12A HEALTH EMERGENCY MANAGEMENT

This capacity focuses on management of health emergencies for enabling countries to be prepared and operationally ready for response to any health event, including emergencies, as per the all-hazard requirement of IHR. Ensuring risk-based plans for emergency preparedness, readiness and response, robust emergency management structures and mobilization of resources during an emergency is critical for a timely response to health emergencies.

IMPACT:

Multisectoral actors at national, subnational and local health response levels are well coordinated and have a common understanding of the priority risks and are ready to implement timely, effective and efficient emergency response operations for outbreaks and other emergencies. Countries have the necessary legal and regulatory processes to allow for rapid national or cross-border deployment and receipt of public health, medical personnel and logistics and supplies during emergencies.

MONITORING AND EVALUATION:

(1) Existence of national strategic multihazard emergency assessments (risk profiles) and resource mapping. (2) Existence of emergency readiness assessments. (3) Development of national health emergency operations centre plans and procedures. (4) Establishment of an emergency response coordination mechanism or incident management system. (5) Evidence of at least one response to a health emergency within the previous year that demonstrates that the country sent or received medical countermeasures and personnel according to written national or international protocols. (6) Existence of an emergency logistic and supply chain management system/mechanism. (7) Existence of policies and procedures for research, development and innovation for emergency preparedness and response.

Benchmark 12A.1

Effective risk profiling, readiness assessment and rapid risk assessment processes are in place and strongly linked to health emergency and disaster management plans and structures

Objective To develop capacities to conduct regular strategic (or equivalent) risk profiling, readiness assessment and RRAs to determine risks to be prioritized for health emergency management and support decision-makers during emergencies

01 NO CAPACITY

  1. National all hazards risk profile not available based on a multihazard risk assessment or has not been updated in the past five years and there is no formal mechanism for the readiness assessment for potential health emergencies.

02 LIMITED CAPACITY

  1. Designate a national authority to coordinate the development of a multihazard risk profile (dedicated unit/department). *
  2. Commence training of public health experts to conduct RRAs. *
  3. Review available data, risk and capacity assessments across sectors to inform an all hazard risk assessment. *
  4. Form a national working group (with ToRs) to lead and support the RRA process at national and subnational levels.
  5. Identify and involve multisectoral stakeholders and trusted community leaders in risk profiling exercise at national level.
  6. Conduct contextual analysis to ensure that relevant factors (cultural, societal, economic, etc.) are taken into consideration during the risk profiling development process. *
  7. Assess existing policies, legislation and legal basis, ethical rules, norms and standards to conduct risk assessments in nonemergency and emergency periods. *
  8. Develop a national risk profile, using a standardized approach with relevant focal points across health and relevant sectors. *
  9. Share available/updated risk profile with multisectoral stakeholders to inform IHR-related planning and actions including readiness and RRAs. *
  10. Designate a national authority to coordinate a readiness assessment and identify priority anticipatory actions for high priority and imminent risks. *
  11. Conduct a readiness assessment of operational capabilities at the national level using a validated readiness checklist for a real or simulated high priority and imminent risk(s) and identify prioritized anticipatory actions to fill gaps. *
  12. Share available/updated readiness assessment and prioritized anticipatory actions with multisectoral stakeholders to inform IHR-related planning and action *
  13. Conduct RRA for major acute public health events. *

03 DEVELOPED CAPACITY

  1. Form/reconvene a risk assessment implementation team to organize, prepare and conduct risk profiling exercises at the national level on a regular basis (i.e. every two years). *
  2. Follow a systematic and stepwise methodology for the RRA process with SOPs after the detection of threats or events that can lead to health emergencies. This includes assessment of hazard, exposure, context and level of impact of the negative consequences of the event and their respective likelihood. *
  3. Share RRA output with relevant stakeholders and partners. *
  4. Use the output of the RRA to support the decision-making process. *
  5. Train a multidisciplinary team that includes health, animal and environment sectors to conduct RRA. *
  6. Engage relevant departments of the health ministry and other relevant governmental ministries and agencies in the development of the initial RRAs and ongoing updates. *
  7. Develop and/or use orientation packages for multisectoral experts participating in risk profiling exercises.
  8. Raise awareness about the importance of risk assessments and application in relevant sectors.
  9. Involvement from relevant ministries, governmental agencies and nonhealth partners/stakeholders in the risk assessment process, operationalization of readiness tools (including checklists) and capacity-building planning, including (but not limited to): various ministries, disaster risk management authority, centralizing authority (such as the prime minister/president’s office) and multisectoral stakeholders and partners.
  10. Train multisectoral risk assessment facilitators to conduct risk profiling exercises, including refresher sessions at the national level, and maintain a risk assessment facilitator roster. *
  11. Define data consolidation process to make use of multiple sources of information/analysis from different sectors, inclusive of all hazards (i.e. natural, human-induced and environmental hazards) to inform the risk profile and anticipatory actions for priority risks. *
  12. Develop or update the national risk profile and share updated risk profile and prioritized risks regularly with relevant multisectoral stakeholders to inform preparedness and readiness action. *
  13. Form/reconvene a readiness multisectoral team to coordinate and conduct readiness assessments at the national level. *
  14. Conduct or update the readiness assessment of operational readiness capabilities using a WHO recommended readiness checklist for a real or simulated high priority and imminent risk(s) and identify prioritized anticipatory actions to fill gaps on a regular basis. *
  15. Develop/update and test the national operational contingency plans or equivalent for high priority and imminent risks based on readiness assessment(s) and prioritized readiness anticipatory actions. *
  16. Integrate the risk profile and prioritized readiness anticipatory actions into relevant national emergency management mechanism(s), plans, strategies and frameworks. *
  17. Conduct RRAs systematically after the detection of an event with provision of updates to the assessment over time. *

04 DEMONSTRATED CAPACITY

  1. Designate an authority to coordinate the development of a multihazard risk profile at the subnational level(s) (dedicated unit/department). *
  2. Establish or designate a RRA division in the health ministry to coordinate the management of risk assessment in all programme divisions and provide appropriate resources for supporting risk assessment activities (staff, funds, material, regular trainings). *
  3. Use information from the most recent strategic risk assessment performed at national and/or subnational levels for RRA to contextualize acute events. *
  4. Conduct SimEx for RRA to identify gaps/best practices and update plan and risk assessment mechanisms accordingly. *
  5. Include RRA trainings in the curricula of postgraduate studies in public heath, health administration, emergency medicine, disaster management and other relevant fields. *
  6. Establish the process for multisectoral partners to cross share relevant risk data, information and mapping to inform risk profile development/maintenance.
  7. Establish cooperation agreements between partners, community representatives and the RRA division to ensure whole-of-society, multisectoral/multidisciplinary risk assessments are conducted at national and subnational levels.
  8. Develop or update existing policies, legislation and legal basis, ethical rules, norms and standards to conduct risk assessments in nonemergency and emergency periods. *
  9. Define how risk profile and rapid risk assessment results will be applied to national and subnational planning mechanisms, operational decision-making, partner engagement and capacity building and apply as appropriate. *
  10. Reinforce capacity to conduct multihazard risk profiling exercise(s) that can support national, subnational and local level profiling exercises. *
  11. Allocate funding to develop and maintain risk profiles at the national and subnational levels. *
  12. Designate an authority to coordinate readiness assessments and the development of operational contingency plan(s) at the subnational level(s). *
  13. Develop/review/update and test hazard specific national and subnational operational contingency plans or equivalent for high priority and imminent risks based on readiness assessment(s) and prioritized readiness anticipatory actions. *
  14. Establish rapid deployment mechanisms for the release of available contingency resources (human, financial, technical) for prioritized readiness anticipatory actions on a no regrets basis. *
  15. Apply hazard specific preparedness and readiness tools based on the risk profile and prioritized risks at the national and subnational levels to inform actions *

05 SUSTAINABLE CAPACITY

  1. Update risk profiles at the national and subnational levels on an annual basis (or as required based on emerging threats). *
  2. Coordinate and collaborate across stakeholders to ensure that the ongoing exchange of data, information, intelligence and joint surveillance activities are in place to support development and periodic updates of risk profile at the national and subnational levels.
  3. Contribute to the clear process for routine risk monitoring and updating the risk profile at national and subnational levels from relevant sectors, based on updated information and changes to the risk situation.
  4. Incorporate research and risk modelling from academic institutions, scientific data and modelling into the national and subnational risk profile through a well defined process with a special focus on emerging threats. *
  5. Apply hazard specific readiness tools based on high priority and imminent risks to assess and scale up readiness of the health sector to respond to health emergencies. *
  6. Regularly update health emergency strategy, contingency plans, legislation, risk informed capacity-building plans and other relevant documents based on risk profiles and readiness assessments at the national and subnational levels. *
  7. Establish or designate national and subnational mechanisms or processes to review the application of the risk profile as related to national and subnational policies, contingency and capacity planning, readiness assessments and risk management are fit for purpose on an annual basis (or as required based on emerging threats). *
  8. Share country experiences, lessons learned and innovations on risk profiling and application of readiness tools within a community of practice. *
  9. Use conclusions and recommendations from RRAs to develop/update contingency or response plans during health emergencies as well as to prioritise public health programmes and capacity-building planning. *
  10. Develop and update RRA methods tailored to the country context and based on M&E results. *
  11. Document country experiences in risk assessment (strategic and RRA), share best practices and engage the country in peer-to-peer learning programmes at subnational, national level and international levels. *

Benchmark 12A.2

Public health emergency operations centre (PHEOC) capacities, procedures and plans are in place

Objective Develop PHEOC capacities to enable countries to respond in a timely manner to all hazard emergencies and disasters

01 NO CAPACITY

  1. A PHEOC has not been identified at the national level and no PHEOC handbook is in place.

02 LIMITED CAPACITY

  1. Conduct high level advocacy on the importance of creating functional PHEOCs with heads of state, ministries and agencies. *
  2. Develop the national incident management system/response coordination structure. *
  3. Conduct a baseline assessment of emergency operations capacities and gaps including infrastructure (facility, communication technology equipment, internet, software, office supplies and power), information systems, workforce, legislation, policies and plans. *
  4. Form a steering committee or other management structure to oversee the implementation and strengthening of PHEOC and a policy group to provide strategic direction and allocation of resources. *
  5. Incorporate the concept of operations for the entire emergency response system, including PHEOC, within the national emergency response plan. *
  6. Develop a PHEOC implementation plan, including resource mobilization plan, to meet the minimum requirements of a functioning PHEOC. *
  7. Complete a comprehensive mapping of existing legal mandates on health emergency management systems and PHEOCs. *
  8. Draft a legal framework for the PHEOC to coordinate emergency operations and advocate for its enactment in the presence of leadership from the health ministry and relevant agencies. *
  9. Identify/establish a designated facility for the PHEOC with limited capacities (e.g. space, information communication technology infrastructure, information management, human resources with at least one designated core staff member, access to required data, etc.) to perform the coordination of emergency operations. *
  10. Develop a PHEOC handbook and other plans and procedures (multihazard response plan, hazard specific plans for priority risks, business continuity plan, necessary SOPs, etc.) that include PHEOC activation and scaled level of response and resource requirements at the national and subnational levels. *

03 DEVELOPED CAPACITY

  1. Enact the legal framework for operationalization of the PHEOC. *
  2. Develop a roster of subject matter experts and identify critical nonhealth sectors that would represent essential participation in PHEOC functioning during a health emergency. *
  3. Develop and implement a training programme for national PHEOC staff (routine and surge staff) on IMS function, roles and PHEOC operations. *
  4. Assess the need for creating and building an additional PHEOC at both the national and subnational levels and identify priority regions for PHEOC establishment based on specific needs. *
  5. Implement and validate health emergency preparedness and response plans, PHEOC handbook and SOPs in routine and emergency operations. *
  6. Assign permanent staff for core PHEOC functions (operations and management in preparedness, response and recovery phases). *
  7. Identify staff to conduct core incident management system (IMS) functions within the national PHEOC. *
  8. Develop standardized forms, templates and other tools for data/information management, task management, reporting, briefing and record keeping. *
  9. Determine data and information requirements (essential elements and critical requirements) to inform decision-making and identify critical sources of information such as epidemic intelligence, laboratory system, risk assessments and resources etc. *
  10. Develop and implement MoUs and SOPs to establish communication, coordination, information management and sharing of mechanisms between relevant stakeholders. *
  11. Establish a PHEOC information system and an interoperability platform, linking the health information system, to capture and manage required information and exchange information between the various existing information systems and stakeholders. *
  12. Develop funding mechanisms to build, equip and operate PHEOCs at the national level and to access additional funds in special circumstances. *

04 DEMONSTRATED CAPACITY

  1. Review and update the national incident management system/response coordination structure. *
  2. Align emergency operations centres (EOCs) existing in relevant sectors with the PHEOC and the national EOC for all hazards to ensure interoperability and harmonization of actions and interventions during health emergencies. *
  3. Monitor, evaluate and improve the PHEOC facility, communication technology infrastructure, information management and sharing platforms, emergency policies, plans, PHEOC handbook and procedures. *
  4. Identify/develop alternative/additional PHEOCs at the national level and establish PHEOCs at the subnational level (based on the risks and geographical need) with associated PHEOC handbooks. *
  5. Mobilize and allocate sufficient and sustainable funds to build, equip, maintain and operate PHEOCs at the national (including alternative PHEOCs) and subnational levels. *
  6. Develop and implement a tracking of decision-making procedures for the activation of a PHEOC. *
  7. Activate the national PHEOC within 120 minutes of receiving an early warning or information of an emergency requiring PHEOC activation. *
  8. Conduct SimEx/AAR/IAR (as relevant). *
  9. Develop and implement a training programme for PHEOC staff (routine and surge staff) on IMS function, roles and PHEOC operations at subnational levels and allocate dedicated resources. *

05 SUSTAINABLE CAPACITY

  1. Regularly review and communicate with stakeholders involved in health emergency management and PHEOC activities including relevant sectors. *
  2. Maintain and regularly update the national database of trained and skilled PHEOC and surge personnel to support preparedness and response coordination at all levels. *
  3. Sustain resources for the implementation of PHEOCs and maintain a network of fully functional, funded PHEOCs and trained staff on a 24/7 basis. *
  4. Test the activation, operation and deactivation of the PHEOC network which includes national, subnational or multisectoral PHEOCs, using real or simulated events and update PHEOC handbooks annually. *
  5. Sustain a regular training and exercise programme to train PHEOC and surge personnel at all levels based on the need or gap analysis. *
  6. Test, review and update PHEOC functions, plans, SOPs and trainings regularly at all levels, including for large scale and concurrent emergencies, based on lessons learned and ensure follow up on the implementation of recommendations from M&E activities. *
  7. Participate in international initiatives including regional and global PHEOC exercises to support capacity-building for functioning PHEOCs. *
  8. Share experiences on PHEOC management and engage the country in peer-to-peer learning programmes at the subnational, national and international levels. *

Benchmark 12A.3

A functional multisectoral, all hazard health emergency response management system is in place

Objective To develop a management and coordination mechanism for timely emergency response to all hazard health emergencies and disasters

01 NO CAPACITY

  1. A formal emergency response coordination mechanism is not in place.
  2. An IMS integrated with a national PHEOC or equivalent structure is not available or under development.

02 LIMITED CAPACITY

  1. Establish a national health emergency coordination focal point that maintains regular contact with experts from human, animal (domestic animals and wildlife) and environmental health as well as other relevant sectors. *
  2. Identify and develop linkages with key potential informants and response partners for health emergency operations that can provide 24/7 coverage in all major health systems. *
  3. Establish capacity for the availability of IHR NFP and other responsible parties to receive information about potential health threats and to report a public health emergency of international concern as outlined in the IHR. *
  4. Develop a plan and SOPs for an IMS which is integrated with the national PHEOC or equivalent structure, including thresholds and levels of activation for the emergency response coordination mechanism, and develop SOPs for the coordination of key health sector actors (such as surveillance, health facilities, emergency medical teams, mental health departments) and other relevant sectors. *
  5. Involve health emergency coordination focal points in the development of NHPSPs to define the country’s vision, policy directions and strategies for ensuring coordination mechanisms for emergency response. *

03 DEVELOPED CAPACITY

  1. Establish an IMS for managing emergency response at the national level, including participation of relevant sectors, and integrate with national PHEOC or equivalent structure. *
  2. Adapt the country’s legal framework to facilitate the coordination of emergency response operations in relevant sectors at both national and subnational levels. *
  3. Identify the roles and responsibilities of multisectoral stakeholders actively involved in the IMS and emergency response. *
  4. Establish and maintain a roster of emergency operations staff with defined roles and functions. *
  5. Develop a training plan linked to other relevant trainings for emergency operations staff, including IMS, and implement at the national level, at a minimum. *
  6. Develop advocacy material and training packages on coordination of emergency response for communities and all relevant stakeholders. *
  7. Develop a strategy, standards of conduct, training and advocacy material to prevent and address misconduct during response operations including sexual exploitation and abuse of vulnerable population, staff harassment, etc. *

04 DEMONSTRATED CAPACITY

  1. Establish a health sector emergency response coordination mechanism with participation from health and relevant sectors, linked to the national IMS and PHEOC or equivalent structure, with capacity to support the management of emergency responses at the subnational level. *
  2. Train subnational and local level health sector staff on the emergency response coordination mechanism. *
  3. Conduct SimEx/AAR/IAR (as relevant) with a focus on IMS, including coordination between national and subnational levels. *
  4. Disseminate advocacy materials and training packages to raise awareness of communities and train or retrain relevant stakeholders on their role(s) and responsibilities during an emergency response. *
  5. Make safety and security training mandatory for all staff before being deployed in emergency response operations. *
  6. Develop an anonymous and secured platform for reporting misconduct during response operations including sexual exploitation and abuse of vulnerable population, staff harassment, etc. Make training and awareness raising campaigns to prevent and address misconduct during emergency operations mandatory for all multisectoral staff before being deployed during and emergency response. *
  7. Develop a platform for mental health support of staff returning from emergency response operations. *

05 SUSTAINABLE CAPACITY

  1. Establish and sustain routine and emergency communications, which are linked to the national IMS and PHEOC or equivalent structure, at national and subnational levels, with international coordination mechanisms through the focal points. *
  2. Allocate sustainable funding for IMS activities at all levels. *
  3. Evaluate, document and disseminate information on activations and, if done, include exercises to promote continuous improvement in communication and coordination. *
  4. Review and adjust plans, SOPs, advocacy material and training packages for IMS and coordination of the emergency response based on lessons learned from SimEx/AAR/IAR (as relevant). *
  5. Keep record and track data of security and safety incidents as well as all allegations of misconduct, conduct investigation and take subsequent actions accordingly across all relevant sectors. *
  6. Share experiences of coordination mechanisms for emergency response and engage the country in peer-to-peer learning programmes at the subnational, national and international levels. *

Benchmark 12A.4

A system is in place for timely and effectively providing surge health personnel and teams during a health emergency

Objective To develop a functional system for activating, sending, receiving and coordinating health personnel and teams during a health emergency

01 NO CAPACITY

  1. No national plan for health personnel deployment or team (sending and receiving) has been drafted, or is under development.
  2. No plan for establishing national rapid response team (RRT)/emergency medical team (EMT) has been drafted and no coordination mechanisms for RRTs/EMTs or health personnel deployment have been described.

02 LIMITED CAPACITY

  1. Review national preparedness and response plans and legal and regulatory frameworks for preparing, sending, coordinating and receiving health personnel with key stakeholder involvement. *
  2. Review national laws and regulations for the licensing and registration of health personnel, including RRTs/EMTs. *
  3. Develop/update national plans, protocols, SOPs, technical guidelines and toolkits for preparing, mobilizing, sending, receiving and coordinating health personnel deployment and teams, and for sharing information as appropriate. *
  4. Conduct stakeholder mapping to determine baseline capacities/capabilities of relevant ministries and partner agencies for the deployment of EMTs and RRTs. *
  5. Appoint an EMT national focal point and request assistance in developing national EMTs as needed from multisectoral organizations and partner agencies. *
  6. Identify points of contact at ministries and/or relevant multisectoral organizations that can contribute to the deployment of health personnel and liaise with trained EMT teams across sectors, such as military forces, for collaboration and rapid deployment of health personnel during an emergency. *
  7. Develop SOPs and trainings for the procurement, storage, organization, transportation and distribution of personal protective equipment, medical and nonmedical supplies and equipment for health personnel. *
  8. Develop standardized plans for triage, IPC, clinical care and operational support during emergency incidents, considering emergency and nonemergency related clinical presentations (based on agreed EMT standards). *
  9. Develop tools for community engagement and education targeting acceptance of deployed health personnel. *

03 DEVELOPED CAPACITY

  1. Develop and implement the technical procedures and legal provisions required to adopt and execute the national plan on health personal and team deployment, adopting a quality assurance approach. *
  2. Conduct SimEx/AAR/IAR (as relevant) to test plans/SOPs/protocols which include sending, receiving and coordinating health personnel and teams, and for the creation of an EMT coordination cell and/or case management pillar in the national PHEOC. *
  3. Establish a multisectoral expert group to advise government on the management and coordination of health personnel and teams during health emergencies at the national and subnational levels. *
  4. Draft and regularly update the mapping of partner agencies to ensure ownership in human resources for health management coordination during health emergencies. *
  5. Apply to the WHO EMT Initiative for mentorship and verification as an internationally classified EMT. *
  6. Define criteria (health and nonhealth) for the activation and deployment of health personnel and teams during a health emergency, at the national and subnational levels. Create a roster of national and local health experts that can be rapidly activated and deployed during health emergencies at the national and subnational levels. *
  7. Develop and implement standardized training plans for emergency staff based on standardized competencies for RRTs and EMTs at the national level, with plans for rollout at subnational level. *
  8. Include prompt processes for licensing and regulation to authorize full or partial practice of qualified foreign health workers deployed specifically for emergency assistance. *

04 DEMONSTRATED CAPACITY

  1. Review the implementation plan of sending and receiving health personnel in at least one event response, or conduct a SimEx if no response has occurred in the past year. *
  2. Establish, maintain and train an updated roster of multisectoral qualified personnel to be activated in a health emergency. *
  3. Conduct regular trainings for emergency response personnel based on standardized competencies at all levels. *
  4. Establish a system for accreditation of national EMTs and obtain external validation of national EMTs. *
  5. Develop and implement an occupational safety strategy (including psychological support) for health personnel deployed during health emergencies at the national and subnational levels. *
  6. Development of sector specific external evaluation mechanisms for multisectoral teams and capacities.

05 SUSTAINABLE CAPACITY

  1. Update plans, SOPs, protocols and trainings based on findings from SimEx/AAR/IAR and identify improvements to regular health system operations resulting from personnel and team deployment during emergencies. *
  2. Identify and partner with regional and international partners (such as GOARN or the EMT Network via the WHO EMT Secretariat) for mobilizing health personnel. *
  3. Share experiences in the management of health personnel during health emergencies with subnational, national and international partners. *
  4. Maintain sustainable sources of funding for maintaining national EMT coordination and deployment mechanisms. *
  5. Achieve certification as international RRTs/EMTs from WHO to support national health personnel deployment in health emergencies. *
  6. Routinely test and evaluate capacity for emergency deployment of health personnel (sending and receiving), including EMT coordination cells and/or case management pillar operations within the national PHEOC, and the provision of continuing education programmes to ensure deployment staff readiness. *
  7. Play a mentoring role for other interested countries for RRT/EMT deployment whilst maintaining ethical standards including for the international hiring of health workers and participate in a twinning arrangement to support at least one country in their development of a national EMT. *
  8. Support research programmes in service delivery and other areas related to the management and deployment of health personnel during health emergencies

Benchmark 12A.5

A system is in place for emergency logistic and supply chain management during a health emergency

Objective To develop a functional system for activating and coordinating emergency logistics and supply chain management during a health emergency

01 NO CAPACITY

  1. Emergency logistics and supply chain management system/mechanisms is under development and/or not able to provide adequate support for health emergencies.

02 LIMITED CAPACITY

  1. Review national preparedness and response plans, legal and regulatory frameworks, and baseline capacity for procuring, stockpiling and deploying medical countermeasures, including sector roles and responsibilities, involving all key stakeholders. *
  2. Review national laws and regulations for the registration, procurement and use of medical devices, vaccines, drugs, biologicals and medical supplies from national and/or international sources during health emergencies. *
  3. Form a national expert group, bringing together all relevant experts, to advise decision-makers on how to strengthen capacity for management of medical countermeasures during a health emergency. *
  4. Draft a national plan to mobilize, receive, stockpile and deploy medical countermeasures, including SOPs for receiving donations of medical countermeasures. *
  5. Develop a legal framework and regulation to facilitate shipping and customs clearance of medical countermeasures during a health emergency. *
  6. Complete feasibility assessment for establishing a medical countermeasures procurement stockpile, including secure and functional facilities at all levels. *
  7. Draft a list of essential medical countermeasures based on the country risk profile (medical devices, vaccines, drugs, biologicals and medical supplies) for the management of high risk health emergencies at the national and subnational levels. *
  8. Identify countermeasures required for use across relevant sectors (PPE for animal culling, for example).

03 DEVELOPED CAPACITY

  1. Adopt and implement the national plan to mobilize, receive, stockpile and deploy medical countermeasures, including mapping resources within the country and with all relevant partners. *
  2. Develop standardized protocols and plans for storage, deployment, logistical and administrative support at all levels. *
  3. Establish regulatory pathways for the use of medical countermeasures including appropriate authorizations, clearances, ethical norms and permissions during investigations and responses. *
  4. Create deployment protocols, SOPs, technical guidelines and toolkits including communication materials, trainings and educational information to inform staff, the community and stakeholders. *
  5. Develop a procedure for accelerated market authorization for novel and innovative drugs and medical products during health emergencies. *
  6. Develop a training plan for rapid logistics needs assessments, planning, management and distribution of stockpiles for health emergencies and train early responders in the appropriate use and management of medical countermeasures. *
  7. Conduct SimEx/AAR/IAR (as relevant) to test the implementation plan. *
  8. Implement measures for the management and distribution of stockpiles at the national level and develop tools for regular monitoring of quantity and quality control of the strategic stockpile of essential medical countermeasures at the national and subnational levels. *
  9. Design and implement joint measures for effective supply chain management by relevant sectors during health emergencies

04 DEMONSTRATED CAPACITY

  1. Review the implementation plan for sending, receiving, stockpiling and deploying medical countermeasures during at least one response or conduct a SimEx if no response has occurred in the past year. *
  2. Develop and implement a strategy to ensure safe and secure access to medical countermeasures for the most vulnerable groups, including forcibly displaced people, low income people, people living in unsafe areas, etc. *
  3. Develop SOPs and train a sufficient number of health workers for rational prescription and utilization of medical countermeasures to provide an appropriate response to health emergencies. *
  4. Conduct regular monitoring and quality control missions of strategic stockpile of essential medical countermeasures at the national and subnational levels. *
  5. Implement rapid needs assessments, planning, management and distribution of stockpiles for health emergencies at national and subnational levels. *
  6. Complete trainings to support the management and distribution of stockpiles for health emergencies. *
  7. Expand procurement of countermeasures to the animal sector in the country plans, procedures or legal provisions.

05 SUSTAINABLE CAPACITY

  1. Test the management of the strategic stockpile regularly and update plans and strengthen capacities accordingly. *
  2. Develop and routinely apply criteria to document progress of sending and receiving medical countermeasures during a response. *
  3. Routinely test and evaluate capacity of for emergency deployment of medical countermeasures and update plans accordingly. *
  4. Develop a system for automatic replenishment of strategic stockpiles of essential medical countermeasures for health emergencies at the national and subnational levels. *
  5. Establish partnerships with countries, regional and international partners that includes procurement, sharing and distribution of medical countermeasures. *
  6. Share experience in activation and coordination of medical countermeasures during a health emergency and engage the country in peer-to-peer learning programme at the subnational, national and international levels *

Benchmark 12A.6

Research, development and innovation (RD&I) capacity for emergency management is in place

Objective To develop and implement a RD&I mechanism to generate evidence-based solutions for emergency preparedness and response through research and development and dissemination of findings

01 NO CAPACITY

  1. Research and development activities (operational and implementation), including approvals of research, are conducted on an ad hoc basis.

02 LIMITED CAPACITY

  1. Establish a national multisectoral committee (with ToRs) with relevant stakeholders and sectors to contribute to the development, updating and implementation of a national RD&I agenda for health emergencies based on the country risk profile and to coordinate dissemination of evidence. *
  2. Develop a national strategy, action plan or framework to guide RD&I for emergency preparedness and response including dissemination and advocacy strategy. *
  3. Map existing national entities (public and private) which provide funding for research and development. *
  4. Develop a national regulatory review process for conducting RD&I in country. *
  5. Assess capacities (including local networks of stakeholders in relevant sectors) to conduct RD&I activities before, during and after health emergencies both at the national and subnational levels. *
  6. Map existing scientific evidence dissemination platforms. *
  7. Identify focal points in all relevant organizations and sectors who can contribute to RD&I on health emergency preparedness and response.

03 DEVELOPED CAPACITY

  1. Implement a national RD&I strategy, action plan or framework which includes mechanisms and procedures for conducting RD&I. *
  2. Share RD&I from relevant sectors, including human, animal health, environment, chemical and radiological to support coordinated RD&I efforts.
  3. Secure sufficient funding, including from external sources if limited resources available from domestic funds, to support RD&I activities. *
  4. Implement the national regulatory review process for conducting RD&I in country. *
  5. Identify institutions, within and outside of the country, that support RD&I activities. *
  6. Create in-country networks of stakeholders from relevant sectors who can contribute to RD&I activities before, during and after health emergencies. *
  7. Develop or adapt RD&I orientation packages to train relevant staff on mechanisms and procedures to conduct research before, during and after health emergencies, based on a training needs assessment. *
  8. Train relevant staff across sectors and organizations at the national level on mechanisms and procedures for efficient RD&I based on country context. *
  9. Develop a platform or network for sharing and exchanging scientific information with relevant sectors during health emergencies at local, subnational, national and international levels. *
  10. Develop strategies for RD&I capacities in relevant sectors to conduct research on topics such as social science, anthropology, economics, politics, etc. before, during and after health emergencies.

04 DEMONSTRATED CAPACITY

  1. Establish a designated, domestic and externally funded, RD&I division to coordinate the management of RD&I including health emergencies across all programme divisions with appropriate resources (staff, funds, material, facilities, etc.) and cooperation agreements with partners, donors and other countries to support multisectoral/multidisciplinary RD&I activities in the country. *
  2. Develop a mechanism to support the fast tracking and expansion of research capacities during health emergencies and increase the frequency of activity during public health emergencies of international concern/novel emergencies to gather the latest evidence and communicate with decision-makers. *
  3. Increase collaboration and engagement between the research community and policymakers, practitioners and stakeholders. *
  4. Share documented research activities, evidence and outcomes with decision-makers to support policy, practice and guideline improvement. *
  5. Expand training of relevant staff across sectors to subnational level and incorporate RD&I into undergraduate and postgraduate studies in relevant programmes. *
  6. Evaluate RD&I mechanisms, procedures and utilization of findings in health emergencies within AARs/IARs, as relevant. *
  7. Collect and record adverse events from all phases of RD&I from all sectors to evaluate and address incidents and preserve transparency and trust in RD&I initiatives. *
  8. Identify and promote opportunities for international cooperation on RD&I related to health emergencies. *
  9. Conduct cross-sectoral collaborative research on health emergencies with joint action to utilize evidence for preparedness and response and advocacy.

05 SUSTAINABLE CAPACITY

  1. Maintain sustainable funding for RD&I from both domestic and international sources. *
  2. Review RD&I strategy and activities based on recent health emergency risk assessments/RD&I evaluations and update accordingly. *
  3. Establish and maintain prearrangements and MoUs to facilitate public-private partnership for multisectoral/multidisciplinary RD&I during health emergencies. *
  4. Review and update training packages and advocacy materials based on assessment and evaluation results. *
  5. Engage the country in peer-to-peer learning programmes for RD&I at the subnational, national and international levels. *
  6. Enact evidence-informed policy, practice and guidance for emergency preparedness and response based on in-country research. *
  7. Review and update RD&I legislation and processes at national and subnational levels in relevant sectors. *

* Participation and contribution of other sectors to action.

Tools

  • Partners platform for health in emergencies [website]. Geneva: World Health Organization; 2023 (https://partnersplatform.who.int/en/).
  • Emergency medical teams initiative [website]. Geneva: World Health Organization; 2020 (https://extranet.who.int/emt/).
  • Health innovation for impact. Digital health [website]. Geneva: World Health Organization; 2023 (https://www.who.int/teams/digital-health-and- innovation/health-innovation-for-impact).
  • Institute of Medicine (US) Roundtable on Research and Development of Drugs, Biologics, and Medical Devices. Washington DC: Davis JR, Nolan VP, Woodcock J, and Estabrook RW; 1999 (https://www.ncbi.nlm.nih.gov/books/NBK224577/).
  • Strategic toolkit for assessing risks: a comprehensive toolkit for all-hazards health emergency risk assessment. Geneva: World Health Organization; 2021 (https://www.who.int/publications/i/item/9789240036086).
  • Words into Action guidelines: National disaster risk assessment. Geneva: United Nations Office for Disaster Risk Reduction; 2017 (https://www.undrr. org/publication/words-action-guidelines-national-disaster-risk-assessment).
  • Rapid risk assessment of acute public health events. Geneva: World Health Organization; 2012 (https://apps.who.int/iris/handle/10665/70810).
  • WHO Human Health Risk Assessment Toolkit: Chemical Hazards, second edition. Geneva: World Health Organization; 2021 (https://www.who.int/ publications/i/item/9789240035720).
  • Joint Risk Assessment Operational Tool. Food and Agriculture Organization of the United Nations, World Health Organization and World Organisation for Animal Health; 2020 (https://www.who.int/initiatives/tripartite-zoonosis-guide/joint-risk-assessment-operational-tool).
  • Kandel N, Chungong S, and the WHO Technical Working Group of the Dynamic Preparedness Metric and Health Security Preparedness Department. Dynamic preparedness metric: a paradigm shift to measure and act on preparedness. The Lancet Global Health. 2022; 10(5), e615–e616. doi: 10.1016/ S2214-109X(22)00097-3.
  • Framework for a Public Health Emergency Operations Centre. Geneva: World Health Organization; 2015 (https://apps.who.int/iris/ handle/10665/196135).
    This document from WHO outlines the key concepts and essential requirements for developing and managing a PHEOC. It provides an outline for developing and managing a PHEOC to achieve a goal.
  • Handbook for developing a public health emergency operations centre part A: Policies, plans and procedures. Geneva: World Health Organization; 2018 (https://www.who.int/publications/i/item/handbook-for-developing-a-public-health-emergency-operations-centre-part-a).

  • Handbook for developing a public health emergency operations centre part C: training and exercises. Geneva: World Health Organization; 2018 (https:// www.who.int/publications/i/item/handbook-for-developing-a-public-health-emergency-operations-centre-part-c).

  • Handbook for Public Health Emergency Operations Center Operations and Management. Brazzaville: WHO Regional Office for Africa; 2021 (https://www. afro.who.int/publications/handbook-public-health-emergency-operations-center-operations-and-management).
  • Public Health Emergency Operations Center (PHEOC) Legal Framework Guide: A Guide for the Development of a Legal Framework to Authorize the Establishment and Operationalization of a PHEOC. Brazzaville: WHO Regional Office for Africa; 2021 (https://www.afro.who.int/publications/public- health-emergency-operations-center-pheoc-legal-framework-guide-guide/).
  • The Public Health Emergency Operations Centre (PHEOC) OpenWHO [website online course]. Geneva: World Health Organization; 2020 (https:// openwho.org/courses/PHEOC-EN).
  • Balajee SA, Pasi OG, Etoundi AGM, Rzeszotarski P, Do TT, Hennessee I, et al. Sustainable Model for Public Health Emergency Operations Centers for Global Settings. Emerg Infect Dis. 2017 Oct;23(13):S190–5. doi:10.3201/eid2313.170435.
  • Incident Management System (Tier 1) OpenWHO [website online course]. Geneva: World Health Organization (https://openwho.org/courses/incident- management-system).
    A training course from WHO that is designed to help users gain a foundational understanding of the Incident management system structure and its procedures at WHO.
  • FEMA Emergency Management Institution. National Incident Management System (NIMS) [website]. United States of America: Federal Emergency Management Agency; 2015 (https://training.fema.gov/nims/).
    From the US Federal Emergency Management Agency, a series of free interactive online courses on incident management.
  • Public Health Incident Leadership Training [website]. United States of America: Minnesota Department of Health; 2022 (https://www.health.state.mn.us/ communities/ep/training/useee/index.html).
    A training for public health practitioners with leadership responsibilities during responses to disasters and events with public health implications.
  • Hazard Information Profiles: Supplement to UNDRR-ISC Hazard Definition & Classification Review - Technical Report. Geneva: United Nations Office for
    Disaster Risk Reduction; 2021 (https://www.undrr.org/publication/hazard-information-profiles-hips).
    Provides a common set of hazard definitions to governments and stakeholders to inform their strategies and actions on risk reduction and
    management.
  • International Coordinating Group on Vaccine Provision [website]. Geneva: World Health Organization; 2023 (https://www.who.int/groups/ icg#:~:text=The%20International%20Coordinating%20Group%20(ICG,to%20countries%20during%20major%20outbreaks).
    Has information on mechanisms to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. This includes vaccines for cholera, meningitis and yellow fever.

  • Global Outbreak Alert and Response Network (GOARN) [website]. Geneva: Global Outbreak Alert and Response Network; 2023 (https://goarn.who.int/). Provides information on how to prepare for field activity, to activate international support, to coordinate response in the field, to evaluate and follow up outbreaks of international importance.

  • Classification and Minimum Standards for Emergency Medical Teams. Geneva: World Health Organization; 2021 (https://apps.who.int/iris/ handle/10665/341857).
    Describes the capacities and capabilities of EMTs, as well as their guiding principles and standards.
  • The regulation and management of international emergency medical teams. Geneva: World Health Organization and International Federation of the Red Cross and Red Crescent Societies; 2017 (https://disasterlaw.ifrc.org/media/1328).
    Provides an overview of the issues in regulating and managing international emergency medical teams in a selection of large and small-scale sudden onset disasters.
  • COVID-19: Operational guidance for maintaining essential health services during an outbreak. Interim guidance, 25 March 2020. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/handle/10665/331561).
  • An R&D Blueprint for Action to Prevent Epidemics. Geneva: World Health Organization; 2017 (https://www.who.int/publications/m/item/an-r-d- blueprint-for-action-to-prevent-epidemics—update-2017).
  • Establishing a global coordination mechanism of R&D to prevent and respond to epidemics – toward implementation of the GCM. Meeting Report from 28 March 2017, London, UK at the Welcome Trust for the R&D Blueprint. London: World Health Organization; 2017 (https://www.who.int/docs/default- source/blue-print/gcm/blue-print-gcm2017-meetingsummary.pdf?sfvrsn=3f78ce1c_2).
  • Seven principles for strengthening research capacity in low- and middle-income countries: simple ideas in a complex world. ESSENCE Good Practice Document Series. Geneva: TDR/ World Health Organization; 2014 (https://tdr.who.int/publications/m/item/2014-06-19-seven-principles-for- strengthening-research-capacity-in-low-and-middle-income-countries-simple-ideas-in-a-complex-world).
  • Planning, monitoring and evaluation Framework for research capacity strengthening. Revision 2016. ESSENCE Good Practice Document Series. Geneva: TDR/ World Health Organization; 2016 (https://tdr.who.int/docs/librariesprovider10/essence/essence-frwk-2016-web-pdf.pdf?sfvrsn=7282f353_6).
  • WHO guidance on research methods for health emergency and disaster risk management. Geneva: World Health Organization; 2021 (https://apps.who. int/iris/handle/10665/345591).
  • GLOSSARY of Health Emergency and Disaster Risk Management Terminology. Geneva: World Health Organization; 2020 (https://www.who.int/ publications/i/item/9789240003699).
  • Simulation exercises [website]. Geneva: World Health Organization; 2023 (https://www.who.int/emergencies/operations/simulation-exercises).
  • WHO simulation exercise manual: a practical guide and tool for planning, conducting and evaluating simulation exercises for outbreaks and public health emergency preparedness and response. Geneva: World Health Organization; 2017 (https://apps.who.int/iris/handle/10665/254741).
  • Guidance for after action review (AAR). Geneva: World Health Organization; 2019 (https://apps.who.int/iris/handle/10665/311537).
  • Guidance for conducting a country COVID-19 intra-action review. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/ handle/10665/333419)