace damaged system within the context of peace consolidation and for health system issues that consolidation and for health system issues that are being given priority during the repair and are being given priority during the repair and recovery phasesrecovery phases

OUTCOME 1OUTCOME 1

Capacity to support crisis mitigationCapacity to support crisis mitigationAdvocacy programmes result in awareness Advocacy programmes result in awareness within the majority of MOH, mitigation within the majority of MOH, mitigation recommendations provided for those making recommendations provided for those making decision about people healthdecision about people healthDisaster mitigation measures included in Disaster mitigation measures included in reconstruction plansreconstruction plans

OUTCOME 2 OUTCOME 2

Global synergy through readiness Global synergy through readiness cohesiveness and institutional knowledge cohesiveness and institutional knowledge

Readiness, cohesivenessReadiness, cohesivenessAll WHO departments, Collaborative centres, All WHO departments, Collaborative centres, operational partners, donor agencies, etc to be operational partners, donor agencies, etc to be mobilised in support to country / community in mobilised in support to country / community in crisiscrisisCommon / Joint assessment, evaluation and Common / Joint assessment, evaluation and planning among country stakeholders for planning among country stakeholders for concerted actionconcerted action

OUTCOME 2OUTCOME 2

An accessible bank of knowledgeAn accessible bank of knowledgeUp to date information widely disseminatedUp to date information widely disseminatedProtocols, standards, methods, techniques, Protocols, standards, methods, techniques, indicators and benchmarks to be applied in indicators and benchmarks to be applied in crisescrisesConstant monitoring and reassessment of Constant monitoring and reassessment of prioritiespriorities

OUTCOME 3 : WHO SURGE OUTCOME 3 : WHO SURGE CAPACITY FOR RAPID CAPACITY FOR RAPID RESPONSE RESPONSE

Rapid responseRapid responseConditions for activation and replenishment of the RRFConditions for activation and replenishment of the RRF

Minimum standards for WHO country office and Global Minimum standards for WHO country office and Global / Regional surge assistance/ Regional surge assistance

Operating proceduresOperating proceduresInformation managementInformation managementCoordination /FacilitationCoordination /FacilitationLogisticsLogisticsSecuritySecurityGaps Gaps Planning and resource mobilization beyond three monthsPlanning and resource mobilization beyond three months

BUDGETBUDGET

8 Millions sough each year during three 8 Millions sough each year during three years:years:Outcome 1: 6,080.000Outcome 1: 6,080.000Outcome 2: 1,590.000Outcome 2: 1,590.000Outcome 3: 330.000Outcome 3: 330.000

PROGRAMME IMPLEMENTATION PROGRAMME IMPLEMENTATION FRAMEWORK: FRAMEWORK: Management TeamManagement Team

RDG, under the RDG, under the DG'sDG's office = opportunities to involve office = opportunities to involve all WHO as and when neededall WHO as and when neededProgramme Manager, responsible for the day to day Programme Manager, responsible for the day to day management of the global programme, working with management of the global programme, working with Regional HAC focal pointsRegional HAC focal pointsSupervision of country HAC focal points is the Supervision of country HAC focal points is the responsibility of Regional focal pointsresponsibility of Regional focal pointsDesk officers are involved in the functional support and Desk officers are involved in the functional support and monitoringmonitoringA Global steering Group to advise, peer review, guide A Global steering Group to advise, peer review, guide and make collective decisions on programme and make collective decisions on programme implementation progress, recruitment, performance implementation progress, recruitment, performance appraisal, etc.appraisal, etc.

PROGRAMME IMPLEMENTATION PROGRAMME IMPLEMENTATION FRAMEWORK: FRAMEWORK: Strategic alliancesStrategic alliances

Catalyst role of HAC in support to:Catalyst role of HAC in support to:National authoritiesNational authoritiesHumanitarian actorsHumanitarian actorsDonorsDonors

Members of the GSG will help build, support Members of the GSG will help build, support and sustain alliancesand sustain alliancesWHO is well placed to offer six regionWHO is well placed to offer six region--specific specific perspectives appreciated by other perspectives appreciated by other humanitarian agencies, in addition to its humanitarian agencies, in addition to its technical expertise and knowtechnical expertise and know--how in dealing how in dealing with public health issueswith public health issues

PROGRAMME IMPLEMENTATION PROGRAMME IMPLEMENTATION FRAMEWORK:FRAMEWORK:Monitoring, Reporting and EvaluationMonitoring, Reporting and Evaluation

Reporting system already available in Reporting system already available in WHO will be used such as the AMSWHO will be used such as the AMS

Interim reports every 6 monthsInterim reports every 6 monthsYearly reportsYearly reportsFinal project reportsFinal project reportsRegular meetings in Geneva, Regional and Regular meetings in Geneva, Regional and at Donor at Donor HeadquaterHeadquater locationlocationJoint field monitoring visitsJoint field monitoring visitsJoint evaluation after two yearsJoint evaluation after two years

PROGRAMME IMPLEMENTATION PROGRAMME IMPLEMENTATION FRAMEWORK: FRAMEWORK: Success factorsSuccess factors

Sustained institutional arrangementsSustained institutional arrangementsFinancial resources as plannedFinancial resources as plannedTransparency and accountability at the Transparency and accountability at the three levelsthree levelsFull involvement of not only the WR but Full involvement of not only the WR but the entire country office in enhancing the the entire country office in enhancing the capacity of WHO for preparedness, capacity of WHO for preparedness, response and recovery from crises.response and recovery from crises.

ConclusionConclusion

The Three Year Programme is more than The Three Year Programme is more than a programme for improving the technical a programme for improving the technical and managerial performance of WHO and managerial performance of WHO with regards to Health aspects of criseswith regards to Health aspects of crisesIt is an opportunity for change in:It is an opportunity for change in:

the way we work with other departments, the way we work with other departments, regions and countries ;regions and countries ;the way we relate to donors, other agencies the way we relate to donors, other agencies and NGOs.and NGOs.

THANK YOUTHANK YOU

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