03 IHR COORDINATION, NATIONAL IHR FOCAL POINT FUNCTIONS AND ADVOCACY

States Parties should have multisectoral multidisciplinary approaches through national partnerships that allow efficient alert and response systems for effective implementation of the IHR. The coordination of nationwide resources allows for the sustainable functioning of a National IHR Focal Point – a national centre for IHR communications which is a key obligation of the IHR – that is accessible at all times. States Parties provide WHO with contact details of National IHR Focal Points, continuously update and annually confirm them. Timely and accurate reporting of notifiable diseases, including the reporting of any events of potential public health significance according to WHO requirements and consistent relay of information to the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH). Planning and capacity development are undertaken and supported through advocacy measures to ensure high-level support for implementation of IHR.

IMPACT:

A mechanism for multisectoral multidisciplinary coordination, communication and partnerships to detect, assess and respond to any public health event or risk is in place. A National IHR Focal Point is accessible at all times to communicate with the WHO IHR Regional Contact Points and with all relevant sectors and other stakeholders in the country. The National IHR Focal Points, the WOAH Delegate and WOAH-World Animal Health Information System (WAHIS) National Focal Point (NFP) will have access to a toolkit of best practices, model procedures, reporting templates and training materials to facilitate rapid (within 24 hours) notification of events that may constitute a potential public health emergency of international concern (PHEIC) to WHO and listed diseases to WOAH, as well as be able to respond rapidly (within 24-48 hours) to communications from these organizations. High-level support for implementation of IHR is present within the country.

MONITORING AND EVALUATION:

(1) A functional multisectoral multidisciplinary mechanism for the coordination and integration of relevant sectors in the implementation of IHR to respond to any public health events. (2) A system to report potential public health events of international concern to WHO and to meet the needs of other official reporting systems, such as WAHIS. (3) Planning and ongoing capacity development efforts with established and effective advocacy mechanisms for implementation of IHR. (4) Mechanisms are regularly tested through exercises with subsequent improvement of arrangements and procedures.

Benchmark 3.1

The IHR NFP is fully functional

Objective To establish a fully functional IHR NFP

01 NO CAPACITY

  1. IHR NFP does not exist, or consists of one individual, lacks legal authority, capacity and resources to effectively carry out functions.
  2. ToRs describing the mandate, structure, roles and responsibilities of NFP are not in place or are under development.

02 LIMITED CAPACITY

  1. Designate or establish an office or centre to serve as the IHR NFP in line with Article 4 of the IHR. *
  2. Develop ToRs outlining the roles and responsibilities of the IHR NFP in fulfilling relevant obligations of the IHR. *
  3. Maintain and regularly update a contact directory including all members of NFP and capacitate NFP to be available 24 hours a day, seven days a week (24/7) in line with Article 4 of the IHR and share with the World Health Organization (WHO) and relevant partners. *
  4. Develop and test SOPs for communicating and coordinating with WHO, including triggers and processes for notification, verification and reporting in line with Annex 2 of the IHR. *
  5. Develop and test SOPs for communication among relevant sectors, including thresholds for reporting, response, coordination and communication mechanisms during health emergencies. *
  6. Develop and implement an IHR NFP training package for NFP unit staff. *
  7. Provide annual reporting to the World Health Assembly on IHR capacity development, in line with IHR obligations. *
  8. Develop processes to complete and submit the States Parties Self-Assessment Annual Report (SPAR) Tool in line with Article 54 of the IHR. *
  9. Designate focal points in relevant sectors to work closely and regularly communicate with IHR NFP.
  10. Raise awareness about SOPs for communication in relevant sectors to share information on urgent events, including those which meet thresholds for reporting and response by IHR NFP.

03 DEVELOPED CAPACITY

  1. Develop policy to designate or establish the IHR NFP, with legal authority to conduct activities in accordance with IHR requirements. *
  2. Establish IHR NFP and share ToRs describing the roles and responsibilities of the IHR NFP at all levels (i.e. senior and technical) within the ministry where the IHR NFP is located. *
  3. Implement SOPs on communication and coordination between NFPs and WHO including triggers and processes for notification, verification and reporting based on relevant articles of the IHR, and review performance regularly. *
  4. Implement SOPs for communicating between NFP and relevant sectors (e.g. those responsible for surveillance and reporting, points of entry, public health services, clinics and hospitals and other government). *
  5. Develop and test SOPs for communication and coordination between the NFP and nongovernmental agencies, including media and civil society communication channels (e.g. website updates or newsletters), to apprise relevant sectors, media and civil society on developments related to IHR implementation. *
  6. Regularly test the processes of the IHR NFP for health emergency management, coordination, multisectoral collaboration and communication through actual experience and/or scenarios for different types of health emergencies. *
  7. Regularly assess staffing and funding needs to maintain a functional IHR NFP and allocate sufficient funds for IHR NFP to perform the basic functions required by the IHR for reporting and response to health emergencies. *
  8. Conduct IHR NFP-led orientation events for relevant stakeholders and sectors. *
  9. Update regularly the IHR NFP list of focal points in relevant sectors

04 DEMONSTRATED CAPACITY

  1. Raise and maintain awareness about the functions of the IHR NFP among senior leadership and technical levels across relevant government sectors through briefing and dissemination of materials. *
  2. Increase IHR awareness among communities, partners and the media by organizing information and education campaigns and consider adding IHR NFP awareness and training to postgraduate curricula for public health and other relevant educational disciplines. *
  3. Conduct SimEx/AAR/IAR (as relevant) to monitor and evaluate the functionality of IHR NFP at national and levels, and apply lessons learned to prioritize actions within relevant national action plans. *
  4. Conduct trainings of new and existing IHR NFP staff and relevant stakeholders necessary for proper function of the IHR NFP, review SOPs and training materials on a regular basis and modify as necessary at the national and subnational levels to ensure a sufficient number of trained multisectoral experts. *
  5. Identify and evaluate challenges to efficient cross-sectoral collaboration necessary for proper functioning of the IHR NFP, including in decision-making processes across sectors. *

05 SUSTAINABLE CAPACITY

  1. Dedicate sustained resources (i.e. financial, human and technical) that are accessible and available for IHR NFP activities. *
  2. Facilitate continuous quality improvement of IHR NFP functionality by leading national multidisciplinary risk assessment processes in line with Annex 2 of the IHR. *
  3. Regularly monitor cross-sectoral surveillance mechanisms and evaluate the response to health emergencies at national and subnational levels. *
  4. Identify, document and address key bottlenecks and gaps in IHR NFP functionalities based on M&E results. *
  5. Document and share lessons learned and best practices related to IHR NFP. *
  6. Facilitate and engage country in peer-to-peer learning programmes at the subnational, national and international levels. *

Benchmark 3.2

Multisectoral IHR coordination mechanism effectively supports the implementation of prevention, detection and response activities

Objective To establish a multisectoral IHR coordination mechanism to support the implementation of prevention, detection and response activities

01 NO CAPACITY

  1. No multisectoral coordination mechanism exists.

02 LIMITED CAPACITY

  1. Define the scope of a multisectoral coordination committee and conduct a stakeholder analysis to identify key entities that should be involved in a multisectoral coordination mechanism for IHR. *
  2. Establish a multisectoral coordination committee that meets regularly to discuss and promote IHR issues and establish, activate and maintain the mechanism. *
  3. Draft ToRs that specify how the multisectoral coordination committee and operations of the multisectoral coordination mechanism reinforce priorities of the IHR NFP. *
  4. Develop a work plan that specifies priority functions and activities of the multisectoral coordination mechanism to develop a protocol, ToRs and identify resources needed for the mechanism (including among private organizations and NGOs). *
  5. Conduct an IHR performance of veterinary services (PVS) National Bridging Workshop, document findings and incorporate into multisectoral coordination mechanism to address zoonoses *
  6. Designate focal points in relevant sectors to participate in the multisectoral coordination committee.
  7. Participate in the IHR-PVS National Bridging Workshop by veterinary services and other relevant sectors.
  8. Conduct a World Organisation for Animal Health (WOAH) PVS evaluation, document findings and incorporate into multisectoral coordination mechanism to address zoonoses and other existing or new events at the human-animal interface.

03 DEVELOPED CAPACITY

  1. Conduct regular meetings of the multisectoral coordination mechanism to advance its mandate and trigger action, ensuring that outcomes of these meetings are promoted among external and internal stakeholders across sectors at the national level. *
  2. Sensitize stakeholders from national level ministries, agencies, departments and partners to the purpose, role and priorities of the multisectoral coordination mechanism and committee. *
  3. Mobilize the multisectoral coordination mechanism at national level by enacting formal MoUs or other formal and legal documents with multisectoral stakeholders whose engagement in IHR implementation is necessary. *
  4. Develop and test a system to assess how the multisectoral coordination mechanism is working to address zoonotic diseases, food safety and other existing or new health events at the human-animal interface at national and subnational levels. *
  5. Host trainings for experts from relevant sectors on the IHR aimed at promoting multisectoral coordination in IHR implementation *
  6. Institutionalize One Health coordination mechanisms (One Health platform/committee).

04 DEMONSTRATED CAPACITY

  1. Conduct regular meetings of the multisectoral coordination mechanism to advance its mandate and trigger actions, ensuring that outcomes of meetings are promoted among external and internal stakeholders across sectors at the national and subnational levels. *
  2. Mobilize the multisectoral coordination mechanism at subnational level by enacting formal MoUs or other formal and legal documents with intermediate multisectoral stakeholders whose engagement in IHR implementation is necessary. *
  3. Routinely monitor and evaluate the functionality of the multisectoral coordination mechanism at both the national and subnational levels through systematic approaches, such as routine data collection and SimEx/AAR/IAR (as relevant). *
  4. Document and disseminate evidence on how effective the multisectoral coordination mechanism is working to manage cross-sectoral public health issues (foodborne diseases, zoonotic diseases, etc.). *
  5. Develop a system to assess how multisectoral coordination mechanism is working to address chemical safety among stakeholders from relevant sectors at national and subnational level. *
  6. Develop a budget for sustained operation of multisectoral coordination mechanism and advocate for its full adoption. *

05 SUSTAINABLE CAPACITY

  1. Allocate funding for sustained operation of the multisectoral coordination mechanism. *
  2. Routinely revise or update existing strategies, guidelines and SOPs for the multisectoral coordination mechanism based on lessons learned from M&E. *
  3. Develop a system to assess how the multisectoral coordination mechanism is working to address radiation emergencies among stakeholders from relevant sectors and safety authorities at national and subnational level. *
  4. Document and share best practices for multisectoral coordination mechanism, and engage country in peer-to-peer learning programmes at the subnational, national and international levels. *

Benchmark 3.3

Strategic planning for IHR, preparedness or health security are in place and supported by functional advocacy mechanisms for IHR implementation

Objective To develop, implement and monitor a national action plan for IHR, preparedness or health security and ensure functional advocacy mechanisms for high level support of health emergency preparedness and IHR implementation 

01 NO CAPACITY

  1. There is no national action plan for IHR, preparedness or health security.
  2. Planning and capacity development for IHR implementation is not supported by advocacy mechanisms or activities are conducted on an ad hoc basis.

02 LIMITED CAPACITY

  1. Identify gaps in health emergency preparedness and IHR implementation by synthesizing results from recent IHR monitoring and evaluation framework (MEF) approaches, assessments and implementation data from existing plans. *
  2. Convene technical area leads to prioritize actions based on synthesized results and recommendations and establish a multisectoral working group to develop national action plan for IHR, preparedness or health security. *
  3. Compile priority actions into a draft national action plan for implementation, cost the plan and map financial and technical gaps as well as available resources to support implementation. *
  4. Conduct stakeholder analysis and mapping to identify actors (ranging from technical area implementers to high level decision makers) from the public and private sectors who are relevant to improving national capacity for IHR implementation. *
  5. Conduct a situational analysis to understand current awareness and contribution to health emergency preparedness and IHR implementation from key policy influencers and national level decision-makers to identify the degree of priority given at the governance level of the country to health security. *
  6. Analyse government policy, priority guidelines of the national government and annual budget allocations in relation to health emergency preparedness and IHR implementation. *
  7. Identify advocacy objectives based on evidence analysis to achieve policy changes and develop an advocacy strategy for gaining whole-of-government and whole-of-society commitments to health emergency preparedness and IHR implementation. *

03 DEVELOPED CAPACITY

  1. Support dissemination of advocacy messages, through effective advocacy channels of the relevant sector, to the highest-level authorities, decision-makers and relevant ministers to improve compliance with multisectoral action for IHR implementation.
  2. Dedicate time in the national governance body (such as parliament) to discuss health emergency preparedness, health security and IHR implementation.
  3. Participate in relevant advisory committees/steering committees of relevant sectors and ministries.
  4. Apply a whole-of-government and whole-of-society approach (including private sector) to identify stakeholders who can contribute to the promotion of IHR implementation
  5. Engage the multisectoral working group to finalize a national action plan for IHR, preparedness or health security, involving relevant sectors across the government. *
  6. Identify offices and individuals in the government who can promote and/or provide avenues for promotion of national action plans (such as NAPHS) and IHR implementation. *
  7. Engage high level decision makers to obtain formal endorsement and adoption of the national action plans (such as NAPHS). *
  8. Disseminate national action plans (such as NAPHS) to all departments, ministries, agencies and partners responsible for implementation. *
  9. Confirm availability and accessibility of the national action plans (such as NAPHS) for stakeholders as well as any guidelines and SOPs needed for IHR implementation. *
  10. Develop and disseminate advocacy messages and materials for raising awareness across government and at all levels on the national action plans (such as NAPHS) and importance of IHR implementation to the country (e.g. by introducing IHR implementation and health emergency preparedness as an economic case). *
  11. Identify and utilize effective advocacy channels, mechanisms, people or groups who can lead disseminating advocacy messages and materials, including media, at national level. *
  12. Develop training materials to improve advocacy capacity for IHR implementation among key stakeholders in relevant sectors and advocacy groups at national level. *
  13. Prepare and disseminate to national level decision-makers, including situational updates and advocacy messages pertaining to health security concerns, health emergency preparedness and IHR implementation before parliamentary engagements. *

04 DEMONSTRATED CAPACITY

  1. Develop a plan for routine monitoring and accountability for implementation of the national action plans (such as NAPHS). *
  2. Develop processes to incorporate SPAR, Joint External Evaluation (JEE), SimEx/AAR/IAR results (as relevant), recommendations and gaps in national action plans (such as NAPHS). *
  3. Define the processes for routine implementation tracking to ensure accountability among stakeholders and includes the key elements of data-driven decision-making: collection, collation, analysis and dissemination of data. *
  4. Organize regular SimEx/AAR/IAR (as relevant) as part of the IHR MEF programme for assessing the potential functionality of IHR capacities to prevent, detect and respond to health emergencies. Ensure that outcomes and key findings are shared with all relevant stakeholders and that plans are updated accordingly, based on outcomes and recommendations *
  5. Conduct a situational analysis to identify gaps in IHR implementation at subnational and local levels that require influence from political authorities and decision-makers. *
  6. Expand and adapt national advocacy strategies to subnational and local levels to disseminate key messages and materials and activate political will for health emergency preparedness and IHR implementation. *
  7. Conduct training on advocacy for IHR implementation and health emergency preparedness for key stakeholders in relevant sectors at the subnational level. *
  8. Provide support, by relevant sectors, at subnational level for advocacy mechanism for health emergency preparedness and IHR implementation through sector-specific advocacy channels to improve compliance for IHR implementation.

05 SUSTAINABLE CAPACITY

  1. Review implementation progress for the national and subnational (if applicable) action plans on a quarterly basis to identify key implementation successes, gaps and recommendations for addressing gaps. *
  2. Regularly (i.e. quarterly) update all relevant stakeholders, ranging from implementers to high level decision makers, on key implementation progress, barriers and recommendations for improvement. *
  3. Facilitate annual reviews of national action plans (such as NAPHS) to ensure that it is updated, costed and resourced each year, based on implementation data and recommendations drawn from other capacity assessments. *
  4. Develop policies to support the development and implementation of national action plans for IHR implementation, preparedness and/or health security. *
  5. Document and share best practices, challenges and lessons learned related to national action plans (such as NAPHS) development, implementation and advocacy across relevant sectors and with other countries through bilateral and international engagements, including capacity-building programmes. *
  6. Collaborate with advocacy experts to influence policy makers and decision-makers at all levels to ensure that health emergency preparedness and IHR implementation remain a priority in the political agenda, with whole-of-government and whole-of-society approaches. *
  7. Advocacy strategies and mechanisms are reviewed and updated regularly. *
  8. Routinely assess and annually update and allocate resources for advocacy strategies at the national and subnational levels. . *

* Participation and contribution of other sectors to action.

Tools