who benchmarks for international health regulations (ihr
TRANSCRIPT
WHO BENCHMARKS for International Health Regulations (IHR) Capacities
FEBRUARY 2019
Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”.
Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.
SUGGESTED CITATION. WHO Benchmarks for International Health Regulations (IHR) Capacities. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.
SALES, RIGHTS AND LICENSING. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing.
THIRD-PARTY MATERIALS. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user.
CATALOGUING-IN-PUBLICATION (CIP) DATA. CIP data are available at http://apps.who.int/iris.
© WORLD HEALTH ORGANIZATION 2019
WHO Benchmarks for International Health Regulations (IHR) CapacitiesISBN 978-92-4-151542-9
GENERAL DISCLAIMERS. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.
The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.
Les Pandas Roux, France
WHO BENCHMARKS FOR IHR CAPACITIES
2
ACRONYMS 4
ANNEX 1: GLOSSARY 135
ACKNOWLEDGEMENT 5
INTRODUCTION 6
WHAT IS THE BENCHMARK TOOL? 6
PURPOSE OF THE BENCHMARK TOOL 6
WHO IS THE AUDIENCE? 6
DEVELOPMENT PROCESS OF THE TOOL 7
STRUCTURE OF THE TOOL 7
DEFINITIONS 7
BUILDING SYSTEM USING THE BENCHMARKS 8
WHEN TO USE THE BENCHMARK TOOL? 8
HOW TO USE THE BENCHMARK TOOL? 8
WHAT IS THE TOOL ABOUT? 11
WHAT IS THE TOOL NOT ABOUT? 11
PROPOSED REVIEW AND UPDATING THE TOOL 11
BENCHMARKS: TECHNICAL AREAS 12
1. NATIONAL LEGISLATION, POLICY AND FINANCING 13
2. IHR COORDINATION, COMMUNICATION AND ADVOCACY AND REPORTING 21
3. ANTIMICROBIAL RESISTANCE 26
4. ZOONOTIC DISEASE 36
5. FOOD SAFETY 41
6. IMMUNIZATION 47
7. NATIONAL LABORATORY SYSTEM 54
8. BIOSAFETY AND BIOSECURITY 63
9. SURVEILLANCE 69
10. HUMAN RESOURCES 77
11. EMERGENCY PREPAREDNESS 89
12. EMERGENCY RESPONSE OPERATIONS 95
13. LINKING PUBLIC HEALTH AND SECURITY AUTHORITIES 102
14. MEDICAL COUNTERMEASURES AND PERSONNEL DEPLOYMENT 106
15. RISK COMMUNICATION 113
16. POINTS OF ENTRY 121
17. CHEMICAL EVENTS 127
18. RADIATION EMERGENCIES 131
TABLE OF CONTENT
WHO BENCHMARKS FOR IHR CAPACITIES
3
ACRONYMS
AEFI adverse event following immunization
AMR antimicrobial resistance
BTWC Biological and Toxin Weapons Convention
EMT emergency medical team
EOC emergency operations centre
FAO Food and Agriculture Organization
GLASS Global Antimicrobial Resistance Surveillance System
GOARN Global Outbreak Alert and Response Network
IAEA International Atomic Energy Agency
IHR International Health Regulations
INFOSAN International Food Safety Authorities Network
INTERPOL International Criminal Police Organization
IPCAT infection prevention and control (IPC) assessment tool
IT information technology
JEE joint external evaluation
MCV measles-containing vaccine
NAPHS National Action Plan for Health Security
NCC National Coordinating Centre
NFP IHR national focal point
OIE World Organisation for Animal Health
OPCW Organisation for the Prohibition of Chemical Weapons
PVS performance of veterinary services
SOP standard operating procedure
SPAR IHR self-assessment annual reporting tool
VPDs vaccine-preventable diseases
WASH water, sanitation and hygiene
WASH FIT water and sanitation for health facility improvement tool
WHA World Health Assembly
WHO World Health Organization
WHO BENCHMARKS FOR IHR CAPACITIES
4
ACKNOWLEDGEMENT
The World Health Organization (WHO) would like to express sincere gratitude to all those who contributed to the development of the WHO Benchmarks for IHR Capacities (Benchmarks Tool).
The tool was developed by Dr Nirmal Kandel, Dr Qudsia Huda and Dr Stella Chungong with contributions from their colleagues – Mr Adam Bradshaw, Dr Benedetta Allegranzi, Mr David Bennitz, Dr Elizabeth Mumford, Ms Elizabeth Taylor, Mr Fernando Gonzalez-Martin, Dr Giorgio Cometto, Dr Ian Norton, Mr Jonathan Abrahams, Dr Jose Guerra, Ms Julie Storr, Ms Joanna H Tempowski, Dr Jostacio Lapitan, Dr Jun Xing, Dr Kazunobu Kojima, Dr Kersten Gutschmidt, Dr Lucy Boulanger, Dr Ninglan Wang, Mr Phillippe Gasquet, Dr Sebastian Cognat, Dr Sergez R Eremin, Dr Stéphane De La Rocque and Ms Yuki Minato – at WHO headquarters.
Special thanks go to Dr Ambrose Talisuna, Dr Ali Ahmed Yahaya, Dr Dalia Samhouri, Dr Gyanendra Gongal, Dr Karen Nahapetyan, Dr Masaya Kato, Dr Muang Muang Htike, Mr Nicolas Isla, Dr Nilesh Buddh, Dr Roberta Andraghetti and Mr Vasily Esenamanov, for providing inputs from WHO regional offices.
Sincere gratitude to all the members of a technical working group: Dr Janneth Mghamba, Dr Jaouad Mahjour, Dr Mahmudur Rahman, Dr Nirmal Kandel, Dr Stella Chungong, and Dr Thomas R Frieden.
The WHO is grateful to the following partners and their teams who provided technical inputs in the tool: African Centres for Disease Control and Prevention (Africa CDC), United States Centers for Disease Control and Prevention (US CDC), Public Health England (PHE), Resolve to Save Lives, and The South Asia Field Epidemiology and Technology Network (SAFETYNET).
WHO BENCHMARKS FOR IHR CAPACITIES
5
INTRODUCTION
WHAT IS THE BENCHMARK TOOL?Benchmarking is a strategic process often used by businesses and institutes to standardize performance in relation to best practices of their sector. World Health Organization (WHO) and its partners have developed a tool with a list of benchmarks and corresponding actions that can be applied to increase the performance of countries in emergency preparedness through the development and implementation of a National Action Plan for Health Security (NAPHS). The WHO Benchmarks for International Health Regulations 2005 (IHR/IHR (2005)) Capacities are broad in nature to improve IHR capacities for health security and integrate multisectoral concerns at subnational (local and regional/provincial) and national levels. This means that if all benchmarks are achieved and sustained, the level of preparedness of the country would be optimum to prevent, detect and respond to threats and events.
PURPOSE OF THE BENCHMARK TOOLThis document guides States Parties, partners, donors and international and national organizations on suggested actions needed to improve IHR capacities for health security. States Parties and other entities working to reduce the risk of global health threats can use these benchmarks and suggested actions to address gaps, including those identified by IHR monitoring and evaluation framework1 components such as the States Party self-assessment annual
reporting tool, voluntary external evaluation such as the joint external evaluation (JEE), after-action reviews and simulation exercises. This document can help countries delineate the relevant steps they can take to reach capacity levels as defined in each benchmark.
WHO IS THE AUDIENCE?The main audiences for this benchmark document are:
States Parties to the IHR, to develop activities for the NAPHS.Cl inical agencies, civi l society and special ized organizat ions at local , subnational, national, regional and global levels, to support the implementation of the NAPHS.Development partners, to confirm that their health security assistance is consistent with evolving needs and to provide objective milestones to help guide and determine the effectiveness of assistance.WHO Secretariat, to be able to promote and monitor consistency of IHR progress and NAPHS implementation.WHO country and regional offices, to be able to prioritize assistance.
1 IHR monitoring and evaluation framework (https://www.who.int/ihr/publications/WHO-WHE-CPI-2018.51/en/, accessed 30 January 2019).
WHO BENCHMARKS FOR IHR CAPACITIES
6
For the propose of this document the following definitions are used:
BENCHMARK Denotes a standard or point of reference for the capacity. Setting benchmarks facilitates the development of plans to increase capacity levels (limited, developed, demonstrated and sustainable) and adopt best practices with a target of reaching sustainable capacity for each benchmark.
ACTION Denotes a set of activities in each capacity level of the benchmark. These actions define the steps that need to be taken to progress from one level to the next for the given benchmarks.
DEVELOPMENT PROCESS OF THE TOOLFollowing the recommendation of the IHR review committee on second extensions for establishing national public health capacities and on IHR Implementation, the WHO Secretariat developed the IHR monitoring and evaluation framework and through global consultations developed monitoring and evaluation tools such as the new IHR States Parties self-assessment annual reporting tool (SPAR) and the JEE.
In May 2018, as per the decision of the Seventy-first World Health Assembly decision on the implementation of the IHR five-year global strategic plan to improve public health preparedness and response, 2018–2023,2 the WHO Secretariat commenced to develop the benchmark tool with suggested actions at each capacity level for the technical areas or capacities that can capture the outcome of the different monitoring and evaluation processes (such as the SPAR and the JEE), which inform the development of national action plans for health security.3 These suggested actions can provide guidance to develop activities to build capacity needed to move from one capacity level to the next; stepping up from level 1 to 2, and 2 to 3 and beyond.
A preliminary draft of this document was shared with a working group of technical experts. Feedback was incorporated, and the revised tool was subsequently piloted and finalized.
STRUCTURE OF THE TOOLThe tool covers all 13 IHR capacities described in the SPAR and 19 technical areas described in the JEE tool that are needed to prevent, detect, assess, notify
and respond to public health risks and acute events of domestic and international concern. For each area, one to four indicators is used to assess the country’s progress towards implementation of the individual capacity, as assessed at five levels. The benchmark tool reflects the amalgam between the JEE and the new annual reporting tool so that all the essential actions required for each level are captured. Where necessary, all essential actions that are not reflected in both the tools are added to corresponding capacity levels of each benchmark. Some capacities and technical areas requiring similar types of actions for incremental progress have been combined, notably IHR coordination and reporting, national laboratory system and biosafety and biosecurity.
DEFINITIONS
2 Implementation of the International Health Regulations (2005): five-year global strategic plan to improve public health preparedness and response, 2018–2023. Seventy-First World Health Assembly Provisional Agenda Item 11.2. WHA71(15) 26 May 2018 (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71(15)-en.pdf, accessed 30 January 2019).3 Public health preparedness and response. Seventy-First World Health Assembly Provisional Agenda Item 11.2. 11 April 2018 (http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_8-en.pdf, accessed 30 January 2019).
WHO BENCHMARKS FOR IHR CAPACITIES
7
BUILDING SYSTEM USING THE BENCHMARKSCollective and coordinated actions described in the benchmarks assist countries in strengthening a system for health security. The system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health security. These benchmark actions are necessary to strengthen health systems capacity (preparedness capacity) of countries to prevent, detect and respond to threats and events. These benchmark actions serve the following three purposes of strengthening the system. First, they allow a definition of desirable attributes – what actions are required for health security at each level of the benchmark. Second, they provide a way of defining health security priorities for countries, development partners and the WHO. Third, they provide a useful way of clarifying essential actions that require a more integrated response and recognize the interdependence of each action of the benchmarks.
WHEN TO USE THE BENCHMARK TOOL?The tool should be used during the planning process when a planning team is identifying and prioritizing activities for the various steps of the NAPHS framework.4
HOW TO USE THE BENCHMARK TOOL?The tool provides a set of actions for each level. When translating priority actions from the evaluation findings, benchmark actions can guide the development of activities in a stepwise process:
R e v i e w t h e p r i o r i t y recommendations based on the situation analysis of the selected technical areas.
Review the benchmark actions and determine wh ich capac i ty l eve l a county would like to achieve. The planning team can use actions mentioned in the tool.
Identify the actions that countries need to establish to achieve the selected level.
Develop a list of activities fo r each act ion that countries need to put in place to achieve the desired level for all actions.
STEP
STEP
STEP
STEP
01
02
03
04
4 NAPHS for all: a 3 step strategic framework for national action plan for health security. Geneva: World Health Organization; 2018 (http://apps.who.int/iris/bitstream/handle/10665/278961/WHO-WHE-CPI-2018.52-eng.pdf, accessed 30 January 2019).
WHO BENCHMARKS FOR IHR CAPACITIES
8
The above figure is an example of applying the benchmark to the recommendations. The priority recommendation is to “establish event-based surveillance.” Benchmark actions are then used to identify or develop activities. The benchmark tool provides a set of actions to develop and establish event-based surveillance. To establish event-based surveillance, the country should have guidelines and standard operating procedures (SOPs). They can select the actions and elaborate activities that are required for that action depending on the country context while drafting the plan.
Benchmark actions may additionally be used to help develop priority recommendations during the JEE or to help track incremental progress made from one level to the next.
Establish
event-based
surveillance.
Develop guidelines and standard
operating procedures (SOPs).
Establish a designated unit at all needed
levels with an operational plan and
procedures.
Develop and put in place case
definitions and the process of detection,
assessment and reporting of the event
(clusters or outbreaks) for country
priority diseases, and disseminate to
national and subnational levels.
Establish a process to capture events
from the community (people from the
community identified, verification teams
at facilities identified, SOPs and flow
of information available) and make the
data available at all needed levels.
Establish systems to capture events
from various other sources (such as
media, social media, private sectors).
Form a working group to develop
guidelines and SOPs for event-based
surveillance.
Identify a focal point for drafting
working documents.
Finalize the guidelines and SOPs.
Develop a training package to roll out
the guidelines and SOPs.
Conduct five trainings (one at the
national level and four at the regional
level).
PRIORITY
RECOMMENDATION
BENCHMARK ACTIONS FOR EVENT-BASED
SURVEILLANCE
IDENTIFY AND DEVELOP ACTIVITIES
WHO BENCHMARKS FOR IHR CAPACITIES
9
CAPACITY
LEVEL
ACTIONS TAKEN TO GO UP ONE STEP TO BEING BETTER PREPAREDThese suggested standardized actions define the steps to be taken to move from one capacity level to the next. For example, actions listed in level 2 are suggested actions to achieve limited capacity.
01NO CAPACITY
The country has to develop and implement all activities listed in level 2 to achieve the limited capacity for each function.
02LIMITED
CAPACITY
ACTIONS TO ACHIEVE THIS LEVEL:
Conduct relevant stakeholder analysis and disseminate to those who need a list of stakeholders, points of contact for each stakeholder, and establish communication channels to support collaboration and coordination.
Identify the people or units responsible for disseminating policy for implementation.
Establish and document how implementation will occur and be reported. Conduct and disseminate detailed assessment of gaps, needs and plans
to support effective implementation.
03DEVELOPED
CAPACITY
ACTIONS TO ACHIEVE THIS LEVEL:
Develop and implement procedures, processes and plans at national level. Develop training materials and train some staff, at least at the national level. Establish systems to manage a minimum number of risks.
04DEMONSTRATED
CAPACITY
ACTIONS TO ACHIEVE THIS LEVEL:
Integrate capacities tested by actual events or exercises and found to be functional into routine systems.
All staff are trained at national and subnational levels. Outliers are identified, and steps are taken to address these outliers. Systems are functioning at all levels of the health system.
05SUSTAINABLE
CAPACITY
ACTIONS TO ACHIEVE THIS LEVEL:
Systems and capacities are now sustainable, including fully funded ones. Monitoring and evaluation occur systematically, and accreditation/certification
is done in a transparent manner. Evidence-based metrics are met (such as reporting in 24 hours). Collaboration/information is shared with other countries as needed and
appropriate.
WHO BENCHMARKS FOR IHR CAPACITIES
10
WHAT IS THE TOOL ABOUT? A list of benchmarks that is required to sustain
IHR capacities. A list of actions that can increase IHR capacities. Is informed by technical experts. A starting point for development of a technically
sound plan for health security.
WHAT IS THE TOOL NOT ABOUT? A list of mandatory activities. Completely applicable to every context. An exhaustive list of actions/recommendations.
PROPOSED REVIEW AND UPDATING THE TOOLOnline materials will be developed and shared to help areas step up preparedness, and the tool will be updated following implementation.
WHO BENCHMARKS FOR IHR CAPACITIES
11
BEN
CHM
ARKS
:TE
CHN
ICAL
ARE
AS
WHO BENCHMARKS FOR IHR CAPACITIES
12
NAT
ION
AL L
EGIS
LATI
ON
, PO
LICY
AN
D FI
NAN
CIN
G
01LE
GIS
LATI
ON
AN
D P
OLI
CY:
An a
dequ
ate
lega
l fra
mew
ork
for S
tate
s Pa
rtie
s is
ess
entia
l to
supp
ort a
nd e
nabl
e th
e im
plem
enta
tion
of a
ll th
eir o
blig
atio
ns a
nd ri
ghts
of t
he
IHR
. Thi
s ca
n in
clud
e th
e cr
eatio
n of
new
legi
slat
ion
and/
or th
e re
visi
on o
f exi
stin
g le
gisl
atio
n, re
gula
tions
or o
ther
inst
rum
ents
to fa
cilit
ate
impl
emen
tatio
n an
d co
mpl
ianc
e w
ith IH
R (2
005)
. A la
ck o
f app
ropr
iate
legi
slat
ion
or p
olic
y ca
n be
a m
ajor
bar
rier t
o im
plem
enta
tion
and
shou
ld
be c
onsi
dere
d a
prio
rity
to e
nabl
e ot
her t
echn
ical
are
as to
be
impl
emen
ted
effe
ctiv
ely.
FIN
AN
CE:
Stat
es P
artie
s sh
ould
hav
e th
e pr
ovis
ion
of a
dequ
ate
fund
ing
for I
HR
impl
emen
tatio
n th
roug
h th
e na
tiona
l bud
get o
r oth
er m
echa
nism
s. T
he
coun
try
shou
ld h
ave
acce
ss to
fina
ncia
l res
ourc
es th
at c
an b
e ac
cess
ed o
n tim
e an
d di
strib
uted
in re
spon
se to
pub
lic h
ealth
em
erge
ncie
s fo
r tim
ely
and
adeq
uate
pre
pare
dnes
s an
d re
spon
se.
IMPA
CT:
Legi
slat
ion
and
finan
cing
is in
pla
ce in
all
rele
vant
sec
tors
to s
uppo
rt IH
R im
plem
enta
tion
incl
udin
g re
leva
nt c
ore
capa
city
dev
elop
men
t and
m
aint
enan
ce.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Cur
rent
legi
slat
ion
incl
udin
g la
ws,
regu
latio
ns, a
dmin
istra
tive
requ
irem
ents
, pol
icie
s or
oth
er g
over
nmen
t ins
trum
ents
, pro
ven
to b
e ad
equa
te
in a
ll rel
evan
t sec
tors
to s
uppo
rt IH
R im
plem
enta
tion.
(2) A
dequ
ate
finan
ces
avai
labl
e to
ena
ble
timel
y, ef
ficie
nt a
nd e
ffect
ive
IHR
impl
emen
tatio
n an
d re
spon
se to
all p
ublic
hea
lth e
mer
genc
ies.
WHO BENCHMARKS FOR IHR CAPACITIES
13
CAPA
CITY
LEVE
L
Benc
hmar
k 1.
1: D
omes
tic le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts a
re a
vaila
ble
in a
ll re
leva
nt
sect
ors
and
effe
ctiv
ely
enab
le c
ompl
ianc
e w
ith th
e IH
RO
bjec
tive:
To
asse
ss, a
djus
t and
alig
n do
mes
tic le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts in
all
rele
vant
sec
tors
to e
nabl
e co
mpl
ianc
e w
ith th
e IH
R
01N
O C
APAC
ITY
No
asse
ssm
ent o
f rel
evan
t leg
isla
tion,
law
s, re
gula
tions
, pol
icy
and
adm
inis
trat
ive
requ
irem
ents
, and
oth
er g
over
nmen
t in
stru
men
ts fo
r IH
R im
plem
enta
tion.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d co
nven
e ke
y st
akeh
olde
rs re
late
d to
the
revi
ew, f
orm
ulat
ion
and
impl
emen
tatio
n of
legi
slat
ion
and
polic
ies.
As
sess
cur
rent
rele
vant
legi
slat
ion,
law
s, re
gula
tions
, pol
icy
and
adm
inis
trat
ive
requ
irem
ents
for I
HR
impl
emen
tatio
n an
d id
entif
y ga
ps, i
nclu
ding
for r
epor
ting,
pre
vent
ion
and
cont
rol.
D
evel
op a
n im
plem
enta
tion
plan
for t
he fo
rmul
atio
n/re
visi
on/a
djus
tmen
t and
app
rova
l of p
riorit
ized
legi
slat
ion/
regu
latio
ns
and
polic
y (in
clud
ing
regu
lato
ry o
r par
liam
enta
ry p
roce
ss b
ased
on
the
coun
try’
s pr
actic
es, a
s ne
cess
ary)
.
Dev
elop
adv
ocac
y m
ater
ials
and
pac
kage
to ra
ise
awar
enes
s of
the
requ
irem
ents
of a
djus
tmen
ts to
par
liam
enta
rians
, go
vern
men
t, op
posi
tions
and
oth
er re
leva
nt s
take
hold
ers.
D
evel
op a
n or
ient
atio
n pa
ckag
e to
impl
emen
t the
legi
slat
ion,
law
s, re
gula
tions
, pol
icy
and
adm
inis
trat
ive
requ
irem
ents
. I
dent
ify le
gisl
ative
/pol
icy
cham
pion
(s) o
r bro
ker(s
) who
can
adv
ocat
e fo
r the
law
or p
olic
y to
reac
h a
succ
essf
ul e
nd s
tate
.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t an
orie
ntat
ion
with
rele
vant
sta
keho
lder
s re
gard
ing
adju
stm
ent i
n th
e le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts.
D
evel
op a
mec
hani
sm to
impl
emen
t the
se le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts.
D
ocum
ent t
he e
xist
ence
and
use
of a
ppro
pria
te le
gisl
atio
n in
all
rele
vant
sec
tors
invo
lved
in IH
R im
plem
enta
tion.
D
evel
op o
r adj
ust t
he le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts fo
r im
plem
enta
tion
of IH
R ca
paci
ties
for f
ood
safe
ty, a
nd if
requ
ired
for c
hem
ical
saf
ety.
WHO BENCHMARKS FOR IHR CAPACITIES
14
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
the
use
of re
leva
nt le
gisl
atio
n, la
ws,
regu
latio
ns, p
olic
y an
d ad
min
istr
ativ
e re
quire
men
ts, a
nd d
eter
min
e w
heth
er th
ey
cove
r mos
t asp
ects
of I
HR
impl
emen
tatio
n.
Iden
tify
spec
ific
area
s5 tha
t req
uire
legi
slat
ion
refe
renc
es (t
hese
are
refe
renc
e la
ws
or re
gula
tions
that
can
sup
port
IHR
impl
emen
tatio
n) s
uch
as e
stab
lishi
ng th
e IH
R na
tiona
l foc
al p
oint
(NFP
) or t
o m
anda
te th
e op
erat
ion.
D
evel
op o
r doc
umen
t leg
isla
tion
refe
renc
es fo
r che
mic
al s
afet
y an
d ra
diat
ion
emer
genc
y th
at c
ontr
ibut
e to
che
mic
al a
nd
radi
o-nu
clea
r eve
nts
prep
ared
ness
, det
ectio
n an
d re
spon
se.
D
ocum
ent t
hese
legi
slat
ion
refe
renc
es a
nd re
leva
nt in
terp
reta
tions
that
can
ass
ist i
n IH
R im
plem
enta
tion.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nfirm
that
rele
vant
legi
slat
ion,
law
s, re
gula
tions
, pol
icy
and
adm
inis
trat
ive
requ
irem
ents
cov
er a
ll as
pect
s of
IHR
impl
emen
tatio
n ba
sed
on th
e ris
k pr
ofile
of t
he c
ount
ry.
D
evel
op o
r doc
umen
t leg
isla
tion
refe
renc
es fo
r any
out
stan
ding
issu
es (i
nclu
ding
radi
atio
n em
erge
ncie
s) th
at c
ontr
ibut
e to
pr
epar
edne
ss, d
etec
tion
and
resp
onse
.
Doc
umen
t the
se le
gisl
atio
n re
fere
nces
and
rele
vant
inte
rpre
tatio
ns th
at c
an a
ssis
t in
IHR
impl
emen
tatio
n.
5 The
se a
re a
reas
not
spe
cific
ally
add
ress
ed b
y ex
istin
g la
ws
or re
gula
tions
.
WHO BENCHMARKS FOR IHR CAPACITIES
15
CAPA
CITY
LEVE
L
Benc
hmar
k 1.
2: F
inan
cing
6 is
avai
labl
e fo
r the
impl
emen
tatio
n of
IHR
capa
citie
sO
bjec
tive:
To
ensu
re fi
nanc
ing
is a
vaila
ble
for t
he im
plem
enta
tion
of IH
R ca
paci
ties
01N
O C
APAC
ITY
No
budg
et li
ne o
r bud
geta
ry a
lloca
tion7 a
vaila
ble
to fi
nanc
e th
e im
plem
enta
tion
of IH
R ca
paci
ties,
and
fina
ncin
g is
han
dled
th
roug
h ex
trab
udge
tary
mea
ns8 .
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d co
nven
e ke
y st
akeh
olde
rs re
late
d to
the
revi
ew o
f fina
ncin
g fo
r im
plem
enta
tion
of IH
R ca
paci
ties,
incl
udin
g bu
dget
ary
allo
catio
n an
d ex
tern
al c
ontr
ibut
ion
for t
he im
plem
enta
tion
of IH
R ca
paci
ties.
Re
view
the
natio
nal a
ctio
n pl
an o
r any
rele
vant
pla
n fo
r the
impl
emen
tatio
n of
IHR
capa
citie
s (if
not
dev
elop
ed, f
ollo
w
guid
elin
es a
nd d
evel
op th
e na
tiona
l act
ion
plan
).
Revi
ew th
e co
st e
stim
ates
and
cur
rent
ly a
vaila
ble
fund
s fo
r the
impl
emen
tatio
n of
IHR
capa
citie
s; if
a c
oste
d pl
an is
no
t ava
ilabl
e, th
en id
entif
y fo
cal p
oint
s of
key
sta
keho
lder
s an
d de
velo
p th
e co
stin
g. If
nec
essa
ry, h
ire c
ostin
g ex
pert
s to
es
timat
e th
e co
st o
f the
pla
n w
orki
ng c
lose
ly w
ith k
ey te
chni
cal f
ocal
poi
nts
of e
ach
tech
nica
l are
a.
Cond
uct a
reso
urce
map
ping
on
dom
estic
and
/or e
xter
nal f
unds
for t
he im
plem
enta
tion
of IH
R ca
paci
ties.
Al
loca
te th
e bu
dget
, eith
er d
omes
tic o
r ext
erna
l fun
ds, t
o th
e re
leva
nt s
ecto
rs a
nd th
eir r
espe
ctiv
e m
inis
trie
s to
sup
port
the
impl
emen
tatio
n of
IHR
capa
citie
s fo
r bio
logi
cal h
azar
ds a
t the
nat
iona
l lev
el.
D
evel
op th
e re
sour
ce m
obili
zatio
n st
rate
gy a
nd a
dvoc
acy
tool
s fo
r the
fina
ncin
g an
d id
entif
y ke
y st
akeh
olde
rs.
D
evel
op a
mec
hani
sm to
lobb
y fo
r dom
estic
reso
urce
s (b
oth
gove
rnm
ent a
nd p
rivat
e se
ctor
s).
6 Fin
anci
ng re
fers
to fu
nds
and
reso
urce
s id
entifi
ed, a
lloca
ted,
dis
trib
uted
and
exe
cute
d w
ith re
gard
to a
ctiv
ities
and
inte
rven
tions
. It d
oes
not c
onsi
der c
ostin
g or
iden
tifyi
ng h
ow m
any
reso
urce
s or
fund
s ar
e ne
cess
ary
for t
he im
plem
enta
tion
of a
ctiv
ities
or i
nter
vent
ions
. 7 A
bud
get l
ine
exis
ts, a
nd a
bud
get i
s al
loca
ted
(the
budg
et li
ne is
fund
ed).
8 Acc
ount
s he
ld b
y go
vern
men
t bod
ies,
but
not
incl
uded
in th
e go
vern
men
t bud
get.
WHO BENCHMARKS FOR IHR CAPACITIES
16
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
reso
urce
map
ping
sta
tus
to a
lloca
te b
udge
t rat
iona
lly to
eve
ry s
ecto
r at t
he n
atio
nal l
evel
.
Allo
cate
ava
ilabl
e bu
dget
from
dom
estic
and
ext
erna
l sou
rces
for h
uman
hea
lth, v
eter
inar
y pu
blic
hea
lth, a
gric
ultu
re, a
nd a
ll ot
her r
elev
ant m
inis
trie
s or
sec
tors
, to
supp
ort t
he im
plem
enta
tion
of a
ll IH
R ca
paci
ties
at th
e na
tiona
l lev
el.
Im
plem
ent a
nd re
view
the
use
of a
vaila
ble
finan
cing
and
its
effe
ctiv
enes
s.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
reso
urce
map
ping
sta
tus
to ra
tiona
lly a
lloca
te b
udge
t to
ever
y se
ctor
at n
atio
nal a
nd s
ubna
tiona
l lev
els.
Al
loca
te s
uffic
ient
9 bud
get a
t nat
iona
l and
sub
natio
nal l
evel
s fo
r the
impl
emen
tatio
n of
all
IHR
capa
citie
s in
all
rele
vant
m
inis
trie
s or
sec
tors
.
Mon
itor b
udge
t dis
trib
utio
n an
d ex
pend
iture
by
all t
he re
leva
nt m
inis
trie
s at
nat
iona
l and
sub
natio
nal l
evel
s.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t reg
ular
mee
tings
to re
view
impl
emen
tatio
n of
the
allo
cate
d bu
dget
by
all r
elev
ant m
inis
trie
s or
sec
tors
.
Dev
elop
a to
ol to
mon
itor t
hat t
imel
y di
strib
utio
n an
d us
e of
the
budg
et a
re c
oord
inat
ed fo
r act
iviti
es a
nd in
terv
entio
ns to
im
plem
ent I
HR
capa
citie
s.
D
ocum
ent a
nd d
isse
min
ate
info
rmat
ion
on th
e tim
ely
dist
ribut
ion
and
effe
ctiv
e us
e of
fund
s to
incr
ease
hea
lth s
ecur
ity
(suc
h as
pre
vent
ing
or s
topp
ing
the
spre
ad o
f dis
ease
), at
the
natio
nal a
nd s
ubna
tiona
l lev
els
in a
ll re
leva
nt m
inis
trie
s or
se
ctor
s.
9 Thi
s re
fers
to a
cces
s to
fund
s by
rele
vant
min
istr
ies
or g
over
nmen
t bod
ies
for t
he im
plem
enta
tion
of a
ll IH
R ca
paci
ties.
Suf
ficie
ncy
is m
easu
red,
whe
re p
ossi
ble,
by
com
parin
g bu
dget
al
loca
tion
amou
nts
to re
sour
ce n
eeds
iden
tified
in n
atio
nal p
lans
rela
ted
to IH
R an
d/or
hea
lth s
ecur
ity.
WHO BENCHMARKS FOR IHR CAPACITIES
17
CAPA
CITY
LEVE
L
Benc
hmar
k 1.
3: F
inan
cing
ava
ilabl
e fo
r tim
ely
resp
onse
to p
ublic
hea
lth e
mer
genc
ies10
Obj
ectiv
e: T
o de
velo
p a
finan
cing
mec
hani
sm to
ens
ure
that
fund
s ar
e av
aila
ble
for t
imel
y re
spon
se to
pub
lic h
ealth
em
erge
ncie
s
01N
O C
APAC
ITY
N
o m
echa
nism
of fi
nanc
ing
exis
ts to
resp
ond
to p
ublic
hea
lth e
mer
genc
ies.
Fu
nds
are
allo
cate
d an
d di
strib
uted
in a
n ad
hoc
man
ner f
rom
diff
eren
t sou
rces
dur
ing
publ
ic h
ealth
em
erge
ncie
s.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d co
nven
e ke
y st
akeh
olde
rs to
revi
ew th
e st
atus
of t
he e
mer
genc
y fin
anci
ng m
echa
nism
11 to
resp
ond
to p
ublic
he
alth
em
erge
ncie
s.
Revi
ew th
e em
erge
ncy
publ
ic fi
nanc
ing
mec
hani
sm, p
artic
ular
ly th
e ac
cept
ance
and
rapi
d di
strib
utio
n of
fund
s to
resp
ond
to p
ublic
hea
lth e
mer
genc
ies.
Co
nduc
t sta
keho
lder
ana
lysi
s to
iden
tify
dom
estic
and
ext
erna
l par
tner
s w
ho c
an s
uppo
rt m
obili
zing
fund
s du
ring
emer
genc
ies,
and
, if n
eces
sary
and
app
ropr
iate
, est
ablis
h a
mem
oran
dum
of u
nder
stan
ding
with
thes
e st
akeh
olde
rs.
D
evel
op o
r rev
ise
the
mec
hani
sm a
nd s
truc
ture
to re
ceiv
e an
d ra
pidl
y di
strib
ute
fund
s du
ring
emer
genc
ies.
Con
duct
a
sim
ulat
ion
exer
cise
or a
fter-
actio
n re
view
to a
sses
s fu
nctio
nalit
y of
the
new
fina
nce
polic
y or
pro
cedu
res.
Doc
umen
t ou
tcom
es a
nd m
ake
nece
ssar
y ch
ange
s to
opt
imiz
e pr
oced
ure.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
and
ens
ure
func
tiona
lity
of th
e em
erge
ncy
publ
ic fi
nanc
ing
mec
hani
sm, p
artic
ular
ly th
e m
obili
zatio
n of
fund
s w
hen
need
ed a
t the
nat
iona
l, st
ate,
pro
vinc
ial a
nd re
gion
al le
vels
for a
ll re
leva
nt s
ecto
rs.
D
evel
op a
nd d
isse
min
ate
prot
ocol
s or
mec
hani
sms
for t
he ti
mel
y ex
ecut
ion12
of f
unds
by
all r
elev
ant s
ecto
rs.
Co
nduc
t a fi
eld
test
of t
he m
echa
nism
and
upd
ate
if ne
cess
ary.
Dem
onst
rate
and
doc
umen
t tha
t the
fund
s ar
e m
obili
zed
in a
dvan
ce o
f a p
ublic
hea
lth e
mer
genc
y.
10 D
efine
d by
the
coun
try
thro
ugh
a se
t of t
rigge
rs th
at d
ecla
re a
situ
atio
n as
a p
ublic
hea
lth e
mer
genc
y.
11 A
spe
cial
set
of p
roce
sses
or c
hann
els
in p
lace
that
act
ivat
es a
spe
cial
em
erge
ncy
publ
ic fi
nanc
ing
mec
hani
sm, a
llow
s fo
r rap
id re
cept
ion
and
dist
ribut
ion
of fu
nds,
and
circ
umve
nts
the
vario
us c
heck
s an
d ba
lanc
es o
f the
nor
mal
pub
lic fi
nanc
ing
mec
hani
sm.
12 R
espo
nse
to p
ublic
hea
lth e
mer
genc
ies
incl
udes
a s
erie
s of
inte
rven
tions
(suc
h as
sup
ply
and
equi
pmen
t pro
cure
men
t, hu
man
reso
urce
con
trac
ting
and
depl
oym
ent,
logi
stic
al
arra
ngem
ents
), an
d en
gage
s ac
tors
not
usu
ally
invo
lved
with
pub
lic s
ecto
r ser
vice
s (s
uch
as n
ongo
vern
men
tal o
rgan
izat
ions
and
the
priv
ate
sect
or),
whi
ch u
nder
nor
mal
circ
umst
ance
s ca
n ta
ke a
fair
amou
nt o
f wor
k an
d tim
e an
d m
ay n
ot e
ven
be p
ossi
ble.
Mec
hani
sms,
incl
udin
g fa
st-t
rack
exe
cutio
n pr
oced
ures
and
lette
rs o
f und
erst
andi
ng w
ith n
onst
ate
acto
rs, n
eed
to b
e in
pl
ace
befo
re a
n em
erge
ncy
occu
rs, t
o al
low
for e
xped
ited
spen
ding
of f
unds
for a
spec
ts th
at a
re c
ruci
al to
em
erge
ncy
resp
onse
.
WHO BENCHMARKS FOR IHR CAPACITIES
18
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
emon
stra
te th
at a
ll re
leva
nt m
inis
tries
hav
e ca
paci
ty to
acc
ess
and
utiliz
e th
e em
erge
ncy
publ
ic fi
nanc
ing
mec
hani
sm
for e
arly
det
ectio
n an
d re
spon
se o
pera
tions
.
Dev
elop
SO
P’s
to s
uppo
rt ac
tors
not
usu
ally
invo
lved
with
pub
lic s
ecto
r ser
vice
s, s
uch
as n
ongo
vern
men
tal o
rgan
izat
ions
an
d th
e pr
ivat
e se
ctor
to a
cces
s em
erge
ncy
fund
s w
hen
need
ed.
D
evel
op S
OP’
s or
MoU
’s th
at fa
st-t
rack
pro
cure
men
t and
ser
vice
agr
eem
ents
that
can
be
activ
ated
dur
ing
emer
genc
ies
to
exp
edite
resp
onse
.
Dev
elop
acc
ount
ing
and
repo
rting
pro
cedu
res
for a
ccou
ntab
ility
and
trans
pare
ncy
of a
ll em
erge
ncy
SOP
and
MO
U’s
that
will
be
used
dur
ing
emer
genc
y re
spon
se.
Re
view
the
effe
ctiv
enes
s of
em
erge
ncy
finan
cing
mec
hani
sm fo
llow
ing
any
resp
onse
to a
pub
lic h
ealth
em
erge
ncie
s
and
adju
st p
roce
dure
s to
ens
ure
spee
d, tr
ansp
aren
cy a
nd a
ccou
ntab
ility
of a
ll fu
nds.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
an e
mer
genc
y co
ntin
genc
y fu
nd a
t the
nat
iona
l lev
el w
ith th
e su
ppor
t of u
rgen
t res
pons
e, a
nd w
hen
requ
ired
a na
tiona
l aut
horit
y w
hich
can
coo
rdin
ate
the
rece
ipt a
nd d
istr
ibut
ion
of fu
nds
to lo
cal a
nd in
term
edia
te le
vels
.
Esta
blis
h a
link
and/
or m
emor
andu
m o
f und
erst
andi
ng w
ith o
ther
regi
onal
or g
loba
l em
erge
ncy
cont
inge
ncy
fund
s, th
roug
h w
hich
a n
atio
nal a
utho
rity
can
coor
dina
te a
nd d
istr
ibut
e fu
nds.
Es
tabl
ish
a sy
stem
for a
ccou
ntab
ility
of t
he d
istr
ibut
ion
and
use
of th
ese
fund
s an
d pu
blis
h in
form
atio
n do
cum
entin
g tr
ansp
aren
cy in
exp
endi
ture
and
pro
gram
me
impa
cts
tow
ards
pro
tect
ing
heal
th.
WHO BENCHMARKS FOR IHR CAPACITIES
19
TOO
LS:
St
reng
then
ing
heal
th s
ecur
ity b
y im
plem
entin
g th
e In
tern
atio
nal H
ealth
Reg
ulat
ions
(200
5) –
Gen
eral
Info
rmat
ion.
In
tern
atio
nal H
ealth
Reg
ulat
ions
(200
5). T
hird
edi
tion.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
016
Su
ppor
t to
natio
nal l
egis
latio
n fo
r IH
R im
plem
enta
tion.
IH
R (2
005)
: Gui
danc
e on
impl
emen
tatio
n in
nat
iona
l leg
isla
tion.
D
eliv
erin
g gl
obal
hea
lth s
ecur
ity th
roug
h su
stai
nabl
e fin
anci
ng. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
201
8
Fund
ing
for e
mer
genc
ies
WHO BENCHMARKS FOR IHR CAPACITIES
20
IHR
COO
RDIN
ATIO
N, C
OM
MU
NIC
ATIO
N A
ND
ADVO
CACY
AN
D RE
PORT
ING
02
IMPA
CT:
A m
echa
nism
for m
ultis
ecto
ral/m
ultid
isci
plin
ary
coor
dina
tion,
com
mun
icat
ion
and
part
ners
hips
to p
reve
nt, d
etec
t, as
sess
and
resp
ond
to a
ny
publ
ic h
ealth
eve
nt o
r em
erge
ncy
is in
pla
ce. A
n IH
R N
FP th
at is
alw
ays
acce
ssib
le to
com
mun
icat
e w
ith th
e re
gion
al W
HO
IHR
Cont
act P
oint
s an
d w
ith a
ll re
leva
nt s
ecto
rs a
nd o
ther
sta
keho
lder
s in
the
coun
try.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Est
ablis
hmen
t of a
func
tiona
l mul
tisec
tora
l and
mul
tidis
cipl
inar
y m
echa
nism
for t
he c
oord
inat
ion
and
inte
grat
ion
of re
leva
nt s
ecto
rs in
th
e im
plem
enta
tion
of IH
R an
d to
resp
ond
to a
ny p
ublic
hea
lth e
vent
s an
d em
erge
ncie
s. (2
) Reg
ular
test
ing
of th
e m
echa
nism
thro
ugh
actu
al
expe
rienc
e an
d/or
exe
rcis
es a
nd s
ubse
quen
t im
prov
emen
t of a
rran
gem
ents
and
pro
cedu
res.
Each
cou
ntry
requ
ires
a w
ell-s
uppo
rted,
ade
quat
ely
train
ed te
am o
f nat
iona
l foc
al p
oint
(s) (
NFP
s) fo
r the
IHR
to e
nsur
e ef
fect
ive
coor
dina
tion,
com
mun
icat
ion
and
part
ners
hips
to p
reve
nt, d
etec
t, as
sess
and
resp
ond
to a
ny p
ublic
hea
lth e
vent
s. T
he c
ount
ry e
nsur
es s
usta
inab
le fu
nctio
ning
of t
he IH
R N
FPs
for I
HR
com
mun
icat
ions
, coo
rdin
atio
n an
d pa
rtner
ship
.
WHO BENCHMARKS FOR IHR CAPACITIES
21
CAPA
CITY
LEVE
L
Benc
hmar
k 2.
1: T
he IH
R N
FP is
fully
func
tiona
l O
bjec
tive:
To
esta
blis
h a
fully
func
tiona
l IH
R N
FP
01N
O C
APAC
ITY
Ther
e is
no
sust
aina
ble
or c
onsi
sten
t NFP
func
tioni
ng fo
r the
IHR.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
De
sign
ate
or e
stab
lish
an N
FP in
line
with
the
IHR
requ
irem
ents
.
Esta
blis
h te
rms
of re
fere
nce
outli
ning
the
role
and
resp
onsi
bilit
ies
of IH
R N
FPs
in fu
lfillin
g re
leva
nt o
blig
atio
ns o
f the
IHR.
M
aint
ain
and
regu
larly
upd
ate
a co
ntac
t dire
ctor
y in
clud
ing
all t
he m
embe
rs o
f NFP
and
cap
acita
te N
FPs
for 2
4 ho
urs
a da
y, se
ven
days
a w
eek
(24/
7) a
cces
sibi
lity.
Co
nduc
t tra
inin
g fo
r NFP
s.
Esta
blis
h SO
Ps fo
r com
mun
icat
ing
and
coor
dina
ting
with
WH
O, in
clud
ing
trigg
er a
nd p
roce
ss fo
r not
ifica
tion
and
repo
rting
.
Esta
blis
h SO
Ps fo
r com
mun
icat
ion
amon
g re
leva
nt s
ecto
rs, in
clud
ing
thre
shol
ds fo
r rep
ortin
g an
d re
spon
se.
De
velo
p ac
tion
plan
s fo
r mul
tisec
tora
l/mul
tidis
cipl
inar
y co
ordi
natio
n an
d co
mm
unic
atio
n m
echa
nism
s in
a v
arie
ty o
f set
tings
in
clud
ing
durin
g tim
es o
f hig
h ris
k, de
liber
ate
even
ts a
nd m
ass
gath
erin
g ev
ents
.
Prov
ide
annu
al re
ports
to th
e W
orld
Hea
lth A
ssem
bly
on IH
R ca
paci
ty d
evel
opm
ent.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent S
OPs
for c
omm
unic
atin
g an
d co
ordi
natin
g be
twee
n N
FPs
and
WH
O a
nd re
view
per
form
ance
regu
larly
.
Impl
emen
t SO
Ps fo
r com
mun
icat
ing
betw
een
the
NFP
and
rele
vant
sec
tors
incl
udin
g th
ose
resp
onsi
ble
for s
urve
illan
ce a
nd
repo
rtin
g, p
oint
s of
ent
ry, p
ublic
hea
lth s
ervi
ces,
clin
ics
and
hosp
itals
and
oth
er g
over
nmen
t dep
artm
ents
/min
istr
ies
and
revi
ew p
erfo
rman
ce re
gula
rly.
Es
tabl
ish
SOPs
for c
omm
unic
atio
n an
d co
ordi
natio
n be
twee
n th
e N
FP a
nd n
ongo
vern
men
tal a
genc
ies,
incl
udin
g m
edia
and
ci
vil s
ocie
ty.
Re
gula
rly te
st th
e m
echa
nism
for m
ultis
ecto
ral c
olla
bora
tion
and
com
mun
icat
ion
thro
ugh
actu
al e
xper
ienc
e an
d/or
sc
enar
ios
for h
igh
risk,
del
iber
ate
or m
ass
gath
erin
g ev
ents
.
Dev
elop
com
mun
icat
ion
chan
nels
, suc
h as
web
site
upd
ates
or n
ewsl
ette
rs, t
o ap
pris
e re
leva
nt s
ecto
rs a
nd p
artn
ers
on
deve
lopm
ents
in th
e re
latio
n to
IHR
impl
emen
tatio
n.
WHO BENCHMARKS FOR IHR CAPACITIES
22
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t for
mal
eva
luat
ion
of th
e ro
le o
f NFP
s an
d th
e co
ordi
natio
n m
echa
nism
.
Cond
uct r
egul
ar re
fresh
er tr
aini
ng fo
r NFP
s an
d or
ient
atio
n/tra
inin
g fo
r new
sta
ff.
Revi
ew N
FP m
aste
ry o
f inf
orm
atio
n an
d be
st p
ract
ices
.
Rout
inel
y co
nduc
t afte
r-ac
tion
revi
ews
or s
imul
atio
ns a
nd a
pply
the
less
ons
lear
nt re
latin
g to
coo
rdin
atio
n an
d N
FP ro
le,
prio
ritiz
ed fo
r act
ions
with
in n
atio
nal a
ctio
n pl
ans.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
edic
ate
sust
aine
d re
sour
ces
(fina
ncia
l, hu
man
, tec
hnic
al) t
hat a
re a
cces
sibl
e an
d av
aila
ble
for t
he N
FP a
nd re
late
d ac
tiviti
es.
D
ocum
ent a
nd s
hare
less
ons
lear
nt re
late
d to
NFP
bes
t pra
ctic
es.
Pr
ovid
e su
ppor
t to
NFP
s in
oth
er c
ount
ries
as re
ques
ted
incl
udin
g th
roug
h bi
late
ral a
nd re
gion
al a
rran
gem
ents
.
WHO BENCHMARKS FOR IHR CAPACITIES
23
CAPA
CITY
LEVE
L
Benc
hmar
k 2.
2: M
ultis
ecto
ral I
HR
coor
dina
tion
mec
hani
sm e
ffec
tivel
y su
ppor
ts th
e im
plem
enta
tion
of p
reve
ntio
n, d
etec
tion
and
resp
onse
act
iviti
es
Obj
ectiv
e: T
o es
tabl
ish
a m
ultis
ecto
ral I
HR
coor
dina
tion
mec
hani
sm to
sup
port
the
impl
emen
tatio
n of
pre
vent
ion,
det
ectio
n an
d re
spon
se a
ctiv
ities
01N
O C
APAC
ITY
No
mul
tisec
tora
l coo
rdin
atio
n m
echa
nism
exi
sts.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t a s
take
hold
er a
naly
sis
and
esta
blis
h a
mul
tisec
tora
l coo
rdin
atio
n m
echa
nism
that
mee
ts re
gula
rly to
dis
cuss
an
d pr
omot
e IH
R is
sues
(dev
elop
a p
roto
col,
term
s of
refe
renc
e an
d id
entif
y re
sour
ces
need
ed fo
r the
mec
hani
sm).
Re
view
exi
stin
g na
tiona
l pla
ns fr
om re
leva
nt s
ecto
rs a
nd in
crea
se c
oord
inat
ion
and
harm
oniz
atio
n of
reso
urce
s an
d ac
tiviti
es w
ithin
the
heal
th s
yste
m a
s w
ell a
s ac
ross
rele
vant
sec
tors
.
Cond
uct a
n O
IE p
erfo
rman
ce o
f vet
erin
ary
serv
ices
(OIE
PVS
) eva
luat
ion
(or o
ther
PVS
ass
essm
ents
) or,
if al
read
y do
ne in
th
e pa
st tw
o or
thre
e ye
ars,
revi
ew th
e O
IE P
VS e
valu
atio
n fin
ding
s an
d th
eir i
mpl
emen
tatio
n st
atus
.
Doc
umen
t and
dis
sem
inat
e ev
iden
ce th
at th
e co
ordi
natio
n m
echa
nism
is w
orki
ng to
add
ress
zoo
nose
s an
d ot
her e
xist
ing
or n
ew h
ealth
eve
nts
at th
e hu
man
–an
imal
inte
rfac
e.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Cr
eate
/upd
ate
the
natio
nal a
ctio
n pl
an fo
r im
prov
ing
heal
th s
ecur
ity a
nd IH
R ca
paci
ty b
ased
on
IHR
mon
itorin
g an
d ev
alua
tion
resu
lts.
U
pdat
e or
revi
ew th
e co
ordi
natio
n m
echa
nism
to a
ddre
ss z
oono
ses
and
othe
r exi
stin
g or
new
hea
lth e
vent
s at
th
e hu
man
–an
imal
inte
rfac
e.
Doc
umen
t and
dis
sem
inat
e ev
iden
ce th
at th
e co
ordi
natio
n m
echa
nism
for f
ood
safe
ty a
mon
g st
akeh
olde
rs fr
om a
ll re
leva
nt
sect
ors
is w
orki
ng a
s pe
r the
pro
toco
l.
WHO BENCHMARKS FOR IHR CAPACITIES
24
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t reg
ular
mul
tisec
tora
l coo
rdin
atio
n m
eetin
gs a
nd e
nsur
e th
at th
e ou
tcom
es o
f the
se m
eetin
gs a
re d
isse
min
ated
to
the
exte
rnal
and
inte
rnal
aud
ienc
e, w
ell d
ocum
ente
d an
d ac
ted
upon
.
Dev
elop
per
form
ance
-bas
ed in
dica
tors
and
regu
larly
mea
sure
out
com
es re
late
d to
NFP
s an
d IH
R co
mpl
ianc
e.
Doc
umen
t and
dis
sem
inat
e ev
iden
ce th
at th
e co
ordi
natio
n m
echa
nism
for c
hem
ical
saf
ety
amon
g st
akeh
olde
rs fr
om a
ll re
leva
nt s
ecto
rs is
wor
king
as
per t
he p
roto
col.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Pr
ovid
e su
stai
ned
fund
ing
for t
he m
ultis
ecto
ral c
oord
inat
ion
mec
hani
sm.
D
ocum
ent a
nd d
isse
min
ate
evid
ence
that
the
coor
dina
tion
mec
hani
sm fo
r rad
iatio
n em
erge
ncie
s am
ong
stak
ehol
ders
from
al
l rel
evan
t sec
tors
and
nat
iona
l rad
iatio
n sa
fety
aut
horit
ies
is w
orki
ng a
s pe
r the
pro
toco
l.
Test
and
revi
se re
leva
nt p
roce
sses
rela
ted
to th
e co
ordi
natio
n m
echa
nism
in th
e ab
senc
e of
any
eve
nts
or e
mer
genc
ies.
D
ocum
ent a
nd s
hare
bes
t pra
ctic
es.
TOO
LS:
N
atio
nal I
HR
foca
l poi
nt g
uide
W
HO
gui
danc
e fo
r the
use
of A
nnex
2 o
f the
Inte
rnat
iona
l Hea
lth R
egul
atio
ns (2
005)
WHO BENCHMARKS FOR IHR CAPACITIES
25
ANTI
MIC
ROBI
AL R
ESIS
TAN
CE
03
IMPA
CT:
Dec
isiv
e an
d co
mpr
ehen
sive
act
ion
to p
reve
nt th
e em
erge
nce
and
redu
ce th
e sp
read
of A
MR.
Cou
ntrie
s w
ill (i
n lin
e w
ith th
e gl
obal
act
ion
plan
) in
crea
se a
war
enes
s of
AM
R ris
ks a
nd h
ow to
resp
ond
to th
em; s
treng
then
sur
veill
ance
and
labo
rato
ry c
apac
ity; e
nhan
ce in
fect
ion
prev
entio
n an
d co
ntro
l act
iviti
es; e
nsur
e un
inte
rrup
ted
acce
ss to
ess
entia
l ant
imic
robi
als
of a
ssur
ed q
ualit
y; re
gula
te a
nd p
rom
ote
the
appr
opria
te u
se o
f an
timic
robi
als
in h
uman
med
icin
e, v
eter
inar
y m
edic
ine,
food
pro
duct
ion
and
othe
r fiel
ds a
s ap
prop
riate
; and
sup
port
initi
ativ
es to
fost
er th
e de
velo
pmen
t and
app
ropr
iate
use
of n
ew a
ntim
icro
bial
age
nts,
vac
cine
s an
d di
agno
stic
tool
s.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Mul
tisec
tora
l nat
iona
l act
ion
plan
to c
omba
t AM
R ha
s be
en p
rodu
ced
and
mad
e pu
blic
. (2)
Impl
emen
tatio
n of
the
AMR
natio
nal a
ctio
n pl
an/
sect
or p
lans
, with
mon
itorin
g an
d ye
arly
repo
rtin
g on
pro
gres
s (in
clud
ing
repo
rtin
g to
the
inte
rnat
iona
l lev
el) i
s in
pla
ce. (
The
JEE
tool
revi
ews
the
coun
try’
s se
lf-as
sess
ed re
spon
se to
the
glob
al m
onito
ring
surv
ey o
n AM
R.)
A fu
nctio
nal s
yste
m in
pla
ce fo
r the
nat
iona
l res
pons
e to
pre
vent
and
com
bat a
ntim
icro
bial
resi
stan
ce (A
MR)
with
a O
ne H
ealth
app
roac
h, in
clud
ing:
Mul
tisec
tora
l wor
k sp
anni
ng h
uman
, ani
mal
, cro
ps, f
ood
safe
ty a
nd e
nviro
nmen
tal a
spec
ts –
this
com
pris
es d
evel
opin
g an
d im
plem
entin
g a
natio
nal
actio
n pl
an to
com
bat A
MR,
con
sist
ent w
ith th
e gl
obal
act
ion
plan
on
AMR.
Su
rvei
llanc
e ca
paci
ty fo
r AM
R an
d an
timic
robi
al u
se a
t the
nat
iona
l lev
el, f
ollo
win
g an
d us
ing
inte
rnat
iona
lly a
gree
d sy
stem
s su
ch a
s th
e W
HO
Glo
bal
Antim
icro
bial
Res
ista
nce
Surv
eilla
nce
Syst
em (G
LASS
) and
the
OIE
glo
bal d
atab
ase
on u
se o
f ant
imic
robi
al a
gent
s in
ani
mal
s.
Prev
entio
n of
AM
R in
hea
lthca
re fa
cilit
ies,
food
pro
duct
ion
and
the
com
mun
ity, t
hrou
gh in
fect
ion
prev
entio
n an
d co
ntro
l mea
sure
s.
Ensu
ring
appr
opria
te u
se o
f ant
imic
robi
als,
incl
udin
g as
surin
g qu
ality
of a
vaila
ble
med
icin
es, c
onse
rvat
ion
of e
xist
ing
treat
men
ts a
nd a
cces
s to
app
ropr
iate
an
timic
robi
als
whe
n ne
eded
, whi
le re
duci
ng in
appr
opria
te u
se.
WHO BENCHMARKS FOR IHR CAPACITIES
26
CAPA
CITY
LEVE
L
Benc
hmar
k 3.
1: E
ffec
tive
mul
tisec
tora
l coo
rdin
atio
n on
AM
R O
bjec
tive:
To
deve
lop
and
impl
emen
t a m
ultis
ecto
ral n
atio
nal a
ctio
n pl
an o
n AM
R
01N
O C
APAC
ITY
No
natio
nal a
ctio
n pl
an fo
r AM
R.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a na
tiona
l mul
tisec
tora
l AM
R co
ordi
natin
g co
mm
ittee
.
Und
erta
ke a
situ
atio
n an
alys
is to
iden
tify
maj
or ri
sks
for d
evel
opm
ent a
nd tr
ansm
issi
on o
f AM
R, a
nd w
here
the
impa
ct o
f re
sist
ance
wou
ld b
e gr
eate
st.
Id
entif
y pr
ogra
mm
es a
nd a
ctiv
ities
rela
ting
to k
ey A
MR
obje
ctiv
es th
at n
eed
to b
e de
velo
ped
or s
cale
d up
.
Iden
tify
a he
alth
min
istr
y le
ad fo
r AM
R, d
evel
op a
cle
ar te
rms
of re
fere
nce
and
coor
dina
te a
ctiv
ities
of t
he re
leva
nt m
inis
trie
s on
AM
R an
d st
ewar
dshi
p.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
pla
n of
act
ion
to a
ddre
ss A
MR
in li
ne w
ith th
e G
loba
l Act
ion
Plan
(GAP
) on
AMR.
Su
bmit
a pl
an fo
r app
rova
l thr
ough
rele
vant
gov
erna
nce
mec
hani
sms
(suc
h as
offi
ce o
f hea
d of
sta
te, c
abin
et, o
r min
istr
ies
of h
ealth
and
agr
icul
ture
).
Dev
elop
term
s of
refe
renc
e fo
r a m
ultis
ecto
ral g
over
nanc
e m
echa
nism
, with
cle
ar li
nes
of a
ccou
ntab
ility
bet
wee
n th
e AM
R co
ordi
natin
g co
mm
ittee
and
the
high
leve
l One
Hea
lth g
roup
.
Org
aniz
e ef
fect
ive
coor
dina
tion
thro
ugh
regu
lar m
eetin
gs.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y pr
iorit
y ac
tions
(bas
ed o
n ris
k an
d fe
asib
ility
) fro
m th
e na
tiona
l act
ion
plan
, dev
elop
an
impl
emen
tatio
n pl
an w
ith
resp
onsi
ble
agen
cies
with
est
ablis
hed
timel
ines
, and
beg
in im
plem
enta
tion
of th
ese
actio
ns.
D
evel
op a
nd im
plem
ent a
n AM
R na
tiona
l act
ion
plan
mon
itorin
g fr
amew
ork.
Re
view
pla
ns a
nd p
rogr
ess
thro
ugh
regu
lar m
eetin
gs o
f the
AM
R go
vern
ance
com
mitt
ee.
Id
entif
y an
d m
ap s
usta
ined
fund
ing
for p
lann
ed a
ctiv
ities
in th
e AM
R na
tiona
l act
ion
plan
.
WHO BENCHMARKS FOR IHR CAPACITIES
27
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
edic
ate
sust
ain
fund
ing
for p
lann
ed a
ctiv
ities
in th
e AM
R na
tiona
l act
ion
plan
.
Ensu
re k
ey a
ctiv
ities
are
inco
rpor
ated
in p
lans
and
bud
gets
of r
elev
ant p
rogr
amm
es a
nd a
genc
ies.
En
sure
regu
lar m
onito
ring
of p
rogr
ess
with
dat
a su
bmitt
ed to
regi
onal
and
glo
bal l
evel
s.
Defi
ne c
lear
ly s
peci
fied
actio
ns w
ithin
pla
nnin
g an
d go
vern
ance
mec
hani
sms
for a
ll ke
y se
ctor
s in
volv
ed.
Id
entif
y po
tent
ial b
arrie
rs a
nd/o
r cha
lleng
es to
impl
emen
ting
the
natio
nal a
ctio
n pl
an a
nd a
ppro
ache
s to
ove
rcom
e th
ese
barr
iers
.
WHO BENCHMARKS FOR IHR CAPACITIES
28
CAPA
CITY
LEVE
L
Benc
hmar
k 3.
2: S
urve
illan
ce s
yste
m o
f AM
R is
in p
lace
O
bjec
tive:
To
deve
lop
a na
tiona
l AM
R su
rvei
llanc
e sy
stem
that
inte
grat
es s
urve
illan
ce o
f AM
R in
pat
hoge
ns o
f con
cern
to
hum
an a
nd a
nim
al h
ealth
and
agr
icul
ture
01N
O C
APAC
ITY
Non
e of
the
labo
rato
ries
that
con
duct
ant
ibio
tic s
usce
ptib
ility
test
ing
are
gene
ratin
g da
ta (a
ntib
iotic
sus
cept
ibili
ty a
nd
acco
mpa
nyin
g cl
inic
al a
nd e
pide
mio
logi
cal d
ata)
and
ther
e is
no
surv
eilla
nce
syst
em re
port
ing
on A
MR.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
esig
nate
a n
atio
nal c
oord
inat
ing
cent
re to
ove
rsee
the
deve
lopm
ent a
nd fu
nctio
ning
of t
he n
atio
nal A
MR
surv
eilla
nce
syst
em.
Co
mpl
ete
an a
sses
smen
t of e
xist
ing
labo
rato
ry c
apac
ities
for i
dent
ifica
tion
and
antib
iotic
sus
cept
ibili
ty te
stin
g of
com
mon
ba
cter
ia in
clud
ing
Myc
obac
teriu
m tu
berc
ulos
is.
D
efine
prio
rity
spec
imen
s, p
atho
gens
and
dru
g–bu
g co
mbi
natio
ns fo
r nat
iona
l rep
ortin
g.
Des
igna
te a
nat
iona
l ref
eren
ce la
bora
tory
to s
uppo
rt A
MR
surv
eilla
nce
and
deve
lop
SOPs
for v
erifi
catio
n an
d ad
ditio
nal
test
ing
and
iden
tify
an e
xter
nal q
ualit
y as
sess
men
t pro
vide
r for
the
natio
nal r
efer
ence
labo
rato
ry.
D
esig
nate
labo
rato
ries
and
secu
re la
bora
tory
reag
ents
to c
ondu
ct d
etec
tion
and
repo
rtin
g of
som
e pr
iorit
y AM
R pa
thog
ens.
Es
tabl
ish
One
Hea
lth A
MR
trai
ning
and
men
tors
hip
prog
ram
mes
for n
atio
nal a
nd c
ount
ry la
bora
torie
s.
Dev
elop
and
initi
ate
trai
ning
pro
gram
mes
for d
ata
colle
ctio
n an
d re
port
ing
of A
MR
at n
atio
nal a
nd re
gion
al le
vels
.
Initi
ate
AMR
surv
eilla
nce
at p
ilot o
r rep
rese
ntat
ive
regi
onal
and
refe
rral
hos
pita
ls.
WHO BENCHMARKS FOR IHR CAPACITIES
29
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
De
fine
labo
rato
ry s
tand
ards
and
cap
acity
requ
irem
ents
that
labo
rato
ries
mus
t mee
t to
parti
cipa
te in
nat
iona
l sur
veilla
nce.
De
velo
p st
eps
to s
treng
then
labo
rato
ry c
apac
ity to
sus
tain
ably
iden
tify
and
perfo
rm id
entifi
catio
n an
d an
tibio
tic s
usce
ptib
ility
test
ing
of c
omm
on b
acte
ria in
clud
ing
M. t
uber
culo
sis.
Esta
blis
h an
ext
erna
l qua
lity
asse
ssm
ent p
rogr
amm
e fo
r the
nat
iona
l ref
eren
ce la
bora
tory
and
ens
ure
that
the
natio
nal
refe
renc
e la
bora
tory
can
con
duct
con
firm
ator
y or
add
ition
al te
stin
g.
Defi
ne n
atio
nal A
MR
surv
eilla
nce
obje
ctiv
es a
nd d
evel
op a
nat
iona
l AM
R su
rvei
llanc
e st
rate
gy.
Es
tabl
ish
SOPs
, pro
toco
ls a
nd d
atab
ases
for s
urve
illanc
e da
ta, a
sys
tem
for r
epor
ting
to m
inis
tries
of h
ealth
and
agr
icul
ture
, an
d a
mec
hani
sm to
ana
lyse
dat
a an
d re
port
back
to fa
cilit
ies
and
to W
HO.
De
velo
p a
natio
nal s
urve
illanc
e pr
otoc
ol in
clud
ing:
sur
veilla
nce
targ
ets,
labo
rato
ry s
tand
ards
, prio
rity
spec
imen
s, pa
thog
ens
and
drug
–bu
g co
mbi
natio
ns, d
efine
d da
tase
ts, m
etric
s, da
ta p
rodu
ctio
n, a
nalys
is a
nd re
porti
ng, q
ualit
y m
anag
emen
t, mon
itorin
g an
d ev
alua
tion)
.
Desi
gnat
e fu
nctio
nal A
MR
surv
eilla
nce
site
s.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ev
alua
te e
xist
ing
AMR
and
drug
-res
ista
nt T
B su
rvei
llanc
e sy
stem
s, d
isse
min
ate
resu
lts a
nd d
evel
op a
n ac
tion
plan
for
impl
emen
tatio
n of
a n
atio
nal s
urve
illanc
e sy
stem
.
Esta
blis
h ex
tern
al q
ualit
y as
sess
men
t pro
gram
me
for a
ll lab
orat
orie
s (h
uman
and
ani
mal
) gen
erat
ing
data
for A
MR
surv
eilla
nce.
De
velo
p an
d m
aint
ain
sust
aina
ble
supp
ort f
or A
MR
and
drug
-res
istan
t TB
surv
eilla
nce
infra
stru
ctur
e in
clud
ing
labo
rato
ry s
uppl
y cha
in.
Ex
pand
AM
R te
stin
g an
d su
rvei
llanc
e to
incl
ude
othe
r clin
ical
site
s an
d/or
oth
er a
reas
of t
he h
ealth
care
sys
tem
(suc
h as
priv
ate
sect
or).
Co
llect
pop
ulat
ion-
base
d de
nom
inat
ors,
suc
h as
thos
e re
com
men
ded
by W
HO
GLA
SS.
D
evel
op a
nd im
plem
ent s
trate
gies
for m
onito
ring
natio
nal A
MR
and
drug
-res
ista
nt T
B.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
En
hanc
e m
onito
ring
of a
ntib
iotic
-res
ista
nce
patte
rns
and
geno
typi
ng, a
s w
ell a
ntib
iotic
usa
ge a
nd m
anag
emen
t pra
ctic
es
at m
ultip
le p
oint
s in
the
prod
uctio
n ch
ain
for f
ood
anim
als
and
reta
il m
eat.
D
isse
min
ate
repo
rts
rela
ting
to m
easu
ring
the
prop
ortio
n of
AM
R pa
thog
ens
amon
g sp
ecim
ens
or is
olat
es, r
esul
ts fr
om
part
icip
atio
n in
inte
rnat
iona
l ext
erna
l qua
lity
asse
ssm
ent r
ound
s of
the
natio
nal r
efer
ence
labo
rato
ry, a
nd in
cide
nce
of
infe
ctio
ns c
ause
d by
AM
R pa
thog
ens
at s
entin
el s
ites
(com
mun
ity a
nd h
ospi
tal a
cqui
red)
.
Dem
onst
rate
the
use
of th
is in
form
atio
n fo
r pol
icy
chan
ges,
impr
ovin
g fa
cilit
ies
and
adap
ting
prev
entio
n an
d co
ntro
l stra
tegi
es.
WHO BENCHMARKS FOR IHR CAPACITIES
30
CAPA
CITY
LEVE
L
Benc
hmar
k 3.
3: In
fect
ion
prev
entio
n an
d co
ntro
l is
in p
lace
O
bjec
tive:
To
deve
lop
a fu
nctio
ning
infe
ctio
n pr
even
tion
and
cont
rol s
yste
m fo
r hea
lthca
re fa
cilit
ies
and
farm
s
01N
O C
APAC
ITY
Syst
emat
ic e
fforts
, nat
iona
l infe
ctio
n pr
even
tion
and
cont
rol (
IPC)
pro
gram
mes
and
“wat
er, s
anita
tion
and
hygi
ene”
(WAS
H) s
tand
ards
, or
resp
onsi
ble
pers
ons
for i
nfec
tion
prev
entio
n an
d co
ntro
l in h
uman
hea
lthca
re fa
cilit
ies
to p
rom
ote
infe
ctio
n pr
even
tion
and
prev
ent
trans
mis
sion
of r
esis
tant
bac
teria
in th
e an
imal
food
pro
duct
ion
sect
or e
ither
do
not e
xist
or a
re a
t the
dev
elop
men
t sta
ge.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
WH
O re
com
men
datio
ns o
n co
re c
ompo
nent
s fo
r effe
ctiv
e IP
C pr
ogra
mm
es a
nd th
e na
tiona
l and
faci
lity
prac
tical
m
anua
ls s
uppo
rtin
g th
eir i
mpl
emen
tatio
n.
Use
IPC
asse
ssm
ent t
ools
(IPC
AT) t
o as
sess
the
core
com
pone
nts
of IP
C pr
ogra
mm
es a
t the
nat
iona
l (IP
CAT2
; too
l 2) a
nd
faci
lity
(IPCA
F; fa
cilit
y le
vel)
leve
ls a
nd id
entif
y pr
ecis
e ar
eas/
core
com
pone
nts
requ
iring
act
ion.
Dev
elop
and
impl
emen
t an
actio
n pl
an, in
form
ed b
y as
sess
men
t res
ults
and
follo
win
g th
e fiv
e-st
ep c
ycle
des
crib
ed in
the
prac
tical
m
anua
ls, t
hat a
ddre
sses
the
iden
tified
prio
rity
core
com
pone
nts
at th
e na
tiona
l and
faci
lity
leve
ls (a
t lea
st a
t maj
or h
ospi
tal c
entre
s),
core
com
pone
nt o
ne (I
PC p
rogr
amm
e) a
nd c
ore
com
pone
nt e
ight
(WAS
H),
acco
rdin
g to
the
WH
O re
quire
men
ts/a
ctio
n ch
eckli
sts.
Es
tabl
ish
a N
atio
nal I
PC C
omm
ittee
and
dev
elop
Nat
iona
l IPC
Com
mitt
ee te
rms
of re
fere
nce
and
loca
l IPC
com
mitt
ees
at
dist
rict a
nd/o
r fac
ility
leve
l, if
an a
ctio
n pl
an is
not
in p
lace
.
Dev
elop
a n
atio
nal I
PC p
olic
y an
d pl
an fo
r ani
mal
hea
lth.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op n
atio
nal I
PC g
uide
lines
for h
uman
and
ani
mal
hea
lth s
ecto
rs (I
PC in
ani
mal
pro
duct
ion)
.
Iden
tify
and
allo
cate
ade
quat
e re
sour
ces
to s
uppo
rt s
elec
ted
heal
thca
re fa
cilit
ies/
farm
s to
impl
emen
t IPC
act
ion
plan
s,
incl
udin
g IP
C gu
idel
ines
.
Use
IPC
asse
ssm
ent t
ools
at n
atio
nal (
IPCA
T2) a
nd fa
cilit
y (IP
CAF)
leve
ls to
iden
tify
prec
ise
area
s re
quiri
ng a
dditi
onal
act
iviti
es to
im
prov
e or
put
in p
lace
add
ition
al IP
C co
re c
ompo
nent
s an
d to
gui
de th
e de
velo
pmen
t of a
det
aile
d im
prov
emen
t pla
n of
act
ion.
Im
plem
ent t
he a
ctio
n pl
an, i
nfor
med
by
asse
ssm
ent r
esul
ts a
nd fo
llow
ing
the
five-
step
cyc
le d
escr
ibed
in th
e pr
actic
al
man
uals
, acc
ordi
ng to
the
WH
O re
quire
men
ts/a
ctio
n ch
eckl
ists
for t
he p
riorit
y co
re c
ompo
nent
s id
entifi
ed.
Re
fer t
o th
e re
com
men
datio
ns a
nd re
quire
men
ts fo
r IPC
gui
delin
es, a
nd tr
ain
adeq
uate
hea
lthca
re w
orke
rs o
n is
sued
gui
delin
es.
M
onito
r IPC
and
WAS
H im
plem
enta
tion
in s
elec
ted
heal
thca
re fa
cilit
ies
usin
g IP
CAF,
hand
hyg
iene
sel
f-as
sess
men
t fr
amew
ork,
han
d hy
gien
e co
mpl
ianc
e ob
serv
atio
n to
ols
WAS
H F
IT to
ol.
WHO BENCHMARKS FOR IHR CAPACITIES
31
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
U
se th
e na
tiona
l IPC
ass
essm
ent t
ool (
IPCA
T2) t
o id
entif
y pr
ecis
e ar
eas
still
requ
iring
act
ion
and
upda
te th
e pl
an o
f act
ion.
M
anda
te a
nd s
uppo
rt IP
C im
prov
emen
t at a
ll he
alth
care
faci
litie
s, re
com
men
ding
the
use
of th
e in
fect
ion
prev
entio
n an
d co
ntro
l ass
essm
ent f
ram
ewor
k (IP
CAF)
and
the
WAS
H fi
t too
l and
ant
ibio
tic s
tew
ards
hip
prog
ram
s.
Upd
ate
and
impl
emen
t act
ion
plan
s, in
form
ed b
y as
sess
men
t res
ults
and
follo
win
g th
e fiv
e-st
ep c
ycle
des
crib
ed in
the
prac
tical
man
uals
, tha
t pro
gres
sive
ly c
over
all
reco
mm
ende
d IP
C pr
iorit
y co
re c
ompo
nent
s at
the
natio
nal a
nd fa
cilit
y le
vels
ac
cord
ing
to th
e W
HO
requ
irem
ents
/act
ion
chec
klis
ts fo
r the
prio
rity
core
com
pone
nts
iden
tified
.
Incl
ude
spec
ific
inte
rven
tions
for A
MR
prev
entio
n ta
ilore
d to
the
loca
l epi
dem
iolo
gica
l situ
atio
n in
thes
e pl
ans.
Sh
are
the
plan
s w
ith n
atio
nal,
subn
atio
nal a
nd lo
cal I
PC c
omm
ittee
s an
d in
corp
orat
e gu
idan
ce fr
om th
em.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Pr
ovid
e ef
fect
ive
supp
ort t
o he
alth
care
faci
lity
IPC
prog
ram
mes
nat
ionw
ide.
En
sure
that
hea
lthca
re fa
cilit
ies
unde
rtak
e an
nual
IPCA
F an
d W
ASH
fit a
sses
smen
ts a
s pa
rt o
f the
ir re
view
cyc
le to
add
ress
lo
ng-t
erm
sus
tain
abili
ty.
Es
tabl
ish
a na
tiona
l sys
tem
for c
ontin
uous
mon
itorin
g of
pro
gres
s in
fulfi
lling
the
IPC
core
com
pone
nts
(i.e.
repe
at
asse
ssm
ents
at l
east
ann
ually
) and
kee
p tr
ack
of c
hang
es a
nd s
core
s an
d de
velo
p a
long
-ter
m im
prov
emen
t pla
n.
Anal
yse
and
regu
larly
repo
rt n
atio
nal I
PC a
nd W
ASH
dat
a an
d su
ppor
t dis
cuss
ions
on
actio
ns to
inco
rpor
ate
less
ons
lear
ned
in th
e lo
ng-t
erm
impr
ovem
ent p
lan.
D
ocum
ent t
he in
cide
nce
of p
atie
nt a
nd h
ealth
care
wor
ker i
nfec
tions
, inc
ludi
ng M
. tub
ercu
losi
s, a
nd th
e ef
fect
iven
ess
of
mea
sure
s to
redu
ce th
eir o
ccur
renc
e.
WHO BENCHMARKS FOR IHR CAPACITIES
32
CAPA
CITY
LEVE
L
Benc
hmar
k 3.
4: O
ptim
ize
use
of a
ntim
icro
bial
med
icin
es in
hum
an a
nd a
nim
al h
ealth
and
agr
icul
ture
O
bjec
tive:
To
ensu
re a
ppro
pria
te u
se o
f all
antim
icro
bial
s in
hum
an a
nd a
nim
al h
ealth
and
agr
icul
ture
01N
O C
APAC
ITY
No
or w
eak
polic
y an
d re
gula
tions
on
appr
opria
te u
se, a
vaila
bilit
y an
d qu
ality
of a
ntim
icro
bial
s.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
U
nder
take
an
asse
ssm
ent o
f ste
war
dshi
p po
licie
s an
d ac
tiviti
es, i
nclu
ding
regu
lato
ry fr
amew
ork
and
supp
ly c
hain
m
anag
emen
t of a
ntim
icro
bial
s, u
sing
a m
ultis
ecto
ral a
ppro
ach.
Re
view
the
esse
ntia
l med
icin
es li
st a
nd c
linic
al g
uide
lines
that
pro
mot
e ap
prop
riate
use
.
Asse
ss e
xist
ing
mon
itorin
g of
ant
imic
robi
al u
se a
nd c
onsu
mpt
ion.
D
evel
op a
dra
ft na
tiona
l ant
imic
robi
al s
tew
ards
hip
plan
or s
trat
egy
and
natio
nal l
egis
latio
n th
at re
gula
te u
se, a
vaila
bilit
y an
d qu
ality
of a
ntim
icro
bial
s.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op/u
pdat
e an
d di
ssem
inat
e na
tiona
l ste
war
dshi
p an
d cl
inic
al/t
reat
men
t gui
delin
es th
at in
clud
e th
e Es
sent
ial
Med
icin
es L
ist A
WaR
e (A
cces
s, W
atch
, Res
erve
) cat
egor
izat
ion
for a
ntib
iotic
s pr
omot
ing
appr
opria
te u
se o
f ant
imic
robi
als.
Im
plem
ent s
tew
ards
hip
prac
tices
at d
esig
nate
d he
alth
care
faci
litie
s.
Esta
blis
h SO
Ps, p
roto
cols
and
dat
abas
es fo
r mon
itorin
g an
timic
robi
al u
se in
hum
ans
and
anim
als.
Im
plem
ent a
ntim
icro
bial
ste
war
dshi
p pr
ogra
mm
es, i
nclu
ding
mon
itorin
g of
ant
imic
robi
al u
se, e
duca
tion/
com
mun
icat
ion,
an
d ot
her i
nter
vent
ions
to im
prov
e an
tibio
tic u
se, a
t des
igna
ted
faci
litie
s.
Dev
elop
or r
evie
w th
e na
tiona
l reg
ulat
ory
fram
ewor
k fo
r app
ropr
iate
use
of a
ntim
icro
bial
s in
hum
ans.
Ap
prov
e an
d en
act l
egis
latio
n an
d re
gula
tions
on
impo
rt, m
arke
ting
auth
oriz
atio
n, p
rodu
ctio
n an
d us
e of
ant
imic
robi
als.
WHO BENCHMARKS FOR IHR CAPACITIES
33
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
onito
r and
eva
luat
e st
ewar
dshi
p pr
ogra
mm
es c
ondu
cted
, inc
ludi
ng th
e an
alys
is o
f ant
imic
robi
al u
se d
ata.
D
evel
op a
nd d
isse
min
ate
info
rmat
ion,
edu
catio
n an
d co
mm
unic
atio
n m
ater
ials
on
drug
resi
stan
ce a
nd d
rug
use
acro
ss
both
hum
an a
nd a
nim
al s
ecto
rs. T
hese
incl
ude
the
use
of e
vide
nce
gene
rate
d fro
m A
MR
and
antim
icro
bial
use
sur
veill
ance
to
info
rm a
ntib
iotic
-use
pra
ctic
es.
D
evel
op a
nat
iona
l reg
ulat
ory
fram
ewor
k fo
r app
ropr
iate
use
of a
fford
able
, qua
lity
assu
red
antim
icro
bial
s in
hum
ans
and
anim
als.
Ex
pand
ant
imic
robi
al s
tew
ards
hip
activ
ities
to a
ll he
alth
care
faci
litie
s.
Reco
mm
end
and
impl
emen
t the
pha
sing
out
of a
ntim
icro
bial
s us
ed a
s an
imal
gro
wth
pro
mot
ion.
M
ap e
xist
ing
rele
vant
legi
slat
ion
and
begi
n th
e re
view
pro
cess
for c
oher
ence
.
Dev
elop
and
impl
emen
t leg
isla
tion
on “p
resc
riptio
n on
ly” s
ales
of k
ey a
ntib
iotic
s.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
ntin
ue to
mon
itor a
ntim
icro
bial
ste
war
dshi
p ac
tiviti
es a
nd u
pdat
e th
e na
tiona
l ste
war
dshi
p pl
an o
n a
timel
y ba
sis
and
publ
icly
repo
rt o
n th
e re
sults
.
Trac
k an
tibio
tic d
ispe
nsin
g an
d se
t nat
iona
l tar
gets
for i
mpr
ovem
ent.
M
easu
re a
ntib
iotic
use
and
ass
ess
appr
opria
tene
ss.
M
onito
r ant
ibio
tic q
ualit
y an
d ad
dres
s dr
iver
s of
pre
scrib
ing
beha
viou
rs.
Im
plem
ent a
nat
iona
l reg
ulat
ory
fram
ewor
k fo
r app
ropr
iate
use
of a
fford
able
, qua
lity
assu
red
antim
icro
bial
s in
hum
ans
and
anim
als.
M
onito
r “pr
escr
iptio
n on
ly” s
ales
of k
ey a
ntib
iotic
s.
Com
plet
e th
e re
view
of r
elev
ant l
egis
latio
n an
d en
act a
men
dmen
ts to
mak
e le
gisl
atio
n co
here
nt.
WHO BENCHMARKS FOR IHR CAPACITIES
34
TOO
LS:
G
uide
line
on c
ore
com
pone
nts
of in
fect
ion
prev
entio
n an
d co
ntro
l pro
gram
mes
at t
he n
atio
nal a
nd a
cute
hea
lth c
are
faci
lity
leve
l.
WH
O c
ore
com
pone
nts
for I
PC –
Impl
emen
tatio
n to
ols
and
reso
urce
s
Nat
iona
l and
faci
lity
prac
tical
man
uals
sup
port
ing
thei
r im
plem
enta
tion
IP
CAF,
hand
hyg
iene
sel
f-as
sess
men
t fra
mew
ork,
han
d hy
gien
e co
mpl
ianc
e ob
serv
atio
n to
ols,
WAS
H F
IT to
ol
Shar
ing
FAO
tool
s fo
r vet
erin
ary
labo
rato
ry a
sses
smen
t. Fo
od a
nd A
gric
ultu
re O
rgan
izat
ion
N
atio
nal a
ntim
icro
bial
resi
stan
ce s
urve
illan
ce s
yste
ms
and
part
icip
atio
n in
the
Glo
bal A
ntim
icro
bial
Res
ista
nce
Surv
eilla
nce
Syst
em (G
LASS
):
A gu
ide
to p
lann
ing,
impl
emen
tatio
n an
d m
onito
ring
and
eval
uatio
n. W
orld
Hea
lth O
rgan
izat
ion;
201
6.
OIE
dat
a co
llect
ion
tem
plat
e. P
aris
: Wor
ld O
rgan
isat
ion
for A
nim
al H
ealth
; 201
7
OIE
sta
ndar
ds a
nd re
com
men
datio
ns [f
acts
heet
]. Pa
ris: W
orld
Org
anis
atio
n fo
r Ani
mal
Hea
lth; 2
016
W
HO
Glo
bal a
ctio
n pl
an o
n an
timic
robi
al re
sist
ance
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
015
G
uide
lines
on
core
com
pone
nts
of in
fect
ion
prev
entio
n an
d co
ntro
l pro
gram
mes
at t
he n
atio
nal a
nd a
cute
hea
lth c
are
faci
lity.
G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
201
6
Nat
iona
l act
ion
plan
for c
omba
ting
antib
iotic
-res
ista
nt b
acte
ria. A
tlant
a: C
ente
rs fo
r Dis
ease
Con
trol a
nd P
reve
ntio
n; 2
015
Ex
ecut
ive
sum
mar
y: Th
e se
lect
ion
and
use
of e
ssen
tial m
edic
ines
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
017
WHO BENCHMARKS FOR IHR CAPACITIES
35
ZOO
NO
TIC
DISE
ASE
04
IMPA
CT:
Func
tiona
l ani
mal
hea
lth, e
nviro
nmen
t and
hum
an h
ealth
sys
tem
s w
ork
indi
vidu
ally
and
col
labo
rativ
ely
thro
ugh
docu
men
ted
mec
hani
sms
and
oper
atio
nal f
ram
ewor
ks, u
sing
a m
ultis
ecto
ral O
ne H
ealth
app
roac
h an
d ba
sed
on in
tern
atio
nal s
tand
ards
, gui
danc
e an
d be
st p
ract
ices
, to
min
imiz
e th
e tr
ansm
issi
on o
f zoo
notic
dis
ease
s to
hum
an p
opul
atio
ns.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Agr
eem
ent b
y th
e an
imal
hea
lth a
nd p
ublic
hea
lth s
ecto
rs o
n a
com
mon
list
of z
oono
tic d
isea
ses/
path
ogen
s of
gre
ates
t nat
iona
l pub
lic
heal
th c
once
rn. (
2) E
xist
ence
of f
unct
iona
l cap
aciti
es in
the
anim
al h
ealth
and
pub
lic h
ealth
sec
tors
and
of c
olla
bora
tion,
coo
rdin
atio
n an
d co
mm
unic
atio
n be
twee
n th
em fo
r pre
pare
dnes
s, d
etec
tion,
ass
essm
ent a
nd re
spon
se to
zoo
notic
dis
ease
s.
Func
tiona
l mul
tisec
tora
l, mul
tidis
cipl
inar
y m
echa
nism
s, p
olic
ies,
sys
tem
s an
d pr
actic
es a
re in
pla
ce to
min
imiz
e th
e tr
ansm
issi
on a
nd s
prea
d of
zoo
notic
di
seas
es b
etw
een
anim
als
and
hum
ans.
WHO BENCHMARKS FOR IHR CAPACITIES
36
CAPA
CITY
LEVE
L
Benc
hmar
k 4.
1: C
oord
inat
ed s
urve
illan
ce s
yste
m is
in p
lace
for p
riorit
y zo
onot
ic d
isea
ses/
path
ogen
s O
bjec
tive:
Str
engt
hen
coor
dina
ted
surv
eilla
nce
syst
ems
for p
riorit
y zo
onot
ic d
isea
ses/
path
ogen
s
01N
O C
APAC
ITY
No
join
tly a
gree
d up
on li
st o
f prio
rity
dise
ases
to fo
cus
coor
dina
ted
surv
eilla
nce
effo
rts.
N
o or
gani
zed
coor
dina
ted
surv
eilla
nce
syst
em in
pla
ce to
con
nect
ani
mal
and
pub
lic h
ealth
sys
tem
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y ke
y st
akeh
olde
rs a
nd fo
cal p
oint
s fro
m a
nim
al h
ealth
(dom
estic
ani
mal
s an
d w
ildlif
e), h
uman
hea
lth, e
nviro
nmen
tal
heal
th a
nd o
ther
key
sec
tors
.
Revi
ew a
nd a
sses
s su
rvei
llanc
e ca
paci
ty in
eac
h se
ctor
and
any
exi
stin
g co
ordi
natio
n or
dat
a sh
arin
g m
echa
nism
bet
wee
n th
e re
leva
nt s
ecto
rs.
Jo
intly
defi
ne a
nd p
riorit
ize
zoon
otic
dis
ease
s of
gre
ates
t nat
iona
l pub
lic h
ealth
con
cern
for t
he c
ount
ry th
roug
h a
One
H
ealth
app
roac
h th
at in
volv
es a
ll re
leva
nt s
take
hold
ers.
D
evel
op s
trat
egy,
guid
elin
es a
nd S
OPs
for c
oord
inat
ed s
urve
illan
ce a
nd re
port
ing
of a
t lea
st tw
o pr
iorit
y zo
onot
ic d
isea
ses
of g
reat
est n
atio
nal p
ublic
hea
lth c
once
rn.
D
evel
op a
dequ
ate
labo
rato
ry c
apac
ity a
nd s
tand
ards
with
in re
leva
nt s
ecto
rs to
det
ect z
oono
tic d
isea
ses.
Dev
elop
ope
ratio
nal p
lans
for t
he m
anag
emen
t of a
t lea
st tw
o pr
iorit
y zo
onot
ic d
isea
ses
of g
reat
est n
atio
nal p
ublic
hea
lth
conc
ern.
D
evel
op a
nd d
isse
min
ate
trai
ning
pac
kage
s on
the
oper
atio
nal p
lan,
ass
ocia
ted
guid
elin
es a
nd S
OPs
.
Des
igna
te a
foca
l poi
nt o
r uni
t with
in th
e an
imal
and
hum
an h
ealth
sec
tors
and
oth
er re
leva
nt s
ecto
rs a
nd fo
rmal
ize
a co
ordi
natio
n m
echa
nism
for p
riorit
y zo
onot
ic d
isea
ses/
path
ogen
s.
WHO BENCHMARKS FOR IHR CAPACITIES
37
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
anim
al–
hum
an in
terf
aces
and
pro
cedu
res
to e
xcha
nge
surv
eilla
nce
info
rmat
ion
on z
oono
tic d
isea
ses
amon
g re
leva
nt s
ecto
rs (a
nd w
ider
whe
n ne
eded
), id
eally
thro
ugh
an e
lect
roni
c sy
stem
.
Esta
blis
h an
inte
rope
rabi
lity
plat
form
or i
nfor
mat
ion
shar
ing
mec
hani
sm b
etw
een
the
rele
vant
sec
tors
to in
itiat
e co
ordi
nate
d su
rvei
llanc
e ac
tiviti
es.
Im
plem
ent t
he o
pera
tiona
l pla
n an
d al
loca
te re
sour
ces
for t
he p
reve
ntio
n an
d de
tect
ion
of p
riorit
y zo
onot
ic d
isea
ses
of
grea
test
nat
iona
l pub
lic h
ealth
con
cern
.
Trai
n re
spon
sibl
e st
aff f
or s
peci
fic a
spec
ts o
f the
sur
veill
ance
and
man
agem
ent o
f prio
rity
zoon
otic
dis
ease
s at
nat
iona
l and
su
bnat
iona
l lev
els.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ex
pand
labo
rato
ry-e
nhan
ced
coor
dina
ted
surv
eilla
nce
to a
ll pr
iorit
y zo
onot
ic d
isea
ses/
path
ogen
s at
all
leve
ls (n
atio
nal,
inte
rmed
iate
and
loca
l lev
els)
in a
ll se
ctor
s.
Enha
nce
the
inte
rope
rabi
lity
plat
form
or i
nfor
mat
ion
shar
ing
mec
hani
sm b
etw
een
the
rele
vant
sec
tors
, ide
ally
thro
ugh
linki
ng e
xist
ing
or e
stab
lishi
ng n
ew e
lect
roni
c sy
stem
s w
here
app
licab
le.
Tr
ain
addi
tiona
l sta
ff ac
ross
all
rele
vant
sec
tors
in th
e su
rvei
llanc
e an
d m
anag
emen
t of z
oono
tic d
isea
ses
at s
ubna
tiona
l le
vels
.
Use
coo
rdin
ated
sur
veill
ance
dat
a to
info
rm d
isea
se p
reve
ntio
n an
d co
ntro
l effo
rts
acro
ss a
ll re
leva
nt s
ecto
rs.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Al
loca
te a
vaila
ble
and
sust
aina
ble
reso
urce
s fo
r coo
rdin
ated
sur
veill
ance
and
man
agem
ent o
f all
prio
rity
zoon
otic
dis
ease
s ac
ross
rele
vant
sec
tors
.
Test
sur
veill
ance
sys
tem
cap
acity
regu
larly
with
all
rele
vant
sec
tors
to d
etec
t zoo
notic
eve
nts
and
the
man
agem
ent o
f zo
onot
ic d
isea
ses
eith
er b
y an
afte
r-ac
tion
revi
ew o
r sim
ulat
ion
exer
cise
.
Use
coo
rdin
ated
sur
veill
ance
dat
a to
info
rm a
nd e
valu
ate
dise
ase
prev
entio
n an
d co
ntro
l effo
rts
acro
ss a
ll re
leva
nt s
ecto
rs.
Ba
sed
on th
e re
sults
of t
hese
exe
rcis
es o
r rev
iew
s, u
pdat
e th
e gu
idel
ines
, SO
Ps a
nd o
pera
tiona
l pla
n w
here
app
ropr
iate
.
WHO BENCHMARKS FOR IHR CAPACITIES
38
CAPA
CITY
LEVE
L
Benc
hmar
k 4.
2: F
unct
iona
l mec
hani
sm to
resp
ond
to p
riorit
y zo
onot
ic d
isea
ses
in p
lace
O
bjec
tive:
Str
engt
hen
mec
hani
sm to
resp
ond
to z
oono
tic d
isea
ses
01N
O C
APAC
ITY
No
coor
dina
ted
resp
onse
mec
hani
sm fo
r prio
rity
zoon
otic
dis
ease
s.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
and
ass
ess
exis
ting
mul
tisec
tora
l pol
icy,
stra
tegy
, pla
n an
d/or
mec
hani
sm fo
r res
pond
ing
to p
riorit
y zo
onot
ic e
vent
s.
Dev
elop
gui
delin
es a
nd S
OPs
for c
oord
inat
ed re
spon
se to
zoo
notic
eve
nts
and
mor
e w
idel
y fo
r the
man
agem
ent o
f prio
rity
zoon
otic
dis
ease
s by
all
rele
vant
sec
tors
.
Des
igna
te a
foca
l poi
nt fr
om e
ach
sect
or (a
nim
al (d
omes
tic a
nim
als
and
wild
life)
, hum
an a
nd e
nviro
nmen
tal h
ealth
) for
re
spon
se c
oord
inat
ion.
D
evel
op a
nd d
isse
min
ate
trai
ning
pac
kage
s on
thes
e gu
idel
ines
and
SO
Ps.
Pu
blis
h th
ese
polic
ies/
stra
tegi
es a
nd p
lan.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
mul
tisec
tora
l One
Hea
lth o
pera
tiona
l pla
n, w
ith th
e pr
ovis
ion
of re
sour
ces,
for a
coo
rdin
ated
resp
onse
to a
n ou
tbre
ak o
f at l
east
two
prio
rity
zoon
otic
dis
ease
s by
all
rele
vant
sec
tors
.
Trai
n st
aff o
f hum
an, a
nim
al (d
omes
tic a
nim
als
and
wild
life)
, and
env
ironm
enta
l hea
lth s
ecto
rs o
n th
ese
guid
elin
es, S
OPs
an
d op
erat
ion
plan
.
Esta
blis
h a
com
mun
icat
ion
mec
hani
sm fo
r rap
idly
ale
rtin
g al
l rel
evan
t sec
tors
to p
riorit
y zo
onot
ic o
utbr
eak
even
ts to
in
crea
se s
ecto
r aw
aren
ess
and
decr
ease
the
time
to c
ondu
ct a
coo
rdin
ated
out
brea
k re
spon
se.
En
sure
that
acc
ess
to la
bora
tory
cap
acity
to d
etec
t pat
hoge
ns fo
r any
prio
rity
zoon
oses
is in
clud
ed in
the
resp
onse
pla
ns.
WHO BENCHMARKS FOR IHR CAPACITIES
39
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
isse
min
ate
and
expa
nd th
e op
erat
iona
l pla
n to
resp
ond
to a
ll pr
iorit
y zo
onot
ic d
isea
ses
to th
e in
term
edia
te a
nd lo
cal l
evel
s fo
r all
the
rele
vant
sec
tors
.
Regu
larly
ana
lyse
and
pro
duce
repo
rts
on th
e tim
elin
ess
of in
form
atio
n ex
chan
ge a
nd a
ctiv
atio
n of
resp
onse
mec
hani
sms
betw
een
sect
ors.
D
evel
op n
ext s
teps
for i
mpr
ovin
g re
spon
se ti
mel
ines
.
Mon
itor a
nd e
valu
ate
the
mul
tisec
tora
l coo
rdin
atio
n m
echa
nism
for c
resp
onse
regu
larly
.
Revi
ew a
nd u
pdat
e th
e op
erat
iona
l pla
n/m
echa
nism
bas
ed o
n th
e re
sults
of m
onito
ring
and
eval
uatio
n.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t afte
r-ac
tion
revi
ews
and/
or s
imul
atio
n ex
erci
ses
to te
st th
e op
erat
iona
lity
of th
e re
spon
se to
zoo
notic
dis
ease
s ev
ents
acr
oss
all r
elev
ant s
ecto
rs.
Re
view
and
upd
ate
the
oper
atio
nal p
lan/
mec
hani
sm b
ased
on
the
resu
lts.
D
ocum
ent a
nd d
isse
min
ate
the
resu
lts a
nd le
sson
s le
arne
d fro
m e
ffort
s to
min
imiz
e an
imal
-to-
hum
an s
prea
d of
dis
ease
.
TOO
LS:
Im
plem
enta
tion
of th
e IH
R at
the
hum
an-a
nim
al-h
ealth
inte
rfac
e
Glo
bal e
arly
war
ning
sys
tem
for m
ajor
ani
mal
dis
ease
incl
udin
g zo
onos
es (G
LEW
S)
Man
agin
g pu
blic
hea
lth ri
sks
at th
e hu
man
-ani
mal
-env
ironm
ent i
nter
face
N
egle
cted
zoo
notic
dis
ease
Zo
onot
ic d
isea
ses
Zo
onot
ic d
isea
ses:
a g
uide
to e
stab
lishi
ng c
olla
bora
tion
betw
een
anim
al a
nd h
uman
hea
lth s
ecto
rs a
t the
cou
ntry
leve
l.
Zoon
otic
– S
urve
illan
ce a
nd C
ontro
l
One
Hea
lth
Anim
al H
ealth
in th
e W
orld
Re
sour
ces
– W
orld
org
anis
atio
n of
ani
mal
hea
lth (O
IE)
O
IE in
tern
atio
nal s
tand
ards
H
andb
ook
for t
he a
sses
smen
t of c
apac
ities
at t
he h
uman
–an
imal
inte
rface
. Wor
ld H
ealth
Org
aniz
atio
n an
d th
e W
orld
Org
anis
atio
n fo
r Ani
mal
Hea
lth; 2
017
WHO BENCHMARKS FOR IHR CAPACITIES
40
FOO
D SA
FETY
05
IMPA
CT:
Tim
ely
dete
ctio
n an
d ef
fect
ive
resp
onse
of p
oten
tial f
ood-
rela
ted
even
ts in
col
labo
ratio
n w
ith o
ther
sec
tors
resp
onsi
ble
for f
ood
safe
ty.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Exi
sten
ce o
f ind
icat
or-b
ased
dis
ease
sur
veilla
nce
or e
vent
-bas
ed d
isea
se s
urve
illanc
e an
d su
ppor
ting
labo
rato
ry a
naly
sis
to d
etec
t and
ass
ign
aetio
logy
for f
oodb
orne
dis
ease
s or
orig
in o
f con
tam
inat
ion
even
t, an
d in
vest
igat
ion
of h
azar
ds in
food
s lin
ked
to c
ases
, out
brea
ks o
r eve
nts.
(2
) Exi
sten
ce o
f a n
atio
nal f
ood
safe
ty e
mer
genc
y pl
an. (
3) E
xist
ence
of a
des
igna
ted
Inte
rnat
iona
l Foo
d Sa
fety
Aut
horit
ies
Net
wor
k (IN
FOSA
N)
Emer
genc
y Co
ntac
t Poi
nt, a
nd th
e O
IE F
ocal
Poi
nt o
n An
imal
Pro
duct
ion
Food
Saf
ety
with
a c
entr
al c
oord
inat
ion
mec
hani
sm in
pla
ce.
A fu
nctio
nal s
yste
m is
in p
lace
for s
urve
illan
ce a
nd re
spon
se c
apac
ity o
f Sta
tes
Part
ies
for f
oodb
orne
dis
ease
and
food
con
tam
inat
ion
risks
or e
vent
s w
ith
effe
ctiv
e co
mm
unic
atio
n an
d co
llabo
ratio
n am
ong
the
sect
ors
resp
onsi
ble
for f
ood
safe
ty.
WHO BENCHMARKS FOR IHR CAPACITIES
41
CAPA
CITY
LEVE
L
Benc
hmar
k 5.
1: S
urve
illan
ce s
yste
ms
in p
lace
for t
he d
etec
tion
and
mon
itorin
g of
food
born
e di
seas
es a
nd fo
od c
onta
min
atio
n O
bjec
tive:
Str
engt
hen
surv
eilla
nce
syst
ems
for f
oodb
orne
dis
ease
s an
d fo
od c
onta
min
atio
n
01N
O C
APAC
ITY
No
or v
ery
limite
d su
rvei
llanc
e sy
stem
in p
lace
for f
oodb
orne
dis
ease
or f
or fo
od c
onta
min
atio
n (c
hem
ical
and
mic
robi
olog
ical
) m
onito
ring.
Th
e co
untr
y ha
s to
dev
elop
and
impl
emen
t all
activ
ities
that
are
list
ed in
leve
l 2 to
ach
ieve
lim
ited
capa
city
for t
he s
urve
illan
ce
syst
em.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
food
born
e di
seas
e su
rvei
llanc
e an
d fo
od c
onta
min
atio
n m
onito
ring
capa
city
, and
ass
ess
gaps
and
nee
ds.
Id
entif
y ke
y st
akeh
olde
rs a
nd
foca
l poi
nts
for f
oodb
orne
dis
ease
su
rvei
llanc
e an
d fo
od c
onta
min
atio
n m
onito
ring.
Id
entif
y re
spon
sibl
e gr
oups
in re
leva
nt
agen
cies
to c
oord
inat
e de
velo
pmen
t an
d im
plem
enta
tion
of fo
odbo
rne
dise
ase
surv
eilla
nce
and
food
co
ntam
inat
ion
mon
itorin
g sy
stem
(s).
D
evel
op a
str
ateg
y to
mon
itor
trend
s an
d de
tect
food
born
e ev
ents
to
inco
rpor
ate
with
in th
e na
tiona
l co
mm
unic
able
dis
ease
sur
veill
ance
st
rate
gy (s
ee s
urve
illan
ce te
chni
cal
area
).
Link
sur
veill
ance
act
iviti
es w
ith th
e su
rvei
llanc
e te
chni
cal a
rea
benc
hmar
ks.
Esta
blis
h in
dica
tor-
base
d di
seas
e su
rvei
llanc
e (o
r)
D
evel
op g
uide
lines
and
SO
Ps fo
r pr
iorit
y fo
odbo
rne
dise
ases
.
Esta
blis
h a
desi
gnat
ed u
nit a
t all
leve
ls w
ith o
pera
tiona
l pla
n an
d pr
oced
ures
.
Esta
blis
h an
d di
ssem
inat
e ca
se
defin
ition
s, p
roce
ss o
f det
ectio
n,
asse
ssm
ent a
nd re
port
ing
of c
ases
(u
ser m
anua
l or g
uide
lines
) to
natio
nal a
nd s
ubna
tiona
l lev
els.
Esta
blis
h ev
ent-
base
d di
seas
e su
rvei
llanc
e
D
evel
op g
uide
lines
and
SO
PS.
Es
tabl
ish
a de
sign
ated
uni
t at a
ll ne
eded
leve
ls w
ith o
pera
tiona
l pla
n an
d pr
oced
ures
.
Dev
elop
and
put
in p
lace
cas
e de
finiti
ons,
pro
cess
of d
etec
tion,
as
sess
men
t and
repo
rtin
g of
ev
ents
(clu
ster
s or
out
brea
ks)
for c
ount
ry p
riorit
y di
seas
es, a
nd
diss
emin
atio
n to
nat
iona
l and
su
bnat
iona
l lev
els.
Es
tabl
ish
a pr
oces
s to
cap
ture
ev
ents
from
com
mun
ity a
nd o
ther
so
urce
s (s
uch
as m
edia
, soc
ial
med
ia, p
rivat
e se
ctor
), an
d m
ake
the
data
ava
ilabl
e at
all
need
ed
leve
ls.
WHO BENCHMARKS FOR IHR CAPACITIES
42
D
evel
op g
uide
lines
and
SO
Ps fo
r the
de
tect
ion
of fo
odbo
rne
even
ts a
nd
impl
emen
t ind
icat
or-/
even
t-ba
sed
dise
ase
surv
eilla
nce
(refe
r to
indi
cato
r-/
even
t-ba
sed
dise
ase
surv
eilla
nce
colu
mns
for r
espe
ctiv
e be
nchm
arks
).13
D
evel
op a
nd d
isse
min
ate
a tr
aini
ng
pack
age
on th
ese
guid
elin
es a
nd S
OPs
.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
ctio
ns (d
escr
ibed
abo
ve) f
or b
oth
indi
cato
r- a
nd e
vent
-bas
ed d
isea
se s
urve
illan
ce s
yste
ms
at n
atio
nal a
nd
inte
rmed
iate
leve
ls (d
istr
ict,
prov
ince
, reg
ion
or s
tate
).
Dev
elop
a la
bora
tory
pro
toco
l for
the
inve
stig
atio
n of
food
born
e di
seas
es a
nd fo
od c
onta
min
atio
n.
Trai
n st
aff o
n th
ese
prot
ocol
s w
ith th
e pr
ovis
ion
of la
bora
tory
logi
stic
s in
des
igna
ted
labo
rato
ries.
En
sure
pro
visi
on o
f res
ourc
es fo
r the
inve
stig
atio
n of
food
born
e di
seas
e or
food
con
tam
inat
ion
even
ts a
t the
nat
iona
l lev
el.
This
sho
uld
incl
ude
inve
stig
atio
ns in
to h
azar
ds in
food
s lin
ked
to c
ases
, out
brea
ks o
r eve
nts.
Te
st fo
r foo
dbor
ne d
isea
ses
and/
or c
onta
min
atio
n fo
r the
cas
es o
r eve
nts
dete
cted
thro
ugh
indi
cato
r- o
r eve
nt-b
ased
di
seas
e su
rvei
llanc
e to
ass
ign
aetio
logy
.
Dev
elop
or a
dopt
the
risk
asse
ssm
ent p
roto
col o
f acu
te fo
odbo
rne
even
ts (c
hem
ical
and
mic
robi
olog
ical
).14
D
evel
op a
n in
form
atio
n-sh
arin
g pr
otoc
ol a
nd m
echa
nism
that
will
app
ly to
all
rele
vant
sta
keho
lder
s in
volv
ed in
food
born
e di
seas
e su
rvei
llanc
e an
d fo
od c
onta
min
atio
n m
onito
ring.
15, 2
2
13 S
treng
then
ing
surv
eilla
nce
of a
nd re
spon
se to
food
born
e di
seas
es.
14 F
ood
safe
ty ri
sk a
naly
sis:
A g
uide
for n
atio
nal f
ood
safe
ty a
utho
ritie
s. R
ome:
Foo
d an
d Ag
ricul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
; 200
9.
15 A
ssur
ing
food
saf
ety
and
qual
ity: g
uide
lines
for s
treng
then
ing
natio
nal f
ood
cont
rol s
yste
ms.
Rom
e: F
ood
and
Agric
ultu
re O
rgan
izat
ion
of th
e U
nite
d N
atio
ns.
WHO BENCHMARKS FOR IHR CAPACITIES
43
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Tr
ain
staf
f at n
atio
nal a
nd s
ubna
tiona
l lev
els
to c
ondu
ct ri
sk a
sses
smen
t of a
cute
food
born
e ev
ents
.
Allo
cate
or i
dent
ify re
sour
ces
for s
uch
trai
ning
and
risk
ass
essm
ents
.
Cond
uct r
isk
asse
ssm
ents
of a
cute
food
born
e ev
ents
(che
mic
al a
nd m
icro
biol
ogic
al) a
nd p
ublis
h a
perio
dic
repo
rt (s
uch
as
an e
pide
mio
logi
cal b
ulle
tin).16
,17,
18,1
9
Tr
ain
iden
tified
food
born
e di
seas
e su
rvei
llanc
e an
d fo
od c
onta
min
atio
n m
onito
ring
foca
l poi
nts
in th
e su
rvei
llanc
e of
suc
h ha
zard
s.
Cond
uct a
Tot
al D
iet S
tudy
or s
imila
r stu
dy a
nd im
plem
ent o
utco
mes
to c
ompl
emen
t the
exi
stin
g na
tiona
l mon
itorin
g an
d su
rvei
llanc
e st
rate
gy.20
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t an
afte
r-ac
tion
revi
ew o
f a fo
odbo
rne
even
t or a
sim
ulat
ion
exer
cise
in th
e ab
senc
e of
a re
al e
vent
to te
st th
e ca
paci
ty o
f sur
veill
ance
and
mon
itorin
g sy
stem
s.
Doc
umen
t find
ings
and
iden
tify
area
s fo
r im
prov
emen
t; up
date
the
stra
tegy
, gui
delin
es a
nd S
OPs
, if a
ppro
pria
te.
Sh
are
outc
ome
with
all
rele
vant
sta
keho
lder
s.
16 P
rinci
ples
and
met
hods
for t
he ri
sk a
sses
smen
t of c
hem
ical
s in
food
: Env
ironm
enta
l Hea
lth C
riter
ia 2
40. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
200
9.
17 H
azar
d ch
arac
teriz
atio
n fo
r pat
hoge
ns in
food
and
wat
er: M
icro
biol
ogic
al ri
sk a
sses
smen
t ser
ies
3, g
uide
lines
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
003.
18
Exp
osur
e as
sess
men
t of m
icro
biol
ogic
al h
azar
ds in
food
: Mic
robi
olog
ical
risk
ass
essm
ent s
erie
s 7,
gui
delin
es. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
200
8.
19 R
isk
char
acte
rizat
ion
of m
icro
biol
ogic
al h
azar
ds in
food
: Mic
robi
olog
ical
risk
ass
essm
ent s
erie
s 17
, gui
delin
es. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
200
9.
20 T
owar
ds a
har
mon
ised
tota
l die
t stu
dy a
ppro
ach:
a g
uida
nce
docu
men
t. W
orld
Hea
lth O
rgan
izat
ion,
Foo
d an
d Ag
ricul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
and
Eur
opea
n Fo
od S
afet
y Au
thor
ity; 2
011.
WHO BENCHMARKS FOR IHR CAPACITIES
44
CAPA
CITY
LEVE
L
Benc
hmar
k 5.
2: A
func
tiona
l mec
hani
sm is
in p
lace
for t
he re
spon
se a
nd m
anag
emen
t of f
ood
safe
ty e
mer
genc
ies
Obj
ectiv
e: S
tren
gthe
n m
echa
nism
s fo
r res
pons
e an
d m
anag
emen
t of f
ood
safe
ty e
mer
genc
ies
01N
O C
APAC
ITY
No
mec
hani
sm fo
r the
resp
onse
and
man
agem
ent o
f foo
d sa
fety
em
erge
ncie
s ha
s be
en e
stab
lishe
d or
in p
lace
, or i
s ve
ry
limite
d.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
the
mec
hani
sm, i
f it e
xist
s, fo
r the
resp
onse
and
man
agem
ent o
f foo
d sa
fety
em
erge
ncie
s to
iden
tify
and
asse
ss
gaps
and
nee
ds, w
ith re
fere
nce
to re
leva
nt F
ood
and
Agric
ultu
re O
rgan
izat
ion
(FAO
)/W
HO
gui
delin
es.21
,22,
23,2
4
Id
entif
y ke
y go
vern
men
t age
ncie
s in
volv
ed in
the
resp
onse
and
man
agem
ent o
f foo
d sa
fety
em
erge
ncie
s.
Dev
elop
SO
Ps a
nd g
uide
lines
for t
he re
spon
se a
nd m
anag
emen
t of f
ood
safe
ty e
mer
genc
ies
(The
se g
uide
lines
sho
uld
be
part
of t
he o
vera
ll su
rvei
llanc
e gu
idel
ine
for f
oodb
orne
dis
ease
s an
d co
ntam
inat
ion)
.25
D
esig
nate
an
INFO
SAN
Em
erge
ncy
Cont
act P
oint
in th
e go
vern
men
t age
ncy
resp
onsi
ble
for t
he re
spon
se a
nd m
anag
emen
t of
food
saf
ety
emer
genc
ies.
26
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
com
mun
icat
ion
chan
nels
am
ong
all r
elev
ant s
ecto
rs in
clud
ing
betw
een
the
INFO
SAN
Em
erge
ncy
Cont
act P
oint
an
d th
e IH
R N
atio
nal F
ocal
Poi
nt.
D
esig
nate
INFO
SAN
Foc
al P
oint
s w
ith re
spon
sibi
lity
for f
ood
safe
ty a
t app
ropr
iate
leve
ls in
oth
er g
over
nmen
t age
ncie
s.
Deve
lop
a co
ordi
natio
n m
echa
nism
with
SOP
s lin
king
all r
elev
ant s
ecto
rs to
geth
er w
ith a
defi
ned
set o
f rol
es a
nd re
spon
sibi
litie
s.
Dev
elop
and
dis
sem
inat
e tr
aini
ng p
acka
ges
on S
OPs
and
gui
delin
es fo
r the
resp
onse
and
man
agem
ent o
f foo
d sa
fety
em
erge
ncie
s.
21 F
AO/W
HO
fram
ewor
k fo
r dev
elop
ing
natio
nal f
ood
safe
ty e
mer
genc
y re
spon
se p
lans
. Rom
e: F
ood
and
Agric
ultu
re O
rgan
izat
ion
of th
e U
nite
d N
atio
ns a
nd W
orld
Hea
lth O
rgan
izat
ion;
201
0.22
FAO
/WH
O g
uide
for a
pplic
atio
n of
risk
ana
lysi
s pr
inci
ples
and
pro
cedu
res
durin
g fo
od s
afet
y em
erge
ncie
s. R
ome:
Foo
d an
d Ag
ricul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
; 201
1.
23 F
AO/W
HO
gui
de fo
r dev
elop
ing
and
impr
ovin
g na
tiona
l foo
d re
call
syst
ems.
Rom
e: F
ood
and
Agric
ultu
re O
rgan
izat
ion
of th
e U
nite
d N
atio
ns a
nd W
orld
Hea
lth O
rgan
izat
ion;
201
2.
24 F
oodb
orne
dis
ease
out
brea
ks: g
uide
lines
for i
nves
tigat
ion
and
cont
rol.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
008.
25
Ris
k m
anag
emen
t and
food
saf
ety:
cons
ulta
tion
repo
rt. R
ome:
Foo
d an
d Ag
ricul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
; 199
8.
26 IN
FOSA
N m
embe
r rol
es a
nd re
spon
sibi
litie
s. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
201
5.
WHO BENCHMARKS FOR IHR CAPACITIES
45
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op s
trat
egie
s an
d gu
idan
ce to
com
mun
icat
e w
ith p
artn
ers,
sta
keho
lder
s, g
ener
al p
ublic
, int
erna
tiona
l org
aniz
atio
ns
and
appl
icab
le re
gion
al a
nd in
tern
atio
nal n
etw
orks
, and
orie
nt th
em o
n th
ese
stra
tegi
es a
nd g
uida
nce.
27
D
evel
op a
nd d
isse
min
ate
risk
com
mun
icat
ion
mes
sage
s to
the
publ
ic, t
hrou
gh a
ppro
pria
te m
edia
, dur
ing
food
saf
ety
emer
genc
ies.
28
Es
tabl
ish
info
rmat
ion
shar
ing
mec
hani
sms
at re
gion
al a
nd in
tern
atio
nal l
evel
s.
Esta
blis
h a
mec
hani
sm o
f sha
ring
info
rmat
ion
regu
larly
by
the
INFO
SAN
Em
erge
ncy
Cont
act P
oint
with
the
IHR
NFP
, IN
FOSA
N F
ocal
Poi
nts
and
all r
elev
ant s
ecto
rs d
urin
g a
food
saf
ety
emer
genc
y.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t afte
r-ac
tion
revi
ews
of re
spon
se to
food
saf
ety
even
ts o
r dev
elop
an
exer
cise
in th
e ab
senc
e of
a re
al e
vent
to
asse
ss a
nd re
view
the
resp
onse
, col
labo
ratio
n an
d co
mm
unic
atio
n m
echa
nism
s.
Ensu
re p
artic
ipat
ion
of th
e IN
FOSA
N E
mer
genc
y Co
ntac
t Poi
nt in
INFO
SAN
sim
ulat
ion
exer
cise
s or
real
food
saf
ety
emer
genc
ies,
with
the
INFO
SAN
Sec
reta
riat.
D
ocum
ent a
nd d
isse
min
ate
the
findi
ngs
in te
rms
of ti
mel
ines
s, in
form
atio
n ex
chan
ge, p
ublic
hea
lth ri
sk m
essa
ging
, ef
ficie
ncy
and
effe
ctiv
enes
s of
resp
onse
, col
labo
ratio
n an
d co
mm
unic
atio
n.
Revi
ew a
nd u
pdat
e th
e m
anag
emen
t and
resp
onse
pla
n ba
sed
on th
ese
findi
ngs.
27 A
ssur
ing
food
saf
ety
and
qual
ity: g
uide
lines
for s
treng
then
ing
natio
nal f
ood
cont
rol s
yste
ms.
Rom
e: F
ood
and
Agric
ultu
re O
rgan
izat
ion
of th
e U
nite
d N
atio
ns; 2
003.
28
Ris
k co
mm
unic
atio
n ap
plie
d to
food
saf
ety
hand
book
(201
6). R
ome:
Foo
d an
d Ag
ricul
ture
Org
aniz
atio
n of
the
Uni
ted
Nat
ions
and
Wor
ld H
ealth
Org
aniz
atio
n; 2
017.
TOO
LS:
Fo
od s
afet
y. [W
HO
web
site
] (ht
tp://
ww
w.w
ho.in
t/fo
odsa
fety
/en/
, acc
esse
d 30
Jan
uary
201
9).
WHO BENCHMARKS FOR IHR CAPACITIES
46
IMM
UN
IZAT
ION
06
IMPA
CT:
Effe
ctiv
e pr
otec
tion
thro
ugh
achi
evem
ent a
nd m
aint
enan
ce o
f im
mun
izat
ion
agai
nst m
easl
es a
nd o
ther
epi
dem
ic-p
rone
vac
cine
-pre
vent
able
di
seas
es (V
PDs)
. Mea
sles
imm
uniz
atio
n is
em
phas
ized
bec
ause
it is
wid
ely
reco
gniz
ed a
s a
prox
y in
dica
tor f
or o
vera
ll im
mun
izat
ion
agai
nst V
PDs
and
beca
use
mea
sles
is a
con
tinue
d ca
use
of s
ubst
antia
l avo
idab
le m
orbi
dity
and
mor
talit
y. C
ount
ries
will
als
o id
entif
y an
d ta
rget
imm
uniz
atio
n to
pop
ulat
ions
at r
isk
of o
ther
epi
dem
ic-p
rone
VPD
s of
nat
iona
l im
port
ance
(suc
h as
cho
lera
, Jap
anes
e en
ceph
aliti
s, m
enin
goco
ccal
dis
ease
, ty
phoi
d an
d ye
llow
feve
r). D
isea
ses
that
are
tran
sfer
able
from
ani
mal
s to
hum
ans,
suc
h as
ant
hrax
and
rabi
es, a
re a
lso
incl
uded
.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: 90
-95%
cov
erag
e of
the
coun
try’
s 12
-mon
th-o
ld p
opul
atio
n w
ith a
t lea
st o
ne d
ose
of m
easl
es-c
onta
inin
g va
ccin
e (M
CV),
as d
emon
stra
ted
by
cove
rage
sur
veys
.
A na
tiona
l vac
cine
del
iver
y sy
stem
is in
pla
ce –
with
nat
ionw
ide
reac
h, e
ffect
ive
dist
ribut
ion,
eas
y ac
cess
for m
argi
naliz
ed p
opul
atio
ns, a
dequ
ate
cold
cha
in
and
ongo
ing
qual
ity c
ontro
l – to
resp
ond
to e
xist
ing
and
new
dis
ease
thre
ats.
WHO BENCHMARKS FOR IHR CAPACITIES
47
CAPA
CITY
LEVE
L
Benc
hmar
k 6.
1: O
ptim
um v
acci
ne c
over
age
(mea
sles
) as
part
of a
nat
iona
l pro
gram
me
Obj
ectiv
e: In
crea
se v
acci
ne c
over
age
for p
riorit
y va
ccin
e pr
even
tabl
e di
seas
es in
the
coun
try
01N
O C
APAC
ITY
Less
than
50%
of t
he c
ount
ry’s
12-
mon
th-o
ld p
opul
atio
n ha
s re
ceiv
ed a
t lea
st o
ne d
ose
of M
CV, a
s de
mon
stra
ted
by c
over
age
surv
eys
or a
dmin
istr
ativ
e da
ta.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
As
sess
and
map
exi
stin
g co
vera
ge d
ata
to id
entif
y hi
gh-r
isk
area
s an
d po
pula
tions
to ta
rget
con
trol o
f sel
ecte
d VP
Ds.
Ev
alua
te im
mun
izat
ion
surv
eilla
nce
data
, im
mun
izat
ion
regi
strie
s, im
mun
izat
ion
data
and
repo
rtin
g sy
stem
s to
iden
tify
area
s fo
r stre
ngth
enin
g of
imm
uniz
atio
n da
ta m
anag
emen
t.
Esta
blis
h a
mul
tista
keho
lder
wor
king
gro
up to
dev
elop
pla
ns to
est
ablis
h a
natio
nal v
acci
natio
n re
gist
ry.
In
tegr
ate
the
WH
O G
loba
l Vac
cine
Act
ion
Plan
era
dica
tion
and
elim
inat
ion
goal
s in
to th
e na
tiona
l im
mun
izat
ion
plan
.
Dev
elop
and
dis
sem
inat
e gu
idan
ce a
nd to
ols
to in
crea
se ro
utin
e im
mun
izat
ion
serv
ices
, with
a fo
cus
on fi
rst-
dose
mea
sles
co
vera
ge a
nd c
ondu
ct a
ctiv
ities
to e
nsur
e 50
–69
% fi
rst-
dose
mea
sles
cov
erag
e of
the
coun
try’
s 12
-mon
th-o
ld p
opul
atio
n w
ith a
t lea
st o
ne d
ose
of M
CV.
D
evel
op p
lans
to p
erfo
rm c
atch
-up
cam
paig
ns o
r sup
plem
enta
l im
mun
izat
ion
activ
ities
, bas
ed o
n ep
idem
iolo
gic
and
cove
rage
dat
a.
Dev
elop
a s
tand
ardi
zed
syst
em o
f mon
itorin
g an
d re
port
ing
of a
dver
se e
vent
s fo
llow
ing
imm
uniz
atio
n.
WHO BENCHMARKS FOR IHR CAPACITIES
48
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
U
se m
appi
ng a
nd a
sses
smen
t dat
a to
pla
n ta
rget
ed a
ctiv
ities
for r
outin
e an
d su
pple
men
tal i
mm
uniz
atio
n fo
r hig
h-ris
k ar
eas
and
popu
latio
ns.
In
trodu
ce th
e na
tiona
l vac
cine
regi
stry
in ta
rget
juris
dict
ions
.
Fina
lize
and
appr
ove
a na
tiona
l im
mun
izat
ion
plan
to: i
mpr
ove
cove
rage
and
intro
duce
vac
cine
into
targ
eted
pop
ulat
ions
, de
velo
p st
eps
to o
pera
tiona
lize
the
plan
, and
dis
sem
inat
e th
e im
mun
izat
ion
plan
to k
ey s
take
hold
ers.
D
isse
min
ate
mes
sagi
ng to
ols
to im
prov
e kn
owle
dge-
base
d ca
paci
ties
(com
mun
icat
ion
and
educ
atio
n) o
f hea
lthca
re s
taff
for c
omm
unity
soc
ializ
atio
n.
Dev
elop
gui
delin
es, S
OPs
, tra
inin
g m
ater
ials
and
tool
kits
on
pre-
and
pos
tser
vice
gui
danc
e fo
r im
mun
izat
ions
; and
trai
n he
alth
care
wor
kers
.
Cond
uct a
ctiv
ities
to a
chie
ve 7
0–89
% fi
rst-
dose
mea
sles
cov
erag
e of
the
coun
try’
s 12
-mon
th-o
ld p
opul
atio
n w
ith a
t lea
st
one
dose
of M
CV.
D
evel
op g
uide
lines
and
tool
s fo
r saf
ety
and
was
te m
anag
emen
t and
dis
sem
inat
e to
all
heal
th fa
cilit
ies.
O
pera
tiona
lize
a st
anda
rdiz
ed s
yste
m o
f mon
itorin
g an
d re
port
ing
of a
dver
se e
vent
s fo
llow
ing
imm
uniz
atio
n (A
EFIs
) at a
ll he
alth
faci
litie
s.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd im
plem
ent s
trat
egie
s to
incr
ease
imm
uniz
atio
n co
vera
ge in
all
grou
ps w
ith <
90%
firs
t-do
se M
CV c
over
age.
Im
plem
ent a
nat
iona
l pla
n, fi
naliz
ed a
nd a
ppro
ved
by n
atio
nal a
nd s
tate
/dis
tric
t/pr
ovin
ce a
utho
ritie
s, to
ach
ieve
95%
na
tiona
l lev
el c
over
age
by 2
020.
D
evel
op q
ualit
y as
sura
nce
stan
dard
s an
d m
echa
nism
s fo
r im
mun
izat
ions
at d
esig
nate
d he
alth
faci
litie
s.
Cond
uct a
ctiv
ities
to e
nsur
e 90
% fi
rst-
dose
mea
sles
cov
erag
e of
the
coun
try’
s 12
-mon
th-o
ld p
opul
atio
n w
ith a
t lea
st o
ne
dose
of M
CV.
Im
plem
ent a
rout
ine
mon
itorin
g an
d ev
alua
tion
syst
em fo
r hea
lth w
orke
rs w
ho p
erfo
rm im
mun
izat
ion.
Pr
omot
e im
mun
izat
ions
and
sen
sitiz
e co
mm
uniti
es th
roug
h ro
utin
e m
essa
ging
via
trad
ition
al/s
ocia
l med
ia, a
nd e
ngag
ing
civi
l soc
iety
org
aniz
atio
ns a
nd re
ligio
us le
ader
s.
Eval
uate
and
val
idat
e th
e AE
FI re
port
ing
syst
em.
WHO BENCHMARKS FOR IHR CAPACITIES
49
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Se
cure
sus
tain
able
dom
estic
fund
ing
for i
mm
uniz
atio
ns.
Es
tabl
ish
full
func
tiona
lity
and
inte
grat
e th
e na
tiona
l vac
cine
regi
stry
with
nat
iona
l hea
lth in
form
atio
n sy
stem
s,
if ap
prop
riate
to th
e na
tiona
l con
text
.
Cond
uct a
ctiv
ities
to e
nsur
e 95
% fi
rst-
dose
mea
sles
cov
erag
e of
the
coun
try’
s 12
-mon
th-o
ld p
opul
atio
n w
ith a
t lea
st o
ne
dose
of M
CV.
Co
nduc
t for
mal
sur
veys
of h
ard-
to-r
each
are
as to
ens
ure
that
cov
erag
e ra
tes
amon
g vu
lner
able
pop
ulat
ions
are
>90
%.
Co
nduc
t an
eval
uatio
n of
sur
veill
ance
dat
a to
ens
ure
that
the
case
-bas
ed s
urve
illan
ce s
yste
m is
suf
ficie
ntly
sen
sitiv
e to
de
tect
cas
es (s
uch
as m
easl
es im
mun
oglo
bulin
M n
egat
ive
febr
ile ra
sh in
cide
nce
rate
≥2
per 1
00 0
00 p
opul
atio
n) a
t the
di
stric
t/pr
ovin
ce/s
tate
leve
ls.
WHO BENCHMARKS FOR IHR CAPACITIES
50
CAPA
CITY
LEVE
L
Benc
hmar
k 6.
2: P
rovi
sion
of n
atio
nal v
acci
ne a
cces
s an
d de
liver
y O
bjec
tive:
Str
engt
heni
ng c
apac
ity fo
r vac
cine
acc
ess
and
deliv
ery
to ta
rget
pop
ulat
ion
01N
O C
APAC
ITY
No
plan
is in
pla
ce fo
r nat
ionw
ide
vacc
ine
deliv
ery,
nor h
ave
plan
s be
en d
rafte
d to
pro
vide
vac
cine
s th
roug
hout
the
coun
try
to
targ
et p
opul
atio
ns; o
r ina
dequ
ate
vacc
ine
proc
urem
ent a
nd fo
reca
stin
g ha
s le
d to
regu
lar s
tock
-out
s at
the
cent
ral o
r dis
tric
t le
vels
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
mpl
ete
a re
view
of p
lans
, pol
icie
s an
d pr
oced
ures
for v
acci
ne d
eliv
ery
syst
ems
and
use
resu
lts to
gui
de v
acci
ne
proc
urem
ent,
acce
ss a
nd d
eliv
ery
of ta
rget
ed v
acci
nes.
Co
mpl
ete
a re
view
of c
old-
chai
n qu
ality
ass
uran
ce a
nd s
afet
y m
easu
res
with
in v
acci
ne s
tora
ge a
nd d
eliv
ery
syst
ems
to
optim
ize
supp
ly c
hain
man
agem
ent.
Re
view
nat
iona
l law
s an
d re
gula
tions
for t
he p
rocu
rem
ent o
f vac
cine
s fro
m n
atio
nal a
nd in
tern
atio
nal s
ourc
es d
urin
g pu
blic
he
alth
em
erge
ncie
s.
Iden
tify
barr
iers
to p
rocu
ring,
rece
ivin
g, s
torin
g an
d de
ploy
ing
vacc
ines
to ta
rget
ed p
opul
atio
ns.
D
evel
op n
atio
nal g
uida
nce
docu
men
ts fo
r vac
cine
sto
ckpi
le a
nd d
eplo
ymen
t, an
d ob
tain
app
rova
l fro
m m
inis
try
of h
ealth
(a
nd m
inis
try
of a
gric
ultu
re, w
here
app
licab
le).
Es
tabl
ish
a co
ld c
hain
for v
acci
ne d
eliv
ery
to a
t lea
st 4
0% o
f dis
tric
ts o
r 40%
of t
he ta
rget
pop
ulat
ion.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t a d
etai
led
asse
ssm
ent o
f exi
stin
g co
ld c
hain
equ
ipm
ent,
incl
udin
g th
e fu
nctio
ning
of c
old
chai
n eq
uipm
ent,
and
iden
tify
bottl
enec
ks to
mai
ntai
ning
nee
ded
cold
cha
in in
fras
truc
ture
at t
he d
istr
ict/
stat
e/pr
ovin
ce le
vels
; use
ass
essm
ent
data
to o
pera
tiona
lize
a pl
an to
ser
vice
/pro
cure
nee
ded
cold
cha
in in
fras
truc
ture
.
Dev
elop
nat
iona
l gui
delin
es fo
r vac
cine
del
iver
y to
targ
eted
pop
ulat
ions
with
ste
ps to
ope
ratio
naliz
e th
e pl
an.
D
evel
op a
nd d
isse
min
ate
prot
ocol
s, S
OPs
, tec
hnic
al g
uide
lines
and
tool
kits
for s
tora
ge, t
rans
port
atio
n an
d de
ploy
men
t of
vacc
ines
to h
ealth
care
wor
kers
and
sta
ff.
Esta
blis
h a
cold
cha
in fo
r vac
cine
del
iver
y to
at l
east
40–
59%
of d
istr
icts
or 4
0–59
% o
f the
targ
et p
opul
atio
n.
Esta
blis
h pr
oced
ures
for p
rocu
rem
ent,
stor
age
and
tran
spor
tatio
n of
vac
cine
s du
ring
publ
ic h
ealth
em
erge
ncie
s.
WHO BENCHMARKS FOR IHR CAPACITIES
51
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Pr
ocur
e an
d se
rvic
e co
ld c
hain
equ
ipm
ent i
n ar
eas
iden
tified
by
a co
mpr
ehen
sive
ass
essm
ent.
Tr
ain
heal
thca
re w
orke
rs a
nd o
ther
imm
uniz
atio
n st
aff o
n pr
otoc
ols,
SO
Ps, t
echn
ical
gui
delin
es a
nd to
olki
ts fo
r sto
rage
, tr
ansp
orta
tion
and
depl
oym
ent o
f vac
cine
s.
Esta
blis
h a
cold
cha
in fo
r vac
cine
del
iver
y to
at l
east
60–
79%
of d
istr
icts
or 6
0–79
% o
f the
targ
et p
opul
atio
n.
Cond
uct q
ualit
y as
sura
nce
of c
old
chai
n eq
uipm
ent a
nd d
eliv
ery
syst
ems.
D
evel
op a
resp
onse
doc
umen
t to
obse
rve
appr
opria
te a
utho
rizat
ions
, cle
aran
ces,
eth
ical
nor
ms
and
perm
issi
ons
durin
g va
ccin
e de
liver
y.
Esta
blis
h an
inve
ntor
y sy
stem
that
mon
itors
and
tran
smits
vac
cine
sup
ply
and
requ
irem
ents
at a
ll ne
eded
leve
ls.
D
evel
op tr
aini
ng a
nd e
xerc
ises
for h
azar
d-sp
ecifi
c re
spon
se a
nd m
anag
emen
t pla
ns w
ith s
ecto
rs, s
take
hold
ers
and
othe
r ag
enci
es.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Se
cure
sus
tain
able
fund
ing
for v
acci
ne d
eliv
ery
syst
ems,
incl
udin
g fo
r pro
cure
men
t and
rout
ine
repa
ir of
col
d ch
ain
equi
pmen
t.
Esta
blis
h a
cold
cha
in fo
r vac
cine
del
iver
y to
mor
e th
an 8
0% o
f dis
tric
ts o
r mor
e th
an 8
0% o
f the
targ
et p
opul
atio
n.
Cond
uct a
func
tiona
l exe
rcis
e (e
ither
a s
imul
atio
n or
vac
cine
cam
paig
n) to
test
vac
cine
del
iver
y sy
stem
s in
a m
ass
cam
paig
n or
pub
lic h
ealth
em
erge
ncy
setti
ng.
Ro
utin
ely
anal
yse
the
inve
ntor
y sy
stem
to m
onito
r vac
cine
sup
ply
need
s an
d fo
reca
st re
quire
men
ts, w
ith a
ntic
ipat
ed
proc
urem
ent.
As
sess
vac
cine
del
iver
y as
sess
men
t in
hard
-to-
reac
h ar
eas,
targ
eted
bas
ed o
n ex
istin
g co
vera
ge/r
egis
try/
surv
eilla
nce
data
, an
d us
e re
sults
to im
prov
e va
ccin
e de
liver
y to
thes
e ar
eas.
D
evel
op a
nat
iona
l str
ateg
ic fr
amew
ork
to p
riorit
ize
reso
urce
s an
d in
vest
men
ts in
imm
uniz
atio
n.
Esta
blis
h a
func
tiona
l nat
iona
l bod
y to
ass
ess
and
reco
mm
end
an e
vide
nce-
base
d na
tiona
l vac
cine
pol
icy.
WHO BENCHMARKS FOR IHR CAPACITIES
52
TOO
LS:
G
loba
l Vac
cine
Act
ion
Plan
— e
ndor
sed
by a
ll 19
4 M
embe
r Sta
tes
of th
e W
orld
Hea
lth A
ssem
bly
in M
ay 2
012;
pro
vide
s a
fram
ewor
k to
pre
vent
m
illio
ns o
f dea
ths
by 2
020
thro
ugh
mor
e eq
uita
ble
acce
ss to
exi
stin
g va
ccin
es fo
r peo
ple
in a
ll co
mm
uniti
es
Trai
ning
for m
id-le
vel M
anag
ers
(MLM
) — m
odul
ar tr
aini
ng p
rogr
am o
n al
l asp
ects
of i
mm
uniz
atio
n de
liver
y, in
clud
ing
cold
cha
in, v
acci
nes,
saf
e in
ject
ion
equi
pmen
t; pa
rtne
ring
with
the
com
mun
ity; i
mm
uniz
atio
n sa
fety
; sup
port
ive
supe
rvis
ion;
mon
itorin
g th
e im
mun
izat
ion
syst
em; a
nnua
l im
mun
izat
ion
plan
ning
and
bud
get;
EPI c
over
age
surv
eys;
VPD
sur
veill
ance
Pl
anni
ng a
nd Im
plem
entin
g H
igh-
Qua
lity
Supp
lem
enta
ry Im
mun
izat
ion
Activ
ities
for I
njec
tabl
e Va
ccin
es —
201
6 gu
idan
ce d
ocum
ent o
n SI
A pl
anni
ng a
nd im
plem
enta
tion,
usi
ng m
easl
es a
nd ru
bella
vac
cine
s as
an
exam
ple
W
HO
reco
mm
enda
tions
for r
outin
e im
mun
izat
ion
–su
mm
ary
of o
ptim
al im
mun
izat
ion
sche
dule
s fo
r use
by
prog
ram
me
man
ager
s
Glo
bal R
outin
e Im
mun
izat
ion
Stra
tegi
es a
nd P
ract
ices
(GRI
SP) —
com
pani
on d
ocum
ent t
o G
VAP;
pro
vide
s a
cohe
sive
del
iver
y an
d ad
voca
cy
plat
form
to p
rom
ote
rout
ine
imm
uniz
atio
ns
WH
O V
acci
ne P
reve
ntab
le D
isea
se S
tand
ards
- up
date
d st
anda
rds
for s
urve
illan
ce o
f VPD
s a
reso
urce
for t
he im
mun
izat
ions
WHO BENCHMARKS FOR IHR CAPACITIES
53
29 N
atio
nal l
abor
ator
y sy
stem
is a
col
labo
rativ
e co
mm
unity
of c
linic
al la
bora
torie
s, p
ublic
hea
lth la
bora
torie
s an
d m
any
indi
vidu
al p
artn
ers
who
initi
ate
test
s an
d/or
use
test
resu
lts.
30 T
ests
list
in e
ach
coun
try
incl
udes
six
test
ing
met
hods
sel
ecte
d ac
cord
ing
to IH
R’s
imm
edia
tely
not
ifiab
le li
st a
nd th
e W
HO
top
10 c
ause
s of
dea
th in
low
-inco
me
coun
trie
s: p
olym
eras
e ch
ain
reac
tion
test
ing
for i
nflu
enza
viru
s; v
irus
cultu
re fo
r pol
iovi
rus;
ser
olog
y fo
r HIV
; mic
rosc
opy
for M
. tub
ercu
losi
s; ra
pid
diag
nost
ic te
stin
g fo
r Pla
smod
ium
spp
.; an
d ba
cter
ial c
ultu
re fo
r Sa
lmon
ella
ent
eriti
dis
sero
type
typh
i. Th
ese
six
met
hods
are
crit
ical
to th
e de
tect
ion
of e
pide
mic
-pro
ne e
mer
ging
dis
ease
s. C
ompe
tenc
y in
thes
e m
etho
ds is
indi
cate
d by
suc
cess
ful t
estin
g fo
r the
spe
cific
pat
hoge
ns li
sted
. The
rem
aini
ng fo
ur te
sts
shou
ld b
e se
lect
ed b
y th
e co
untr
y ba
sed
on m
ajor
nat
iona
l pub
lic h
ealth
con
cern
s.
NAT
ION
AL L
ABO
RATO
RY S
YSTE
M
07
IMPA
CT:
Effe
ctiv
e us
e of
a n
atio
nwid
e la
bora
tory
sys
tem
, inc
ludi
ng a
ll re
leva
nt s
ecto
rs, c
apab
le o
f saf
ely
and
accu
rate
ly d
etec
ting
and
char
acte
rizin
g pa
thog
ens
caus
ing
epid
emic
dis
ease
, incl
udin
g bo
th k
now
n an
d un
know
n th
reat
s, fr
om a
ll par
ts o
f the
cou
ntry
. Exp
ande
d de
ploy
men
t, ut
iliza
tion
and
sust
ainm
ent o
f mod
ern,
saf
e, s
ecur
e, a
fford
able
and
app
ropr
iate
dia
gnos
tics
test
s or
dev
ices
est
ablis
hed.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) A n
atio
nwid
e la
bora
tory
sys
tem
abl
e to
relia
bly
cond
uct t
ests
30 a
t lea
st fo
r prio
rity
dise
ases
of t
he c
ount
ry o
n ap
prop
riate
ly id
entifi
ed a
nd
colle
cted
, and
sus
pect
ed o
r con
firm
ed o
utbr
eak
spec
imen
s tr
ansp
orte
d sa
fely
and
sec
urel
y to
acc
redi
ted
labo
rato
ries
from
at l
east
80%
of
inte
rmed
iate
leve
ls/d
istr
icts
in th
e co
untr
y. (2
) Exi
sten
ce o
f nat
iona
l qua
lity
labo
rato
ry s
tand
ards
and
sys
tem
for l
icen
sing
labo
rato
ries.
Surv
eilla
nce
with
a n
atio
nal l
abor
ator
y sy
stem
,29 in
clud
ing
all r
elev
ant s
ecto
rs, p
artic
ular
ly in
hum
an a
nd a
nim
al (d
omes
tic a
nim
als
and
wild
life)
hea
lth, a
nd
effe
ctiv
e m
oder
n po
int-
of-c
are
and
labo
rato
ry-b
ased
dia
gnos
tics
is in
pla
ce.
WHO BENCHMARKS FOR IHR CAPACITIES
54
CAPA
CITY
LEVE
L
Benc
hmar
k 7.
1: L
abor
ator
y te
stin
g fo
r det
ectio
n of
prio
rity
dise
ases
is in
pla
ce
Obj
ectiv
e: S
tren
gthe
ning
labo
rato
ry te
stin
g fo
r det
ectio
n of
prio
rity
dise
ases
01N
O C
APAC
ITY
Coun
try
has
not t
aken
a ri
sk-b
ased
app
roac
h to
det
erm
ine
test
ing
for p
riorit
y di
seas
es.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
clea
r SO
Ps a
nd n
eces
sary
agr
eem
ents
with
inte
rnat
iona
l lab
orat
orie
s to
per
form
dia
gnos
tic a
nd c
onfir
mat
ory
test
ing
of s
peci
men
s an
d su
ppor
t out
brea
k de
tect
ion
and
resp
onse
s w
hen
loca
l cap
acity
is n
ot a
vaila
ble.
D
efine
10
core
test
s ba
sed
on th
e pr
iorit
y di
seas
es li
st (l
ink
this
with
the
surv
eilla
nce
benc
hmar
k).
Se
lect
at l
east
five
prio
rity
dise
ases
for t
estin
g us
ing
the
resu
lts o
f ris
k an
alys
is, s
urve
illan
ce d
ata
and
prio
ritiz
atio
n m
etho
dolo
gies
.
Asse
ss la
bora
tory
alg
orith
ms,
sta
ndar
ds a
nd te
stin
g ca
paci
ty in
clud
ing
equi
pmen
t inv
ento
ry fo
r the
10
prio
rity
dise
ases
.
Asse
ss th
e ca
paci
ty a
nd e
ssen
tial f
unct
ioni
ng o
f tar
get h
uman
and
ani
mal
hea
lth la
bora
torie
s to
mee
t dia
gnos
tic a
nd
confi
rmat
ory
requ
irem
ents
for p
riorit
y di
seas
es.
D
evel
op p
lan,
bas
ed o
n as
sess
men
t, to
targ
et h
uman
and
ani
mal
hea
lth la
bora
torie
s fo
r cap
acity
bui
ldin
g an
d es
sent
ial
func
tioni
ng to
mee
t dia
gnos
tic a
nd c
onfir
mat
ory
requ
irem
ents
for p
riorit
y di
seas
es, e
nsur
ing
that
pro
ficie
ncy
is
dem
onst
rabl
e fo
r bac
terio
logy
, ser
olog
y, po
lym
eras
e ch
ain
reac
tion
and
othe
rs.
Es
tabl
ish
dom
estic
ext
erna
l qua
lity
asse
ssm
ent p
rogr
amm
es fo
r all
prio
rity
test
s or
cov
er th
em w
ith in
tern
atio
nal e
xter
nal
qual
ity a
sses
smen
t sch
emes
.
Dev
elop
a n
atio
nal l
abor
ator
y po
licy
that
iden
tifies
exp
ecte
d ca
paci
ties
at e
ach
leve
l of t
he n
atio
nal l
abor
ator
y sy
stem
.
Dev
elop
a h
ands
-on-
trai
ning
cur
ricul
um fo
r all
labo
rato
ry s
taff
that
incl
udes
task
-bas
ed tr
aini
ng, r
efre
sher
trai
ning
and
m
ento
ring
in th
eir a
ppro
pria
te te
chni
cal a
nd a
dmin
istr
ativ
e ar
eas.
Co
nduc
t a h
ands
-on
trai
ning
or r
efre
sher
trai
ning
ses
sion
for p
ublic
hea
lth la
bora
tory
sta
ff on
tech
niqu
es to
dia
gnos
e th
e co
untr
y’s
prio
rity
dise
ases
.
Dev
elop
and
dis
sem
inat
e te
stin
g SO
Ps a
nd q
ualit
y co
ntro
l SO
Ps fo
r all
core
test
s fo
r prio
rity
dise
ases
; and
est
ablis
h su
pply
an
d pr
ocur
emen
t cha
ins.
Tr
ain
rele
vant
labo
rato
ry s
taff
on te
chni
ques
use
d fo
r cor
e te
stin
g an
d do
cum
ent q
ualit
y co
ntro
l res
ults
.
WHO BENCHMARKS FOR IHR CAPACITIES
55
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd d
isse
min
ate
test
ing
SOPs
and
pro
cure
men
t cha
ins
to c
ondu
ct te
stin
g fo
r at l
east
10
prio
rity
dise
ases
.
Mak
e av
aila
ble
exte
rnal
qua
lity
asse
ssm
ent f
or a
t lea
st th
ree/
four
cor
e te
sts
for p
riorit
y di
seas
es a
t nat
iona
l or c
entr
al
labo
rato
ries.
Be
gin
esta
blis
hing
a c
ompr
ehen
sive
qua
lity
man
agem
ent s
yste
m in
labo
rato
ries
that
con
duct
cor
e te
sts
for p
riorit
y di
seas
es.
Re
gula
rly tr
ain
staf
f on
the
test
ing,
and
doc
umen
t qua
lity
cont
rol r
esul
ts.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd d
isse
min
ate
test
ing
SOPs
; pro
cure
men
t cha
ins
shou
ld c
ondu
ct te
stin
g fo
r at l
east
15
prio
rity
dise
ases
.
Cond
uct q
ualit
y as
sura
nce
for a
ll co
re te
sts.
D
evel
op a
str
ateg
ic fr
amew
ork
to p
riorit
ize
natio
nal i
nves
tmen
ts in
to la
bora
tory
sys
tem
sus
tain
abili
ty.
Co
nduc
t mon
itorin
g an
d ev
alua
tion
to d
ocum
ent d
iagn
ostic
s, d
ata
qual
ity a
nd s
taff
perf
orm
ance
, and
inco
rpor
ate
reco
mm
enda
tions
into
the
natio
nal l
abor
ator
y st
rate
gic
plan
.
Esta
blis
h a
natio
nal e
xter
nal q
ualit
y as
sess
men
t pro
gram
me
for p
ublic
hea
lth la
bora
torie
s.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ex
pand
ext
erna
l qua
lity
asse
ssm
ent p
rogr
amm
es to
incl
ude
test
ing
in th
e pr
ivat
e se
ctor
and
ani
mal
hea
lth la
bora
torie
s.
Secu
re s
usta
inab
le fi
nanc
ing
for t
he la
bora
tory
sys
tem
to s
uppo
rt o
ngoi
ng te
stin
g of
prio
rity
dise
ases
.
WHO BENCHMARKS FOR IHR CAPACITIES
56
CAPA
CITY
LEVE
L
Benc
hmar
k 7.
2: S
peci
men
refe
rral
and
tran
spor
t sys
tem
are
in p
lace
for a
ll re
leva
nt s
ecto
rs
Obj
ectiv
e: S
tren
gthe
n sp
ecim
en re
ferr
al a
nd tr
ansp
ort s
yste
m
01N
O C
APAC
ITY
No
syst
em in
pla
ce fo
r tra
nspo
rtin
g sp
ecim
ens
from
inte
rmed
iate
leve
ls/d
istr
icts
to n
atio
nal l
abor
ator
ies;
or o
nly
ad h
oc
tran
spor
tatio
n is
ava
ilabl
e.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
exi
stin
g sp
ecim
en re
ferr
al a
nd tr
ansp
orta
tion
netw
orks
for p
riorit
y di
seas
es, m
ap e
xist
ing
labo
rato
ry c
apac
ity fo
r pr
iorit
y di
seas
es31
, and
est
ablis
h re
ferr
al n
etw
orks
for e
ach
path
ogen
.
Conv
ene
hum
an a
nd a
nim
al h
ealth
sec
tors
and
oth
er s
take
hold
ers
to a
sses
s re
ferr
al m
echa
nism
s an
d lin
kage
s am
ong
vario
us le
vels
of h
ealth
faci
litie
s, in
clud
ing
inte
rnat
iona
l net
wor
ks w
ith g
uida
nce
and
tool
s fo
r dis
sem
inat
ion.
D
evel
op S
OPs
(as
part
of d
isea
se o
utbr
eak
inve
stig
atio
n pr
otoc
ols)
for s
peci
men
col
lect
ion,
man
agem
ent a
nd
tran
spor
tatio
n an
d sh
are
with
all
leve
ls.
Tr
ain
staf
f of c
ourie
r com
pany
and
hea
lth fa
cilit
y on
app
ropr
iate
man
agem
ent o
f spe
cim
ens
from
sus
pect
ed c
ases
of
prio
rity
dise
ases
.
Esta
blis
h a
serv
ice
agre
emen
t with
a c
ourie
r com
pany
(pub
lic o
r priv
ate)
for s
peci
men
tran
spor
tatio
n fro
m a
t lea
st 5
0% o
f he
alth
faci
litie
s in
the
publ
ic s
ecto
r thr
ough
out a
ll m
ajor
sub
divi
sion
s of
the
coun
try.
Es
tabl
ish
a m
echa
nism
to e
nsur
e tr
ansp
orta
tion
of s
peci
men
s fro
m 5
0% o
f all
heal
th fa
cilit
ies
to n
atio
nal l
abor
ator
ies.
Pr
ovid
e pr
epos
ition
out
brea
k in
vest
igat
ion
kits
(sam
ple
colle
ctio
n an
d tr
ansp
orta
tion
kits
) in
at le
ast 5
0% o
f hea
lth fa
cilit
ies.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ex
pand
a s
ervi
ce a
gree
men
t with
a c
ourie
r com
pany
(pub
lic o
r priv
ate)
for s
peci
men
tran
spor
tatio
n fro
m a
t lea
st 8
0% o
f the
he
alth
faci
litie
s.
Esta
blis
h a
mec
hani
sm to
ens
ure
tran
spor
tatio
n of
spe
cim
ens
from
50–
80%
of a
ll he
alth
faci
litie
s to
nat
iona
l lab
orat
orie
s.
Impl
emen
t sta
ff tr
aini
ng p
rogr
amm
es a
nd s
tand
ards
at t
he n
atio
nal l
evel
for t
he s
afe
ship
men
t of i
nfec
tious
sub
stan
ces
follo
win
g av
aila
ble
WH
O g
uida
nce.
Pr
ovid
e pr
epos
ition
out
brea
k in
vest
igat
ion
kits
(sam
ple
colle
ctio
n an
d tr
ansp
orta
tion
kits
) at 8
0% o
r mor
e he
alth
faci
litie
s.
31 T
hese
are
the
prio
rity
dise
ases
defi
ned
in th
e te
chni
cal a
reas
of s
urve
illan
ce, z
oono
sis
and
food
saf
ety.
WHO BENCHMARKS FOR IHR CAPACITIES
57
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a m
echa
nism
to e
nsur
e tr
ansp
orta
tion
of s
peci
men
s fro
m a
t lea
st 8
0% o
f all
heal
th fa
cilit
ies
to n
atio
nal
labo
rato
ries
cove
ring
all g
eogr
aphi
c ar
eas
of th
e co
untr
y.
Prov
ide
prep
ositi
on o
utbr
eak
inve
stig
atio
n ki
ts (s
ampl
e co
llect
ion
and
tran
spor
tatio
n ki
ts) a
t all
the
heal
th fa
cilit
ies.
Co
nduc
t reg
ular
revi
ews
of s
peci
men
tran
spor
tatio
n sy
stem
s to
con
firm
that
spe
cim
ens
are
bein
g tr
ansp
orte
d pr
ompt
ly
and
in a
man
ner t
hat m
aint
ains
saf
ety
and
spec
imen
qua
lity.
Es
tabl
ish
a sy
stem
to c
olle
ct a
nd te
st s
peci
men
s fro
m h
ard-
to-r
each
are
as.
D
evel
op a
mec
hani
sm to
ens
ure
that
sta
ff at
the
natio
nal l
evel
hav
e in
tern
atio
nally
reco
gniz
ed c
ertifi
catio
n to
shi
p po
tent
ially
infe
ctio
us s
peci
men
s.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t eva
luat
ion
or s
imul
atio
n ex
erci
ses
to c
onfir
m fu
nctio
nalit
y of
spe
cim
en re
ferr
al s
yste
ms
in a
ll he
alth
faci
litie
s.
Ensu
re c
omm
itted
sus
tain
able
fund
ing
for t
he n
atio
nal s
tand
ard
of s
peci
men
col
lect
ion,
han
dlin
g, p
rese
rvat
ion,
pro
tect
ion,
tr
ansp
orta
tion,
dis
posa
l, pa
ckag
ing
and
impo
rt/e
xpor
t pro
cedu
res.
WHO BENCHMARKS FOR IHR CAPACITIES
58
Benc
hmar
k 7.
3: E
ffec
tive
natio
nal d
iagn
ostic
net
wor
k is
in p
lace
O
bjec
tive:
Est
ablis
h ef
fect
ive
natio
nal d
iagn
ostic
net
wor
k
01N
O C
APAC
ITY
No
evid
ence
of u
se o
f rap
id a
nd a
ccur
ate
poin
t-of
-car
e an
d fa
rm-b
ased
dia
gnos
tics
and
labo
rato
ry-b
ased
dia
gnos
tics,
and
no
tier-
spec
ific
diag
nost
ic te
stin
g st
rate
gies
are
doc
umen
ted.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y in
tern
atio
nal l
abor
ator
ies
with
test
ing
capa
city
for c
onfir
mat
ory
labo
rato
ry d
iagn
ostic
s w
hen
they
are
not
cur
rent
ly
avai
labl
e in
the
coun
try.
D
evel
op a
nat
iona
l lab
orat
ory
polic
y th
at id
entifi
es th
e ex
pect
ed c
apac
ities
at e
ach
leve
l of t
he n
atio
nal l
abor
ator
y sy
stem
.
Asse
ss n
atio
nal d
iagn
ostic
cap
abili
ty, a
nd b
ased
on
the
findi
ngs,
dev
elop
a n
atio
nal p
lan
for a
chie
ving
goa
ls s
tate
d in
the
polic
y.
Cond
uct a
revi
ew o
f exi
stin
g po
int-
of-c
are/
rapi
d di
agno
stic
test
s th
at a
re a
vaila
ble
to th
e co
untr
y fo
r det
ectio
n of
prio
rity
dise
ases
.
Cond
uct a
labo
rato
ry a
nd fi
eld
valid
atio
n of
the
use
of p
oint
-of-
care
/rap
id d
iagn
ostic
test
s fo
r som
e pr
iorit
y di
seas
es.
D
evel
op a
nd im
plem
ent p
oint
-of-
care
dia
gnos
tic te
stin
g st
rate
gies
for p
riorit
y di
seas
es.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd d
isse
min
ate
SOPs
for t
iere
d te
stin
g, in
clud
ing
poin
t-of
-car
e/ra
pid
diag
nosi
s an
d sp
ecim
en re
ferr
al s
yste
ms
to
the
appr
opria
te la
bora
tory
idea
lly w
ithin
the
fram
ewor
k of
a n
atio
nal l
abor
ator
y po
licy,
for e
ach
prio
rity
dise
ase.
D
evel
op in
-ser
vice
trai
ning
pla
ns fo
r all
staf
f tha
t inc
lude
task
-bas
ed tr
aini
ng, r
efre
sher
trai
ning
and
men
torin
g in
thei
r ap
prop
riate
tech
nica
l and
adm
inis
trat
ive
area
s.
Allo
cate
reso
urce
s (h
uman
and
mat
eria
l) to
con
duct
app
ropr
iate
dia
gnos
tic te
stin
g at
the
subn
atio
nal l
evel
in li
ne w
ith th
e na
tiona
l lab
orat
ory
polic
y.
WHO BENCHMARKS FOR IHR CAPACITIES
59
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
onito
r im
plem
enta
tion
of th
e tie
red
test
ing
appr
oach
, inc
ludi
ng v
alid
atio
n/qu
ality
ass
uran
ce o
f poi
nt-o
f-ca
re te
stin
g.
Trai
n la
bora
tory
sta
ff on
rele
vant
nov
el d
iagn
ostic
pro
cedu
res
to d
etec
t prio
rity
dise
ases
.
Use
poi
nt-o
f-ca
re d
iagn
ostic
test
ing
for s
ome
of th
e pr
iorit
y di
seas
es a
nd fu
rthe
r con
firm
by
tiere
d te
stin
g ap
proa
ch fr
om
refe
rral
labo
rato
ries.
O
btai
n su
stai
nabl
e fu
ndin
g fo
r lab
orat
ory
proc
urem
ent,
capa
city
bui
ldin
g an
d po
int-
of c
are
diag
nost
ics.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op c
apac
ity to
con
duct
adv
ance
d m
olec
ular
and
ser
olog
ical
test
ing
for c
onfir
mat
ion
of p
riorit
y di
seas
es in
clud
ing
the
abili
ty to
con
duct
mol
ecul
ar s
ubty
ping
.
Dev
elop
and
impl
emen
t a p
lan
to in
crea
se n
atio
nal t
estin
g ca
paci
ty fo
r all
prio
rity
dise
ases
, inc
ludi
ng c
ross
-tra
inin
g of
na
tiona
l lab
orat
ory
staf
f in
diffe
rent
test
ing
met
hodo
logi
es.
D
evel
op q
ualit
y m
anag
emen
t sys
tem
mec
hani
sm fo
r poi
nt-o
f-ca
re te
stin
g, in
clud
ing
qual
ity in
dica
tors
.
WHO BENCHMARKS FOR IHR CAPACITIES
60
CAPA
CITY
LEVE
L
Benc
hmar
k 7.
4: L
abor
ator
y qu
ality
sys
tem
is in
pla
ce
Obj
ectiv
e: T
o en
sure
labo
rato
ry q
ualit
y
01N
O C
APAC
ITY
Ther
e ar
e no
nat
iona
l lab
orat
ory
qual
ity s
tand
ards
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
an in
depe
nden
t uni
t at t
he c
entr
al le
vel w
ith a
spe
cific
bud
get l
ine
and
pers
onne
l to
over
see
labo
rato
ry s
ervi
ces
and
deve
lop
natio
nal l
abor
ator
y qu
ality
sta
ndar
ds.
Es
tabl
ish
a qu
ality
ass
essm
ent p
rogr
amm
e fo
r nat
iona
l or c
entr
al la
bora
torie
s fo
r dia
gnos
tics
of d
isea
ses
with
epi
dem
ic
pote
ntia
l.
Dev
elop
a ro
adm
ap fo
r lab
orat
ory
insp
ectio
ns, l
icen
sing
and
acc
redi
tatio
n, in
line
with
the
natio
nal l
abor
ator
y st
rate
gy.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a na
tiona
l qua
lity
asse
ssm
ent p
rogr
amm
e fo
r per
iphe
ral l
abor
ator
ies
for d
iagn
osis
of d
isea
ses
with
epi
dem
ic
pote
ntia
l.
Dev
elop
min
imum
sta
ndar
ds fo
r cer
tifica
tion
or li
cens
ing,
as
a pa
rt o
f the
sys
tem
for r
egul
atio
n of
labo
rato
ries.
Im
plem
ent a
sys
tem
of i
nspe
ctin
g an
d lic
ensi
ng la
bora
torie
s, in
clud
ing
usin
g lo
cal a
dapt
atio
ns o
f int
erna
tiona
l sta
ndar
ds
and
norm
s an
d ob
tain
ing
requ
ired
fund
ing
and
hum
an re
sour
ces.
D
evel
op e
xper
tise
by tr
aini
ng s
elec
ted
labo
rato
ry s
taff
in th
e in
spec
tion
of la
bora
torie
s ba
sed
on th
e st
anda
rds.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
man
dato
ry li
cens
ing
prog
ram
me
for n
atio
nal a
nd s
ubna
tiona
l pub
lic h
ealth
labo
rato
ries.
Es
tabl
ish
natio
nal q
ualit
y st
anda
rds
that
follo
w in
tern
atio
nal n
orm
s an
d st
anda
rds.
WHO BENCHMARKS FOR IHR CAPACITIES
61
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
nat
iona
l ext
erna
l qua
lity
assu
ranc
e pr
ogra
mm
e ac
ross
mic
robi
olog
y, vi
rolo
gy, s
erol
ogy
and
para
sito
logy
.
Accr
edit
all n
atio
nal r
efer
ence
labo
rato
ries
to in
tern
atio
nal s
tand
ards
(suc
h as
usi
ng IS
O 1
5189
).
Stre
ngth
en th
e na
tiona
l pla
n fo
r qua
lity
man
agem
ent s
yste
m c
ompl
ianc
e at
the
subn
atio
nal a
nd n
atio
nal l
evel
s th
roug
h co
ntin
uous
qua
lity
impr
ovem
ent b
ased
on
anal
ysis
of a
ctua
l exp
erie
nce
in th
e co
untr
y.
TOO
LS:
La
bora
tory
Qua
lity
Step
wis
e Im
plem
enta
tion
Tool
— W
HO
LQ
SI to
ol in
the
form
of a
web
site
that
pro
vide
s a
step
wis
e pl
an to
gui
de m
edic
al
labo
rato
ries
tow
ard
impl
emen
ting
a qu
ality
man
agem
ent s
yste
m in
com
plia
nce
with
ISO
151
89 o
r nat
iona
l sta
ndar
d w
ith s
imila
r req
uire
men
ts
Met
hodo
logy
for P
riorit
izin
g Se
vere
Em
ergi
ng D
isea
ses
for R
esea
rch
and
Dev
elop
men
t — W
HO
gui
danc
e to
iden
tify
glob
al d
isea
se th
reat
s;
met
hods
can
be
appl
ied
to id
entif
ying
prio
rity
dise
ases
for l
abor
ator
y te
stin
g in
cou
ntrie
s
Stre
ngth
enin
g La
bora
tory
Man
agem
ent T
owar
d Ac
cred
itatio
n –
A s
truc
ture
d qu
ality
impr
ovem
ent p
rogr
am th
at te
ache
s la
bora
tory
man
ager
s ho
w to
impl
emen
t pra
ctic
al q
ualit
y m
anag
emen
t sys
tem
s in
reso
urce
-lim
ited
setti
ngs
La
bora
tory
Qua
lity
Man
agem
ent S
yste
m T
rain
ing
Tool
kit —
WH
O to
olki
t to
trai
n la
bora
tory
man
ager
s, s
enio
r bio
logi
sts
and
tech
nolo
gist
s in
qu
ality
man
agem
ent s
yste
ms
St
epw
ise
impl
emen
tatio
n of
a q
ualit
y m
anag
emen
t sys
tem
for a
hea
lth la
bora
tory
. WH
O E
MRO
pub
licat
ion
adap
ting
the
ISO
151
89 s
tand
ard
to
the
cont
ext a
nd re
aliti
es o
f res
ourc
e-lim
ited
coun
trie
s, w
here
the
requ
irem
ents
of t
he IS
O s
tand
ard
may
be
too
strin
gent
to im
plem
ent.
ht
tp://
apps
.who
.int/
iris/
hand
le/1
0665
/249
570
WHO BENCHMARKS FOR IHR CAPACITIES
62
32 L
abor
ator
y bi
osaf
ety
desc
ribes
the
cont
ainm
ent p
rinci
ples
, tec
hnol
ogie
s an
d pr
actic
es th
at a
re im
plem
ente
d to
pre
vent
uni
nten
tiona
l exp
osur
e to
pat
hoge
ns a
nd to
xins
, or t
heir
acci
dent
al re
leas
e.
33 L
abor
ator
y bi
osec
urity
des
crib
es th
e pr
otec
tion,
con
trol a
nd a
ccou
ntab
ility
for v
alua
ble
biol
ogic
al m
ater
ials
with
in la
bora
torie
s, a
s w
ell a
s in
form
atio
n re
late
d to
thes
e m
ater
ials
and
dua
l-us
e re
sear
ch, t
o pr
even
t the
ir un
auth
oriz
ed a
cces
s, lo
ss, t
heft,
mis
use,
div
ersi
on o
r int
entio
nal r
elea
se.
34 L
ist o
f hum
an a
nd a
nim
al p
atho
gens
and
toxi
ns fo
r exp
ort c
ontro
l. 35
Min
imal
/bes
t pra
ctic
es a
s re
ferr
ed in
the
WH
O la
bora
tory
bio
safe
ty m
anua
l. 36
Res
pons
ible
life
sci
ence
s re
sear
ch fo
r glo
bal h
ealth
sec
urity
: a g
uida
nce
docu
men
t. W
HO
/HSE
/GAR
/BD
P/20
10.2
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
010.
37
Bot
h hu
man
and
ani
mal
hea
lth s
ecto
rs.
BIO
SAFE
TY A
ND
BIO
SECU
RITY
08
IMPA
CT:
Impl
emen
tatio
n of
a c
ompr
ehen
sive
, sus
tain
able
and
lega
lly e
mbe
dded
nat
iona
l ove
rsig
ht p
rogr
amm
e fo
r bio
safe
ty a
nd b
iose
curit
y, in
clud
ing
the
safe
and
sec
ure
use,
sto
rage
, dis
posa
l and
con
tain
men
t of p
atho
gens
foun
d in
labo
rato
ries
and
a m
inim
al n
umbe
r of h
oldi
ngs
acro
ss th
e co
untry
, and
invo
lvin
g re
sear
ch, d
iagn
ostic
and
bio
tech
nolo
gy fa
cilit
ies
with
in a
ll sec
tors
.37 S
treng
then
ed, s
usta
inab
le b
iolo
gica
l ris
k m
anag
emen
t be
st p
ract
ices
are
in p
lace
usi
ng c
omm
on e
duca
tiona
l mat
eria
ls. S
afe
and
com
plia
nt tr
ansp
ort o
f inf
ectio
us s
ubst
ance
s is
als
o co
nsid
ered
ac
cord
ing
to n
atio
nal a
nd in
tern
atio
nal r
egul
atio
ns.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Exi
sten
ce o
f a n
atio
nal f
ram
ewor
k fo
r pat
hoge
n bi
osaf
ety
and
bios
ecur
ity, s
trai
n co
llect
ions
and
con
tain
men
t lab
orat
orie
s th
at in
clud
es
iden
tifica
tion
and
stor
age
of n
atio
nal s
trai
n co
llect
ions
in a
min
imal
num
ber o
f fac
ilitie
s fr
om a
ll se
ctor
s. (2
) Exi
sten
ce o
f a c
ompr
ehen
sive
ov
ersi
ght a
nd m
onito
ring
syst
em.
A w
hole
-of-
gove
rnm
ent m
ultis
ecto
ral n
atio
nal b
iosa
fety
32 a
nd b
iose
curit
y33 s
yste
m w
ith d
ange
rous
pat
hoge
ns34
iden
tified
, hel
d, s
ecur
ed a
nd m
onito
red
in
a m
inim
al n
umbe
r of f
acili
ties
acco
rdin
g to
bes
t pra
ctic
es;35
bio
logi
cal r
isk
man
agem
ent t
rain
ing
and
educ
atio
nal o
utre
ach
cond
ucte
d to
pro
mot
e a
shar
ed
cultu
re o
f res
pons
ibili
ty,36
redu
ce d
ual-u
se ri
sks,
miti
gate
bio
logi
cal p
rolif
erat
ion
and
ensu
re s
afe
trans
fer o
f bio
logi
cal a
gent
s; a
nd c
ount
ry-s
peci
fic b
iosa
fety
an
d bi
osec
urity
legi
slat
ion,
labo
rato
ry li
cens
ing
and
path
ogen
con
trol m
easu
res
in p
lace
as
appr
opria
te.
WHO BENCHMARKS FOR IHR CAPACITIES
63
CAPA
CITY
LEVE
L
Benc
hmar
k 8.
1: W
hole
-of-
gove
rnm
ent b
iosa
fety
and
bio
secu
rity
syst
em is
in p
lace
for a
ll se
ctor
s (in
clud
ing
hum
an, a
nim
al
(dom
estic
ani
mal
s an
d w
ildlif
e) a
nd e
nviro
nmen
t fac
ilitie
s)
Obj
ectiv
e: T
o de
velo
p an
d im
plem
ent a
bio
safe
ty a
nd b
iose
curit
y sy
stem
for a
ll se
ctor
s (in
clud
ing
hum
an, a
nim
al (d
omes
tic
and
wild
life)
and
env
ironm
ent f
acili
ties)
to m
inim
ize
the
risk
of a
ccid
enta
l or i
nten
tiona
l inf
ectio
n of
labo
rato
ry s
taff
or
rele
ase
of h
azar
dous
pat
hoge
ns
01N
O C
APAC
ITY
Elem
ents
of a
com
preh
ensi
ve n
atio
nal b
iosa
fety
and
bio
secu
rity
syst
em, s
uch
as p
olic
y in
stru
men
ts a
nd p
rope
r fina
ncin
g, a
re
not i
n pl
ace.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d do
cum
ent h
uman
and
ani
mal
hea
lth fa
cilit
ies
that
sto
re/m
aint
ain
dang
erou
s pa
thog
ens
and
toxi
ns in
the
rele
vant
sec
tors
and
hea
lth p
rofe
ssio
nals
resp
onsi
ble
for t
hem
.
Revi
ew a
nd d
evel
op o
r rev
ise
the
natio
nal l
egis
latio
n/re
gula
tions
for b
iosa
fety
and
bio
secu
rity
by th
e hu
man
hea
lth s
ecto
r (o
r oth
er a
ppro
pria
te a
utho
rity)
.
Esta
blis
h a
mec
hani
sm fo
r lab
orat
ory
licen
sing
in h
uman
and
ani
mal
hea
lth s
ecto
rs; e
nsur
e th
at b
iosa
fety
and
bio
secu
rity
requ
irem
ents
are
incl
uded
in g
ener
al li
cens
ing
requ
irem
ents
.
Cond
uct a
sses
smen
ts o
f cur
rent
bio
safe
ty a
nd b
iose
curit
y pr
actic
es, p
roce
dure
s an
d en
gine
erin
g co
ntro
ls a
t the
nat
iona
l le
vel.
D
evel
op p
atho
gen
cont
rol m
easu
res,
incl
udin
g st
anda
rds
for c
onta
inm
ent,
oper
atio
nal h
andl
ing
and
failu
re re
port
ing
syst
ems.
WHO BENCHMARKS FOR IHR CAPACITIES
64
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
bio
safe
ty a
nd b
iose
curit
y na
tiona
l fra
mew
ork
incl
udin
g gu
idel
ines
and
reco
rd-k
eepi
ng o
blig
atio
ns a
t all
labo
rato
ries
wor
king
with
haz
ardo
us a
gent
s.
Dev
elop
and
mai
ntai
n in
vent
orie
s fo
r dan
gero
us p
atho
gens
.
Secu
re d
ange
rous
pat
hoge
ns a
nd to
xins
at m
inim
um n
umbe
r of n
atio
nal l
evel
labo
rato
ries.
Im
plem
ent b
iosa
fety
and
bio
secu
rity
best
pra
ctic
es in
all
natio
nal,
inte
rmed
iate
and
loca
l lab
orat
orie
s.
Esta
blis
h an
info
rmat
ion
secu
rity
syst
em fo
r all
sens
itive
doc
umen
tatio
n in
faci
litie
s w
here
dan
gero
us p
atho
gens
and
toxi
ns
are
stor
ed.
Im
plem
ent n
atio
nal b
iosa
fety
and
bio
secu
rity
regu
latio
ns a
nd g
uide
lines
with
all
rele
vant
sec
tors
(suc
h as
hum
an, a
nim
al,
envi
ronm
enta
l hea
lth, d
efen
ce m
inis
try
and
stak
ehol
ders
) with
sta
ndar
dize
d cl
assi
ficat
ion
and
accr
edita
tion
stan
dard
s th
at
cove
r pat
hoge
n co
ntro
l and
per
sonn
el re
liabi
lity
prog
ram
me
requ
irem
ents
.
Dev
elop
an
actio
n pl
an to
repl
ace
dang
erou
s pa
thog
en c
ultu
res
with
saf
er in
vest
igat
ion
met
hods
.
Begi
n de
velo
ping
inci
dent
and
em
erge
ncy
resp
onse
pro
gram
mes
in fa
cilit
ies
stor
ing
dang
erou
s pa
thog
ens.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent t
he b
iosa
fety
and
bio
secu
rity
natio
nal f
ram
ewor
k in
all
labo
rato
ries
at th
e na
tiona
l, in
term
edia
te a
nd lo
cal l
evel
s.
Dev
elop
site
-spe
cific
bio
safe
ty/b
iose
curit
y su
ppor
ting
docu
men
ts th
at in
clud
e in
cide
nt re
spon
se a
nd e
mer
genc
y pl
ans
(suc
h as
in c
ase
of e
xplo
sion
, fire
, flo
od, w
orke
r exp
osur
e, a
ccid
ent o
r illn
ess,
maj
or s
pilla
ge, w
aste
man
agem
ent)
for
labo
rato
ries
at n
atio
nal,
inte
rmed
iate
and
loca
l lev
els.
D
evel
op d
ocum
ents
for d
ual-u
se re
sear
ch a
nd re
spon
sibl
e co
de o
f con
duct
for s
cien
tists
and
sta
ff.
Dev
elop
and
impl
emen
t an
inci
dent
repo
rtin
g sy
stem
that
incl
udes
iden
tifyi
ng in
cide
nts,
repo
rtin
g ac
cord
ing
to re
gula
tions
, an
d ad
dres
sing
act
ion
item
s th
at im
prov
e sa
fety
and
sec
urity
.
Esta
blis
h ex
tern
al m
onito
ring
and
over
sigh
t of b
iosa
fety
and
bio
secu
rity
prac
tices
.
Dev
elop
and
impl
emen
t equ
ipm
ent o
pera
tion
and
mai
nten
ance
pla
ns a
t lab
orat
orie
s st
orin
g pa
thog
ens
of s
ecur
ity c
once
rn.
WHO BENCHMARKS FOR IHR CAPACITIES
65
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
sust
aina
ble
fund
ing
and
an o
vers
ight
mec
hani
sm to
sup
port
bio
safe
ty a
nd b
iose
curit
y pr
ogra
mm
es/in
itiat
ives
.
Doc
umen
t im
plem
enta
tion
of th
e na
tiona
l bio
safe
ty a
nd b
iose
curit
y le
gisl
atio
ns, w
hich
are
alig
ned
with
the
inte
rnat
iona
l be
st p
ract
ices
at a
ll le
vels
.
Doc
umen
t and
gen
erat
e in
tern
atio
nal g
ood
prac
tices
for b
iosa
fety
and
bio
secu
rity
arra
ngem
ents
.
Secu
re s
usta
inab
le fu
ndin
g an
d an
ove
rsig
ht a
nd e
nfor
cem
ent m
echa
nism
to s
uppo
rt b
iosa
fety
and
bio
secu
rity
prog
ram
mes
/initi
ativ
es a
t the
min
istr
y le
vel.
WHO BENCHMARKS FOR IHR CAPACITIES
66
CAPA
CITY
LEVE
L
Benc
hmar
k 8.
2: B
iosa
fety
and
bio
secu
rity
trai
ning
and
pra
ctic
es in
all
rele
vant
sec
tors
(inc
ludi
ng h
uman
, ani
mal
(dom
estic
an
imal
s an
d w
ildlif
e) a
nd e
nviro
nmen
t)
Obj
ectiv
e: T
o de
velo
p a
publ
ic h
ealth
wor
kfor
ce th
at is
ava
ilabl
e an
d tr
aine
d to
ena
ble
early
det
ectio
n, p
reve
ntio
n,
prep
ared
ness
and
resp
onse
to p
oten
tial e
vent
s of
inte
rnat
iona
l con
cern
at a
ll le
vels
of h
ealth
sys
tem
s to
eff
ectiv
ely
impl
emen
t IH
R
01N
O C
APAC
ITY
No
bios
afet
y an
d bi
osec
urity
trai
ning
or p
lans
are
in p
lace
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
As
sess
bio
safe
ty a
nd b
iose
curit
y tr
aini
ng n
eeds
and
gap
s in
all
rele
vant
sec
tors
.
Cond
uct a
n en
gage
men
t mee
ting
to d
evel
op b
iosa
fety
and
bio
secu
rity
trai
ning
pro
gram
mes
that
alig
n ac
adem
ic c
urric
ulum
w
ith in
tern
atio
nal b
est p
ract
ices
.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ad
apt i
n-se
rvic
e an
d co
ntin
uing
edu
catio
n tr
aini
ng c
urric
ula,
SO
Ps, t
oolk
its, g
ood
mic
robi
olog
ical
pra
ctic
es a
nd p
roce
dure
s to
com
ply
with
bio
safe
ty a
nd b
iose
curit
y ru
les
and
regu
latio
ns a
nd a
ligne
d w
ith in
tern
atio
nal b
est p
ract
ices
.
Trai
n an
d ov
ersi
ght f
acili
ties
that
are
hou
sing
or w
orki
ng w
ith d
ange
rous
pat
hoge
ns a
nd to
xins
to c
ompl
y w
ith b
iosa
fety
and
bi
osec
urity
rule
s an
d re
gula
tions
.
Begi
n de
velo
ping
sus
tain
ed a
cade
mic
and
con
tinui
ng e
duca
tion,
and
trai
ning
pro
gram
mes
for b
iosa
fety
and
bio
secu
rity
alig
ned
with
inte
rnat
iona
l bes
t pra
ctic
es.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent t
rain
ing
prog
ram
mes
and
ove
rsig
ht a
nd a
sses
s th
at th
ey c
ompl
y w
ith b
iosa
fety
and
bio
secu
rity
rule
s an
d re
gula
tions
, and
are
alig
ned
with
inte
rnat
iona
l bes
t pra
ctic
es.
Im
plem
ent s
usta
inab
le tr
aini
ng p
rogr
amm
es, t
hat a
re a
ligne
d w
ith in
tern
atio
nal b
est p
ract
ices
, in
inst
itutio
ns th
at tr
ain
thos
e w
ho m
aint
ain
or w
ork
with
dan
gero
us p
atho
gens
and
toxi
ns.
WHO BENCHMARKS FOR IHR CAPACITIES
67
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Al
ign
and
impl
emen
t sus
tain
able
trai
ning
pro
gram
mes
in b
iosa
fety
and
bio
secu
rity
alig
ned
with
inte
rnat
iona
l bes
t pra
ctic
es.
G
uara
ntee
sus
tain
ed fu
ndin
g to
sup
port
trai
ning
pro
gram
mes
from
the
natio
nal g
over
nmen
t.
Incl
ude
bios
afet
y an
d bi
osec
urity
trai
ning
cou
rses
in u
nive
rsity
cur
ricul
a of
pre
trai
ning
edu
catio
n in
bot
h hu
man
and
ani
mal
he
alth
sec
tors
.
Revi
ew tr
aini
ng n
eeds
ass
essm
ents
on
a re
gula
r bas
is a
nd a
djus
t and
upd
ate
trai
ning
pro
gram
mes
acc
ordi
ng to
the
asse
ssm
ent r
esul
ts.
Im
plem
ent p
erio
dic
trai
ning
pro
gram
mes
on
emer
genc
y re
spon
se p
roce
dure
s.
TOO
LS:
W
HO
labo
rato
ry b
iosa
fety
man
ual.
Third
edi
tion.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
004
W
HO
gui
danc
e do
cum
ent:
Step
wis
e im
plem
enta
tion
of re
gula
tory
requ
irem
ents
for e
nsur
ing
bios
afet
y an
d bi
osec
urity
in b
iom
edic
al fa
cilit
ies
(bei
ng fi
naliz
ed w
ith e
xpec
ted
publ
icat
ion
in 2
019)
.
Gui
de to
par
ticip
atin
g in
the
confi
denc
e-bu
ildin
g m
easu
res
of th
e bi
olog
ical
wea
pons
con
vent
ion.
Gen
eva:
Uni
ted
Nat
ions
Offi
ce fo
r Dis
arm
amen
t Af
fairs
; 201
3
WHO BENCHMARKS FOR IHR CAPACITIES
68
38 S
urve
illanc
e m
eans
the
syst
emat
ic o
ngoi
ng c
olle
ctio
n, c
olla
tion
and
anal
ysis
of d
ata
for p
ublic
hea
lth p
urpo
ses
and
the
timel
y di
ssem
inat
ion
of p
ublic
hea
lth in
form
atio
n fo
r ass
essm
ent a
nd p
ublic
he
alth
resp
onse
as
nece
ssar
y. 39
Inte
rope
rabl
e, d
escr
ibes
the
exte
nt to
whi
ch s
yste
ms
and
devi
ces
can
exch
ange
dat
a, a
nd in
terp
ret t
hat s
hare
d da
ta. F
or tw
o sy
stem
s to
be
inte
rope
rabl
e, th
ey m
ust b
e ab
le to
exc
hang
e da
ta a
nd
subs
eque
ntly
pre
sent
that
dat
a in
a m
anne
r tha
t can
be
unde
rsto
od b
y th
e us
er (d
efini
tion
by H
ealth
care
Info
rmat
ion
and
Man
agem
ent S
yste
ms
Soci
ety)
. 40
Stro
ng s
urve
illanc
e w
ill su
ppor
t the
tim
ely
reco
gniti
on o
f the
em
erge
nce
of re
lativ
ely
rare
or p
revi
ousl
y un
desc
ribed
pat
hoge
ns in
spe
cific
cou
ntrie
s.
41 E
ach
coun
try h
as to
defi
ne a
“pot
entia
l ris
k to
pub
lic h
ealth
”, pe
rform
risk
map
ping
and
iden
tify
prio
rity
dise
ases
. 42
Cou
ntrie
s w
ill su
ppor
t the
use
of i
nter
oper
able
, inte
rcon
nect
ed s
yste
ms
capa
ble
of lin
king
and
inte
grat
ing
mul
tisec
tora
l sur
veilla
nce
data
and
usi
ng th
e re
sulti
ng in
form
atio
n to
enh
ance
the
capa
city
to
qui
ckly
det
ect a
nd re
spon
d to
dev
elop
ing
biol
ogic
al th
reat
s. F
ound
atio
nal c
apac
ity is
nec
essa
ry fo
r bot
h in
dica
tor-
and
evi
denc
e-ba
sed
surv
eilla
nce,
to s
uppo
rt pr
even
tion
and
cont
rol a
ctiv
ities
, and
in
terv
entio
n ta
rget
ing
for b
oth
esta
blis
hed
infe
ctio
us d
isea
ses
and
new
and
em
ergi
ng p
ublic
hea
lth th
reat
s.
43 In
tern
atio
nally
reco
gniz
ed s
tand
ards
for s
yndr
omic
sur
veilla
nce
are
avai
labl
e fo
r the
follo
win
g fiv
e sy
ndro
mes
: (i)
seve
re a
cute
resp
irato
ry s
yndr
ome,
(ii)
acut
e fla
ccid
par
alys
is, (
iii) a
cute
ha
emor
rhag
ic fe
ver, (
iv) a
cute
wat
ery
diar
rhoe
a w
ith d
ehyd
ratio
n, a
nd (v
) acu
te ja
undi
ce s
yndr
ome.
Thr
ee c
ore
synd
rom
es a
re c
hose
n de
pend
ing
on n
atio
nal d
isea
se c
ontro
l prio
ritie
s. T
he s
urve
illanc
e sy
stem
sho
uld
incl
ude
epid
emio
logi
cal d
ata
and
labo
rato
ry fi
ndin
gs, w
hich
sho
uld
be a
naly
sed
by tr
aine
d ep
idem
iolo
gist
s.
SURV
EILL
ANCE
09
IMPA
CT:
(1) A
func
tioni
ng p
ublic
hea
lth s
urve
illan
ce s
yste
m40
cap
able
of i
dent
ifyin
g po
tent
ial e
vent
s of
con
cern
for p
ublic
hea
lth a
nd h
ealth
sec
urity
.41 (2
) En
hanc
ed n
atio
nal a
nd in
term
edia
te le
vel r
egio
nal c
apac
ity to
ana
lyse
and
link
dat
a fro
m a
nd b
etw
een
the
diffe
rent
leve
ls o
f the
stre
ngth
ened
ea
rly-w
arni
ng s
urve
illan
ce s
yste
m.42
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Sur
veill
ance
for a
t lea
st th
ree
core
syn
drom
es43
indi
cativ
e of
pot
entia
l pub
lic h
ealth
em
erge
ncie
s co
nduc
ted
acco
rdin
g to
inte
rnat
iona
l st
anda
rds.
(2) R
egul
ar a
naly
sis
and
repo
rtin
g of
sur
veill
ance
dat
a.
Stre
ngth
ened
sur
veilla
nce38
sys
tem
s ar
e ab
le to
det
ect e
vent
s of
sig
nific
ance
for p
ublic
hea
lth a
nd h
ealth
sec
urity
; impr
ove
com
mun
icat
ion
and
colla
bora
tion
acro
ss s
ecto
rs a
nd b
etw
een
subn
atio
nal (
loca
l and
inte
rmed
iate
), na
tiona
l and
inte
rnat
iona
l leve
ls o
f aut
horit
y re
gard
ing
surv
eilla
nce
of e
vent
s of
pub
lic h
ealth
si
gnifi
canc
e; a
nd im
prov
e na
tiona
l and
inte
rmed
iate
leve
l reg
iona
l cap
acity
to a
naly
se a
nd lin
k da
ta fr
om a
nd b
etw
een,
stre
ngth
ened
ear
ly-w
arni
ng s
urve
illanc
e,
incl
udin
g in
tero
pera
ble,
39 in
terc
onne
cted
ele
ctro
nic
tool
s. T
his
wou
ld in
corp
orat
e ep
idem
iolo
gica
l, clin
ical
, labo
rato
ry, e
nviro
nmen
tal t
estin
g, p
rodu
ct s
afet
y an
d qu
ality
, and
bio
info
rmat
ics
data
; and
adv
ance
s in
fulfi
lling
core
cap
acity
requ
irem
ents
for s
urve
illanc
e in
acc
orda
nce
with
the
IHR
and
OIE
gui
delin
es.
WHO BENCHMARKS FOR IHR CAPACITIES
69
CAPA
CITY
LEVE
L
Benc
hmar
k 9.
1: F
unct
iona
l sur
veill
ance
sys
tem
to id
entif
y po
tent
ial e
vent
s of
con
cern
for p
ublic
hea
lth a
nd h
ealth
sec
urity
is
in p
lace
Th
e su
rvei
llanc
e sy
stem
sho
uld
incl
ude
the:
abili
ty to
con
duct
sur
veill
ance
for a
t lea
st th
ree
core
syn
drom
es in
dica
tive
of a
pub
lic h
ealth
em
erge
ncy
and
ongo
ing,
re
gula
r, sy
stem
atic
and
acc
urat
e su
rvei
llanc
e fo
r dis
ease
s an
d co
nditi
ons
of a
ctua
l or p
oten
tial e
pide
mio
logi
cal i
mpo
rtan
ce
in th
e co
untr
y;
abili
ty to
pro
vide
sys
tem
atic
/rou
tine
repo
rts
and
data
to h
igh-
leve
l pub
lic h
ealth
dec
isio
n-m
aker
s in
the
coun
try,
and
feed
back
to lo
wer
leve
ls im
plem
entin
g th
e co
ntro
l pro
gram
mes
; and
lin
kage
s to
labo
rato
ry a
nd o
ther
info
rmat
ion
syst
ems
to p
rovi
de re
pres
enta
tive,
tim
ely
and
accu
rate
sur
veilla
nce
info
rmat
ion.
Obj
ectiv
e: S
tren
gthe
n su
rvei
llanc
e sy
stem
01N
O C
APAC
ITY
The
coun
try
has
to d
evel
op a
nd im
plem
ent a
ll ac
tiviti
es th
at a
re li
sted
in le
vel 2
to a
chie
ve th
e lim
ited
capa
city
for t
he
surv
eilla
nce
syst
em.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
De
velo
p na
tiona
l com
mun
icab
le
dise
ase
surv
eilla
nce
stra
tegy
bas
ed
on IH
R re
quire
men
ts, w
hich
incl
udes
a
list o
f prio
rity/
epid
emic
-pro
ne
dise
ases
and
syn
drom
es m
ost
rele
vant
to th
e co
untr
y.
Esta
blis
h a
dise
ase
surv
eilla
nce
unit
or d
epar
tmen
t and
fina
lize
the
oper
atio
nal p
lan44
and
pro
cess
.
Des
igna
te s
urve
illan
ce fo
cal p
erso
ns
at s
ubna
tiona
l lev
els.
Es
tabl
ish
indi
cato
r-ba
sed
surv
eilla
nce
D
evel
op g
uide
lines
and
SO
Ps fo
r in
dica
tor-
base
d su
rvei
llanc
e.
Es
tabl
ish
a de
sign
ated
uni
t at a
ll le
vels
, with
ope
ratio
nal p
lan
and
proc
edur
es.
In
clud
e co
untr
y pr
iorit
y di
seas
es in
in
dica
tor-
base
d su
rvei
llanc
e.
Dis
sem
inat
e ca
se d
efini
tions
and
en
sure
that
pro
cess
of d
etec
tion,
Es
tabl
ish
even
t-ba
sed
surv
eilla
nce
D
evel
op g
uide
lines
and
sta
ndar
d op
erat
ing
proc
edur
es fo
r eve
nt-
base
d su
rvei
llanc
e.
Esta
blis
h a
desi
gnat
ed u
nit a
t all
need
ed le
vels
, with
ope
ratio
nal p
lan
and
proc
edur
es.
D
evel
op a
nd p
ut in
pla
ce c
ase
defin
ition
s an
d th
e pr
oces
s of
de
tect
ion,
ass
essm
ent a
nd re
port
ing
of th
e ev
ent (
clus
ters
or o
utbr
eaks
)
44 T
he p
lan
that
cle
arly
defi
nes
actio
ns it
will
take
to s
uppo
rt th
e st
rate
gy.
WHO BENCHMARKS FOR IHR CAPACITIES
70
Id
entif
y re
sour
ces
for c
ontro
l of
prio
rity
dise
ases
.
Dev
elop
trai
ning
mat
eria
ls fo
r di
seas
e su
rvei
llanc
e fo
r nat
iona
l and
su
bnat
iona
l lev
els.
D
isse
min
ate
case
defi
nitio
ns a
nd
proc
ess
of d
etec
tion,
ass
essm
ent,
and
repo
rtin
g of
cas
es (u
ser m
anua
l or
gui
delin
es) a
t nat
iona
l and
in
term
edia
te le
vels
.
Dev
elop
and
impl
emen
t ind
icat
or-
base
d su
rvei
llanc
e or
eve
nt-b
ased
su
rvei
llanc
e (re
fer t
o re
spec
tive
colu
mn
for t
heir
benc
hmar
ks).
asse
ssm
ent a
nd re
port
ing
of c
ases
(u
ser m
anua
l or g
uide
lines
) are
in
plac
e at
nat
iona
l and
sub
natio
nal
leve
ls.
for c
ount
ry p
riorit
y di
seas
es
and
diss
emin
ate
to n
atio
nal a
nd
subn
atio
nal l
evel
s.
Esta
blis
h a
proc
ess
to id
entif
y po
tent
ial e
vent
s fro
m c
omm
unity
- ba
sed
repo
rtin
g (p
eopl
e id
entifi
ed
from
the
com
mun
ity, v
erifi
catio
n te
ams
at fa
cilit
ies
iden
tified
, SO
P an
d flo
w o
f inf
orm
atio
n av
aila
ble)
an
d m
ake
the
data
ava
ilabl
e at
all
need
ed le
vels
.
Esta
blis
h sy
stem
s to
iden
tify
pote
ntia
l eve
nts
from
var
ious
oth
er
sour
ces
(suc
h as
med
ia, s
ocia
l m
edia
, priv
ate
sect
or).
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
ctio
ns (d
escr
ibed
abo
ve) f
or b
oth
indi
cato
r- a
nd e
vent
-bas
ed s
urve
illan
ce s
yste
ms
at n
atio
nal a
nd in
term
edia
te
leve
ls (d
istr
ict,
prov
ince
, reg
ion
or s
tate
).
Trai
n 70
% o
f hea
lth w
orke
rs (c
linic
ians
, lab
orat
oria
ns, s
urve
illan
ce o
ffice
rs) i
n de
tect
ion,
mon
itorin
g an
d ev
alua
tion
of
even
ts a
nd c
ases
, with
cle
ar g
uida
nce
for f
ollo
w-u
p di
ssem
inat
ed a
t nat
iona
l and
inte
rmed
iate
leve
ls; d
ocum
ent t
hat h
ealth
w
orke
rs h
ave
rece
ived
trai
ning
.
Esta
blis
h a
proc
ess
of im
med
iate
and
wee
kly
repo
rtin
g fro
m e
very
repo
rtin
g un
it, a
lthou
gh re
port
s m
ay n
ot b
e av
aila
ble
for
ever
y w
eek.
Es
tabl
ish
a pr
oces
s to
ens
ure
that
repo
rted
cas
es o
r eve
nts
with
out
brea
k po
tent
ial a
re in
vest
igat
ed a
nd a
sses
sed
for p
ublic
he
alth
resp
onse
and
link
ed to
the
labo
rato
ry re
sults
, and
that
dat
a fro
m th
e in
vest
igat
ion
are
man
aged
in a
sta
ndar
dize
d tim
efra
me
and
man
ner.
Co
nduc
t reg
ular
trai
ning
for s
urve
illan
ce s
taff
on S
OPs
, gui
delin
es, p
roce
dure
s an
d be
st p
ract
ices
at n
atio
nal a
nd
inte
rmed
iate
leve
ls.
WHO BENCHMARKS FOR IHR CAPACITIES
71
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Tr
ain
mor
e th
an 9
0% lo
cal h
ealth
wor
kers
, vol
unte
ers
or b
oth
on d
etec
tion
and
repo
rtin
g of
cas
es, c
lust
ers,
out
brea
ks o
r ev
ents
, and
doc
umen
t tha
t hea
lth w
orke
rs a
re tr
aine
d.
Impl
emen
t the
imm
edia
te a
nd w
eekl
y re
port
ing
mec
hani
sm in
all
heal
th fa
cilit
ies
(pub
lic a
nd p
rivat
e) fr
om a
ll le
vels
, and
en
sure
that
wee
kly
repo
rts
are
rece
ived
.
Trai
n su
rvei
llanc
e st
aff a
t all
leve
ls o
n m
onito
ring
and
eval
uatin
g ev
ents
, and
dev
elop
and
impl
emen
t a c
lear
follo
w-u
p of
the
proc
ess
at n
atio
nal,
inte
rmed
iate
and
loca
l lev
els.
D
evel
op a
mec
hani
sm fo
r cro
ss-b
orde
r sur
veill
ance
by
mea
ns o
f an
agre
ed c
ross
-bor
der s
urve
illan
ce s
yste
m a
t poi
nts
of
entr
y, or
som
e ot
her m
echa
nism
of r
egul
arly
sha
ring
data
and
info
rmat
ion
betw
een
neig
hbou
ring
coun
trie
s.
Cond
uct r
egul
ar tr
aini
ng o
n SO
Ps, g
uide
lines
, pro
cedu
res
and
best
pra
ctic
es a
t all
leve
ls, i
nclu
ding
at t
he lo
cal/h
ealth
faci
lity
leve
l, fo
r sur
veill
ance
sta
ff.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd im
plem
ent a
n op
erat
iona
l pla
n fo
r ong
oing
eva
luat
ion
of th
e su
rvei
llanc
e sy
stem
at a
ll le
vels
.
Esta
blis
h a
mec
hani
sm to
upd
ate
the
surv
eilla
nce
syst
em b
ased
on
eval
uatio
n fin
ding
s at
all
leve
ls.
Se
cure
sus
tain
ed fu
ndin
g fo
r per
sonn
el a
nd m
ater
ials
for t
he s
urve
illan
ce s
yste
m.
D
evel
op a
pla
n an
d pr
oces
s to
sup
port
effo
rts
of o
ther
cou
ntrie
s to
dev
elop
/enh
ance
sur
veill
ance
sys
tem
s, in
clud
ing
cont
ribut
ing
to re
gion
al a
nd/o
r int
erna
tiona
l sur
veill
ance
net
wor
ks.
M
onito
r im
plem
enta
tion
of c
ross
-bor
der s
urve
illan
ce a
nd d
emon
stra
te th
at in
form
atio
n-sh
arin
g pr
otoc
ol is
effe
ctiv
e.
Esta
blis
h a
mec
hani
sm to
con
trib
ute
to re
gion
al o
r int
erna
tiona
l sur
veill
ance
net
wor
ks.
WHO BENCHMARKS FOR IHR CAPACITIES
72
CAPA
CITY
LEVE
L
Benc
hmar
k 9.
2: S
urve
illan
ce s
yste
m is
sup
port
ed b
y el
ectr
onic
tool
s O
bjec
tive:
App
licat
ion
of e
letr
onic
tool
s fo
r sur
veill
ance
sys
tem
01N
O C
APAC
ITY
No
syst
em d
evel
oped
; an
asse
ssm
ent o
f the
ele
ctro
nic
syst
em is
pla
nned
or i
s be
ing
cond
ucte
d.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
U
se a
d ho
c el
ectro
nic
tool
s (s
uch
as E
xcel
spr
eads
heet
s) to
repo
rt a
nd a
naly
se s
urve
illan
ce d
ata,
whi
le a
mor
e so
phis
ticat
ed
syst
em is
und
er d
evel
opm
ent.
Pi
lot a
vaila
ble
elec
troni
c to
ols.
D
evel
op a
str
ateg
y fo
r int
egra
ted
elec
troni
c re
al-t
ime
repo
rtin
g sy
stem
for p
ublic
hea
lth s
urve
illan
ce w
ith th
e in
volv
emen
t of
mul
tisec
tora
l sta
keho
lder
s an
d pa
rtne
rs.
D
evel
op o
pera
tiona
l pla
n, s
tand
ards
for d
ata,
and
pla
ns fo
r int
erop
erab
ility
and
dat
a sh
arin
g.
Esta
blis
h a
link
of th
e el
ectro
nic
syst
em u
nder
dev
elop
men
t to
the
exis
ting
heal
th in
form
atio
n m
anag
emen
t sys
tem
.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
n el
ectro
nic
surv
eilla
nce
syst
em a
t the
nat
iona
l lev
el fo
r bot
h in
dica
tor-
and
eve
nt-b
ased
sur
veill
ance
.
Dev
elop
an
elec
troni
c ev
ent m
anag
emen
t sys
tem
at t
he n
atio
nal l
evel
.
Link
ele
ctro
nic
tool
s w
ith th
e la
bora
tory
info
rmat
ion
man
agem
ent s
yste
m a
t the
nat
iona
l lev
el.
D
evel
op a
nd d
isse
min
ate
SOPs
, pro
cedu
res
and
guid
elin
es a
t all
leve
ls.
Tr
ain
80%
of n
atio
nal-
and
inte
rmed
iate
-leve
l sur
veill
ance
sta
ff on
app
licat
ion/
softw
are
for s
urve
illan
ce.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent t
he e
lect
roni
c sy
stem
in 8
0% le
vels
of t
he h
ealth
sys
tem
.
Dev
elop
an
elec
troni
c ev
ent m
anag
emen
t sys
tem
at a
ll le
vels
of t
he h
ealth
sys
tem
.
Link
ele
ctro
nic
tool
s w
ith th
e la
bora
tory
info
rmat
ion
man
agem
ent s
yste
m a
t all
leve
ls.
Co
nduc
t rou
tine
trai
ning
on
appl
icat
ion
or s
oftw
are
for s
urve
illan
ce s
taff
at a
ll le
vels
, inc
ludi
ng 1
00%
of n
atio
nal-
and
inte
rmed
iate
-leve
l sur
veill
ance
sta
ff.
WHO BENCHMARKS FOR IHR CAPACITIES
73
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent t
he e
lect
roni
c sy
stem
at a
ll le
vels
of t
he h
ealth
sys
tem
, inc
ludi
ng fr
om p
rivat
e he
alth
care
pro
vide
rs a
nd p
rivat
e la
bora
torie
s.
Secu
re re
sour
ces
for o
pera
tion
of th
e sy
stem
, inc
ludi
ng h
uman
reso
urce
s, h
ardw
are,
sof
twar
e an
d ne
twor
k in
fras
truc
ture
to
run
the
syst
em a
t all
leve
ls.
M
onito
r and
eva
luat
e th
e el
ectro
nic
surv
eilla
nce
syst
em fo
r upd
atio
n as
nee
ded.
Te
st in
tero
pera
bilit
y of
the
elec
troni
c sy
stem
with
oth
er re
leva
nt e
lect
roni
c to
ols
of o
ther
sec
tors
.
Dev
elop
and
dis
sem
inat
e gu
idan
ce to
all
sect
ors
(suc
h as
ani
mal
hea
lth, f
ood
safe
ty) o
n da
ta s
harin
g an
d in
tero
pera
bilit
y.
Trai
n st
aff a
nd d
evel
op p
roto
cols
to s
hare
dat
a w
ith re
gion
al o
r int
erna
tiona
l act
ors
(suc
h as
sha
ring
influ
enza
dat
a in
Glo
bal
Influ
enza
Sur
veill
ance
and
Res
pons
e Sy
stem
and
/or F
luN
ET (a
glo
bal w
eb-b
ased
tool
for i
nflu
enza
viro
logi
cal s
urve
illan
ce))
WHO BENCHMARKS FOR IHR CAPACITIES
74
CAPA
CITY
LEVE
L
Benc
hmar
k 9.
3: S
yste
mat
ic a
naly
sis
of s
urve
illan
ce d
ata
for a
ctio
n is
in p
lace
O
bjec
tive:
Con
duct
ana
lysi
s of
dat
a fo
r act
ion
01N
O C
APAC
ITY
No
capa
city
to a
naly
se d
ata.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op s
tand
ards
and
exp
ecta
tions
for a
naly
sis
of s
urve
illan
ce d
ata,
with
an
oper
atio
nal p
lan.
D
evel
op a
trai
ning
pac
kage
for d
ata
man
agem
ent (
data
col
latio
n, a
naly
sis,
tren
d an
alys
is a
nd d
evel
opin
g re
port
s or
su
mm
arie
s).
D
evel
op a
nd d
isse
min
ate
guid
elin
es a
nd p
roce
dure
s to
ass
ess
the
risk
of u
nusu
al c
ase
repo
rts
and
surv
eilla
nce
sign
als
at
all l
evel
s.
Prod
uce
ad h
oc re
port
s of
ana
lyse
d su
rvei
llanc
e da
ta fo
r out
brea
ks o
r oth
er p
ublic
hea
lth e
vent
s an
d di
ssem
inat
e fro
m th
e na
tiona
l lev
el.
D
evel
op a
tool
and
sta
ndar
ds fo
r dat
a qu
ality
ass
essm
ent.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t tra
inin
g on
dat
a an
alys
is a
t nat
iona
l and
inte
rmed
iate
leve
ls.
Pr
oduc
e an
d di
ssem
inat
e an
nual
and
mon
thly
repo
rts
base
d on
som
e an
alys
is (i
.e. n
ot o
nly
num
eric
al c
ase
info
rmat
ion)
fro
m th
e na
tiona
l sur
veill
ance
team
.
Dev
elop
a tr
aini
ng p
acka
ge a
nd tr
ain
staf
f on
the
asse
ssm
ent o
f ris
k of
unu
sual
cas
e re
port
s an
d su
rvei
llanc
e si
gnal
s at
na
tiona
l and
inte
rmed
iate
leve
ls.
D
evel
op a
pro
cess
and
pub
lish
rout
ine
repo
rts
of e
pide
mio
logi
cal i
nfor
mat
ion
for p
riorit
y di
seas
es a
t the
nat
iona
l lev
el.
D
evel
op s
tand
ards
, con
tent
and
form
at o
f an
epid
emio
logi
cal b
ulle
tin fo
r nat
iona
l, in
term
edia
te a
nd lo
cal l
evel
s.
Dev
elop
cap
acity
to c
ondu
ct p
erio
dic
asse
ssm
ent o
f dat
a qu
ality
at t
he n
atio
nal l
evel
.
WHO BENCHMARKS FOR IHR CAPACITIES
75
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t tra
inin
g on
dat
a an
alys
is fo
r sur
veill
ance
sta
ff at
all
leve
ls.
Pr
oduc
e w
eekl
y ep
idem
iolo
gica
l rep
orts
with
ana
lyse
d da
ta o
n pr
iorit
y di
seas
es a
nd d
isse
min
ate
to a
ll le
vels
.
Cond
uct a
trai
ning
ass
essm
ent o
f the
risk
of u
nusu
al c
ase
repo
rts
and
surv
eilla
nce
sign
als
at a
ll le
vels
.
Prod
uce
anal
yses
and
dis
sem
inat
e ep
idem
iolo
gic
inte
rpre
tatio
n of
all
maj
or e
vent
s at
all
leve
ls.
O
pera
tiona
lize
a m
echa
nism
for m
onito
ring
data
qua
lity
and
anal
ysis
at n
atio
nal a
nd in
term
edia
te le
vels
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a de
dica
ted
team
for d
ata
anal
ysis
, ris
k as
sess
men
t and
repo
rtin
g at
nat
iona
l and
inte
rmed
iate
leve
ls.
D
evel
op a
mec
hani
sm a
nd tr
ain
staf
f to
shar
e da
ta w
ith o
ther
tool
s th
at a
re u
sed
at re
gion
al o
r int
erna
tiona
l lev
els
(suc
h as
sh
arin
g in
fluen
za d
ata
in G
ISRS
).
Secu
re s
usta
inab
le fu
ndin
g an
d re
sour
ces
for d
ata
anal
ysis
sta
ff an
d w
eekl
y re
port
ing
syst
em.
D
emon
stra
te c
ontin
uous
impr
ovem
ent o
f dat
a qu
ality
at a
ll le
vels
, usi
ng a
sses
smen
t res
ults
.
TOO
LS:
Pu
blic
Hea
lth S
urve
illan
ce –
WH
O re
sour
ces
In
tegr
ated
Dis
ease
Sur
veill
ance
– R
esou
rces
W
HO
reco
mm
ends
sur
veill
ance
sta
ndar
ds –
Sec
ond
Editi
on
WHO BENCHMARKS FOR IHR CAPACITIES
76
HU
MAN
RES
OU
RCES
10
IMPA
CT:
Prev
entio
n, d
etec
tion
and
resp
onse
act
iviti
es (i
nclu
ding
hea
lth p
rom
otio
n, o
ccup
atio
nal h
ealth
saf
ety
and
secu
rity,
and
appr
opria
te c
are
of th
ose
affe
cted
) con
duct
ed e
ffect
ivel
y an
d su
stai
nabl
y by
a fu
lly c
ompe
tent
, coo
rdin
ated
, eva
luat
ed a
nd o
ccup
atio
nally
div
erse
mul
tisec
tora
l wor
kfor
ce.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) A tr
aine
d he
alth
wor
kfor
ce th
at in
clud
es n
urse
s an
d m
idw
ives
, phy
sici
ans,
epi
dem
iolo
gist
s an
d ot
her p
ublic
hea
lth a
nd e
nviro
nmen
tal
spec
ialis
ts, s
ocia
l sci
entis
ts, l
abor
ator
y sc
ient
ists
/tec
hnic
ians
, bio
stat
istic
ians
, IT
spec
ialis
ts a
nd b
iom
edic
al te
chni
cian
s. (2
) Exi
sten
ce o
f a
corr
espo
ndin
g w
orkf
orce
in th
e an
imal
sec
tor o
f vet
erin
aria
ns, p
ara-
vete
rinar
ians
, ani
mal
hea
lth p
rofe
ssio
nals
, epi
dem
iolo
gist
s, IT
spe
cial
ists
an
d ot
hers
.
Stat
es P
artie
s w
ith c
ompe
tent
and
wel
l-mot
ivat
ed h
ealth
per
sonn
el fo
r sus
tain
able
and
func
tiona
l pub
lic h
ealth
sur
veill
ance
and
resp
onse
are
ava
ilabl
e at
al
l lev
els
of th
e he
alth
sys
tem
for e
ffect
ive
impl
emen
tatio
n of
IHR.
Hum
an re
sour
ces
incl
ude
nurs
es a
nd m
idw
ives
, phy
sici
ans,
epi
dem
iolo
gist
s an
d ot
her
publ
ic h
ealth
and
env
ironm
enta
l spe
cial
ists
, soc
ial s
cien
tists
, com
mun
icat
ions
per
sonn
el, o
ccup
atio
nal h
ealth
per
sonn
el, la
bora
tory
sci
entis
ts/t
echn
icia
ns,
bios
tatis
ticia
ns, in
form
atio
n te
chno
logy
(IT)
spe
cial
ists
and
bio
med
ical
tech
nici
ans.
The
re is
a c
orre
spon
ding
wor
kfor
ce in
the
anim
al s
ecto
r of v
eter
inar
ians
, an
imal
hea
lth p
rofe
ssio
nals
, par
a-ve
terin
aria
ns, e
pide
mio
logi
sts
and
IT s
peci
alis
ts.
The
reco
mm
ende
d de
nsity
of d
octo
rs, n
urse
s an
d m
idw
ives
per
100
0 po
pula
tion
for o
pera
tiona
l rou
tine
serv
ices
is 4
.45
plus
30%
sur
ge c
apac
ity. T
he o
ptim
al
targ
et fo
r sur
veill
ance
is o
ne tr
aine
d (fi
eld)
epi
dem
iolo
gist
(or e
quiv
alen
t) pe
r 200
000
pop
ulat
ion
who
can
sys
tem
atic
ally
coo
pera
te to
mee
t rel
evan
t IH
R an
d PV
S co
re c
ompe
tenc
ies.
One
trai
ned
epid
emio
logi
st is
nee
ded
per r
apid
resp
onse
team
.
WHO BENCHMARKS FOR IHR CAPACITIES
77
CAPA
CITY
LEVE
L
Benc
hmar
k 10
.1: A
n up
-to-
date
, mul
tisec
tora
l wor
kfor
ce s
trat
egy
is in
pla
ce
Obj
ectiv
e: T
o de
velo
p an
d im
plem
ent a
n up
-to-
date
wor
kfor
ce s
trat
egy
for a
func
tiona
l mul
tisec
tora
l hea
lth w
orkf
orce
01N
O C
APAC
ITY
No
mul
tisec
tora
l One
Hea
lth w
orkf
orce
str
ateg
y in
pla
ce.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
As
sess
45 a
nd d
evel
op/d
ocum
ent46
cou
ntry
’s c
urre
nt h
ealth
wor
kfor
ce s
trat
egy.
Bu
ild p
lann
ing
capa
city
to d
evel
op o
r im
prov
e hu
man
reso
urce
s fo
r hea
lth p
olic
y an
d st
rate
gies
that
qua
ntify
hea
lth
wor
kfor
ce n
eeds
, dem
ands
and
sup
ply
unde
r var
ied
futu
re s
cena
rios.
D
evel
op a
mec
hani
sm fo
r mul
tisec
tora
l act
ion
on h
ealth
wor
kfor
ce is
sues
to g
ener
ate
requ
ired
supp
ort f
rom
all
rele
vant
he
alth
sec
tors
, min
istr
ies
of fi
nanc
e, e
duca
tion
and
labo
ur (o
r equ
ival
ent),
col
labo
ratin
g pa
rtne
rs a
nd s
take
hold
ers.
D
evel
op a
pla
n to
fund
and
impl
emen
t the
hea
lth w
orkf
orce
str
ateg
y (a
nim
al a
nd h
uman
hea
lth s
ecto
r), a
nd d
onor
co
ntrib
utio
ns.
D
ocum
ent a
nd d
isse
min
ate
the
publ
ic h
ealth
wor
kfor
ce/h
uman
reso
urce
str
ateg
y.
45 T
his
asse
ssm
ent m
ust d
escr
ibe
whi
ch c
ateg
orie
s of
hea
lth w
orke
rs a
re in
clud
ed in
the
wor
kfor
ce s
trat
egy
(suc
h as
epi
dem
iolo
gist
s, v
eter
inar
ians
, lab
orat
ory
assi
stan
ts a
nd s
peci
alis
ts,
doct
ors,
nur
ses
and
com
mun
ity h
ealth
wor
kers
). 46
Doc
umen
t job
spe
cific
atio
ns fo
r var
ious
cat
egor
ies
of h
ealth
wor
kers
(inc
ludi
ng s
cope
s of
pra
ctic
e, p
erfo
rman
ce a
ppra
isal
, com
pete
ncy
stan
dard
s, c
aree
r lad
der o
ptio
ns).
WHO BENCHMARKS FOR IHR CAPACITIES
78
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op p
roto
cols
, SO
Ps, a
nd te
chni
cal g
uide
lines
to e
nsur
e re
gula
r rev
iew
and
upd
ate
of th
e m
ultis
ecto
ral w
orkf
orce
st
rate
gy w
ith fi
nal a
ppro
val f
rom
oth
er re
leva
nt s
ecto
rs o
r oth
er re
leva
nt g
over
nmen
t age
ncie
s.
Dev
elop
min
imum
sta
ndar
ds fo
r ani
mal
(dom
estic
and
wild
life)
, env
ironm
enta
l and
hum
an h
ealth
sta
ffing
leve
ls.
D
ocum
ent a
sep
arat
e w
orkf
orce
str
ateg
y fo
r hum
an re
sour
ces
for t
he a
nim
al a
nd e
nviro
nmen
tal h
ealth
sec
tors
, if n
ot
alre
ady
incl
uded
as
part
of t
he p
ublic
hea
lth w
orkf
orce
str
ateg
y.
Crea
te a
ppro
pria
te jo
b cl
assifi
catio
n an
d jo
b de
scrip
tion
for h
ealth
wor
kers
at a
ll lev
els
of th
e re
levan
t min
istrie
s, an
d cl
ear c
aree
r lad
der.
Es
tabl
ish
a na
tiona
l cas
e fo
r inv
estm
ent i
n hu
man
reso
urce
s fo
r hea
lth a
s a
vita
l com
pone
nt o
f the
Sus
tain
able
Dev
elop
men
t G
oals
, Uni
vers
al H
ealth
Cov
erag
e an
d un
iver
sal a
cces
s to
hea
lthca
re (G
loba
l Stra
tegy
on
HRH
203
0 O
bj3.
59).
Co
nduc
t adv
ocac
y to
impl
emen
t the
stra
tegy
to re
leva
nt s
take
hold
ers,
incl
udin
g m
inis
tries
of h
ealth
, fina
nce,
pla
nnin
g an
d ad
min
istra
tion/
civi
l ser
vice
.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
onito
r and
eva
luat
e th
e im
plem
enta
tion
of th
e m
ultis
ecto
ral w
orkf
orce
str
ateg
y to
trac
k pr
ogre
ss a
nd b
arrie
rs.
D
ocum
ent h
ow th
e na
tiona
l pub
lic h
ealth
wor
kfor
ce is
fina
nced
with
in th
e co
untr
y (G
loba
l Str
ateg
y on
HRH
203
0 O
bj2.
38).
D
evel
op a
str
ateg
ic fr
amew
ork
to n
atio
nally
prio
ritiz
e re
sour
ces
and
inve
stm
ents
in O
ne H
ealth
wor
kfor
ce d
evel
opm
ent.
M
ap a
nd a
lign
inve
stm
ent i
n hu
man
reso
urce
s fo
r hea
lth w
ith th
e cu
rren
t and
futu
re n
eeds
of t
he p
opul
atio
n an
d he
alth
sy
stem
s to
add
ress
sho
rtag
es a
nd e
nhan
ce d
istr
ibut
ion
of h
ealth
wor
kers
, to
enab
le m
axim
um im
prov
emen
ts in
hea
lth
outc
omes
, soc
ial w
elfa
re, e
mpl
oym
ent c
reat
ion
and
econ
omic
gro
wth
(Glo
bal S
trat
egy
on H
RH 2
030
Obj
2).
D
ocum
ent a
nd d
isse
min
ate
annu
al re
port
s of
the
mul
tisec
tora
l wor
kfor
ce s
trat
egic
pla
n w
hich
is c
ompl
eted
and
has
bee
n im
plem
ente
d co
nsis
tent
ly.
WHO BENCHMARKS FOR IHR CAPACITIES
79
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ad
opt,
revi
ew a
nd re
vise
str
ateg
y re
gula
rly, r
egar
ding
sus
tain
abili
ty o
f wor
kfor
ce, s
taffi
ng a
nd in
cent
ive
mod
els,
sta
ff re
crui
tmen
t, de
velo
pmen
t/tr
aini
ng a
nd re
tent
ion
mec
hani
sms,
pla
nnin
g an
d m
onito
ring
of h
uman
reso
urce
s, a
nd
impl
emen
tatio
n of
a c
aree
r lad
der.
Es
tabl
ish
natio
nal h
ealth
wor
kfor
ce re
gist
ries
of c
ompe
tent
and
pra
ctic
ing
staf
f, an
d co
llect
key
per
form
ance
indi
cato
rs o
n he
alth
wor
ker s
tock
, dis
trib
utio
n, fl
ow, d
eman
d, s
uppl
y ca
paci
ty a
nd re
mun
erat
ion,
in b
oth
the
publ
ic a
nd p
rivat
e se
ctor
s,
disa
ggre
gate
d by
age
, sex
, eth
nic
or li
ngui
stic
gro
up, a
nd p
lace
of e
mpl
oym
ent (
Glo
bal S
trat
egy
on H
RH 2
030
Obj
4.75
).
Inco
rpor
ate
with
in th
e w
orkf
orce
str
ateg
y ap
prop
riate
ince
ntiv
e pa
ckag
es a
nd s
trat
egie
s to
attr
act,
trai
n an
d re
tain
exp
erts
fo
r any
wor
kfor
ce s
peci
altie
s (m
ay in
clud
e ph
ysic
ians
, nur
ses,
vet
erin
aria
ns, b
iost
atis
ticia
ns la
bora
tory
ass
ista
nts
and
spec
ialis
ts, o
r ani
mal
hea
lth p
rofe
ssio
nals
) to
mee
t nat
iona
l and
sub
natio
nal n
eeds
thro
ugh
dom
estic
ally
trai
ned
heal
th
wor
kers
(Glo
bal S
trat
egy
on H
RH 2
030
Obj
1.25
).
Esta
blis
h a
natio
nal (
and
subn
atio
nal w
here
rele
vant
) con
tinui
ng p
rofe
ssio
nal e
duca
tion
prog
ram
me
for p
rofe
ssio
nals
(G
loba
l Str
ateg
y on
HRH
203
0 O
bj1.
24).
WHO BENCHMARKS FOR IHR CAPACITIES
80
CAPA
CITY
LEVE
L
Benc
hmar
k 10
.2: H
uman
reso
urce
s ar
e av
aila
ble
to e
ffec
tivel
y im
plem
ent I
HR
Obj
ectiv
e: T
o de
velo
p a
publ
ic h
ealth
wor
kfor
ce th
at is
ava
ilabl
e an
d tr
aine
d to
pre
vent
, det
ect,
asse
ss, n
otify
, rep
ort a
nd
resp
ond
to p
ublic
hea
lth ri
sks
and
acut
e ev
ents
of d
omes
tic a
nd in
tern
atio
nal c
once
rn a
nd h
ealth
ser
vice
pro
visi
on (i
.e.
epid
emic
pre
pare
dnes
s an
d co
ntro
l) at
all
leve
ls o
f hea
lth s
yste
ms
to e
ffec
tivel
y im
plem
ent I
HR
01N
O C
APAC
ITY
Coun
try
does
not
hav
e ap
prop
riate
hum
an re
sour
ces
capa
city
in re
leva
nt s
ecto
rs re
quire
d fo
r epi
dem
ic p
repa
redn
ess
and
cont
rol.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y a
resp
onsi
ble
unit
and
advi
sory
com
mitt
ee fo
r the
dev
elop
men
t of h
uman
reso
urce
cap
acity
to m
eet I
HR
capa
city
ne
eds.
Co
nduc
t eng
agem
ent m
eetin
gs w
ith th
e hu
man
, ani
mal
and
env
ironm
enta
l hea
lth s
ecto
r wor
kfor
ce a
nd o
ther
sta
keho
lder
s to
exp
and
the
mul
tisec
tora
l pub
lic h
ealth
wor
kfor
ce s
trat
egy
to in
clud
e IH
R ca
paci
ty n
eeds
, suc
h as
pub
lic h
ealth
trai
ning
pr
ogra
mm
es, h
uman
reso
urce
infr
astr
uctu
re, e
xist
ing
and
requ
ired
prof
essi
onal
sta
ffing
leve
ls, a
dmin
istr
ativ
e su
ppor
t and
fu
ndin
g re
quire
men
ts.
Id
entif
y th
e ne
eds
as w
ell a
s cu
rren
t ava
ilabi
lity
and
dist
ribut
ion
of h
uman
reso
urce
s fo
r hea
lth c
apac
ities
: (G
loba
l Str
ateg
y on
HRH
203
0 O
bj1.
28, O
bj4.
75)
Su
rvei
llanc
e of
ficer
s (in
clud
ing
field
epi
dem
iolo
gy s
hort
-cou
rse
trai
ned
and
long
er c
ours
e tr
aine
d) a
nd b
iost
atis
ticia
ns ;
Cl
inic
ians
and
clin
ical
ass
ista
nts
;
Nur
ses
;
Labo
rato
ry s
peci
alis
ts a
nd te
chni
cian
s ;
Ve
terin
aria
ns, v
eter
inar
y te
chni
cian
s an
d pa
ra-v
eter
inar
ians
;
Info
rmat
ion
spec
ialis
ts a
nd a
ssis
tant
s ;
So
cial
sci
entis
ts ;
O
ther
rele
vant
pub
lic h
ealth
per
sonn
el.
Es
tabl
ish
or s
treng
then
nat
iona
l rap
id re
spon
se te
ams
so th
at it
is m
ultid
isci
plin
ary
and
mul
tilev
el.
WHO BENCHMARKS FOR IHR CAPACITIES
81
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
hum
an re
sour
ces
for h
ealth
uni
t in
the
hum
an a
nd a
nim
al h
ealth
sec
tors
that
can
mon
itor p
olic
ies
and
plan
s to
in
crea
se th
e m
ultis
ecto
r ani
mal
and
hum
an h
ealth
wor
kfor
ce, a
nd to
pro
mot
e th
e re
crui
tmen
t and
rete
ntio
n of
qua
lified
m
ultid
isci
plin
ary
staf
f.
Dev
elop
a d
atab
ase
of in
-cou
ntry
mul
tidis
cipl
inar
y su
bjec
t mat
ter e
xper
ts re
leva
nt to
IHR.
M
ap re
leva
nt p
ublic
hea
lth m
ultid
isci
plin
ary
wor
kfor
ce a
nd re
view
cur
ricul
um, w
ith u
nive
rsiti
es a
nd p
artn
ers,
for a
ll IH
R hu
man
reso
urce
requ
irem
ents
(suc
h as
for t
he fi
eld
epid
emio
logy
trai
ning
pro
gram
me
curr
icul
um, t
rain
ing
mat
eria
ls,
men
tors
, eva
luat
ion
proc
edur
es, a
ccre
dita
tion)
.
Dev
elop
con
tinui
ng p
rofe
ssio
nal e
duca
tion
prog
ram
mes
, in
prio
rity
One
Hea
lth d
isci
plin
es, a
t the
nat
iona
l and
sub
natio
nal
leve
ls w
ithin
the
stra
tegi
c fr
amew
ork
that
als
o tr
acks
wor
kfor
ce re
tent
ion
and
perf
orm
ance
.
Esta
blis
h te
rms
of re
fere
nce
and
job
desc
riptio
ns fo
r int
erm
edia
te le
vel (
prov
inci
al, d
istr
ict)
rapi
d re
spon
se te
ams
and
publ
ic
heal
th o
ffice
r in-
char
ge o
f out
brea
k pr
epar
edne
ss a
nd re
spon
se.
Tr
ain
or re
crui
t hum
an re
sour
ces
for t
he im
plem
enta
tion
of IH
R ca
paci
ties
for a
ll re
leva
nt s
ecto
rs a
t the
nat
iona
l lev
el.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ex
pand
the
mul
tisec
tora
l str
ateg
ic w
orkf
orce
pla
n na
tionw
ide
to th
e su
bnat
iona
l lev
el.
Im
plem
ent t
he m
ultis
ecto
ral s
trat
egic
wor
kfor
ce p
lan
cons
iste
ntly
at t
he n
atio
nal,
and
subn
atio
nal l
evel
s, w
ith re
gula
r re
view
s to
trac
k pr
ogre
ss a
nd b
arrie
rs, a
nd a
t lea
st a
nnua
l upd
ates
.
Mob
ilize
reso
urce
s to
ens
ure
each
loca
l lev
el h
as s
ome
capa
city
for e
pide
mio
logy
, cas
e m
anag
emen
t, la
bora
tory
ser
vice
s,
One
Hea
lth, a
nd o
ther
s as
nee
ded.
D
evel
op a
nd im
plem
ent S
OPs
on
how
pro
fess
iona
ls a
t the
nat
iona
l and
sub
natio
nal l
evel
s co
mm
unic
ate
durin
g an
in
fect
ious
dis
ease
out
brea
k.
Esta
blis
h a
data
base
of h
uman
reso
urce
s in
all
rele
vant
sec
tors
and
leve
ls o
f the
pub
lic h
ealth
sys
tem
that
can
pro
vide
m
ultid
isci
plin
ary
heal
th p
erso
nnel
dur
ing
publ
ic h
ealth
em
erge
ncie
s w
ith S
OPs
for u
pdat
ing
and
mai
ntai
ning
it.
WHO BENCHMARKS FOR IHR CAPACITIES
82
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
nat
iona
l pre
pare
dnes
s an
d re
spon
se p
lans
as
wel
l as
lega
l and
regu
lato
ry fr
amew
orks
and
est
ablis
h pr
otoc
ols,
SO
Ps, t
echn
ical
gui
delin
es a
nd to
olki
ts to
sen
d an
d re
ceiv
e m
ultid
isci
plin
ary
heal
th p
erso
nnel
dur
ing
publ
ic h
ealth
em
erge
ncie
s.
Revi
ew th
e im
plem
enta
tion
plan
of s
endi
ng a
nd re
ceiv
ing
mul
tidis
cipl
inar
y he
alth
per
sonn
el in
at l
east
one
eve
nt re
spon
se.
If th
ere
is n
o re
spon
se in
the
prev
ious
yea
r, th
en d
evel
op a
nd c
ondu
ct a
sim
ulat
ion
exer
cise
to te
st th
e ca
paci
ty.
Id
entif
y re
gion
al a
nd in
tern
atio
nal (
such
as
Glo
bal O
utbr
eak
Aler
t and
Res
pons
e N
etw
ork)
par
tner
s fo
r mul
tidis
cipl
inar
y he
alth
per
sonn
el a
nd e
stab
lish
part
ners
hips
or f
orm
al a
gree
men
ts w
ith th
em.
WHO BENCHMARKS FOR IHR CAPACITIES
83
CAPA
CITY
LEVE
L
Benc
hmar
k 10
.3: I
n-se
rvic
e tr
aini
ngs
are
avai
labl
e O
bjec
tive:
To
deve
lop
a fu
nctio
ning
and
acc
redi
ted
cont
inui
ng p
rofe
ssio
nal e
duca
tion
prog
ram
me
thro
ugh
in-s
ervi
ce
trai
ning
s at
nat
iona
l and
sub
natio
nal l
evel
s
01N
O C
APAC
ITY
No
cont
inui
ng p
rofe
ssio
nal e
duca
tion
prog
ram
me
thro
ugh
in-s
ervi
ce tr
aini
ng c
ours
e is
in p
lace
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d ad
dres
s tr
aini
ng n
eeds
for v
ario
us p
rofe
ssio
ns/c
adre
s.
Iden
tify
and
docu
men
t tra
inin
g pr
ogra
mm
es s
peci
fic to
pro
fess
ions
with
in e
ach
pres
ervi
ce tr
aini
ng c
urric
ula
and
join
t tr
aini
ng p
rogr
amm
es.
Pu
blis
h a
natio
nal l
ist o
f in-
serv
ice
trai
ning
ava
ilabl
e in
the
coun
try
incl
udin
g na
tiona
l tra
inin
g in
stitu
tes,
pro
fess
iona
l bod
ies,
sc
hool
s of
pub
lic h
ealth
, nur
sing
, mid
wife
ry, v
eter
inar
y m
edic
al c
olle
ges
and
univ
ersi
ties
that
pro
vide
in-s
ervi
ce tr
aini
ng
cour
ses.
Id
entif
y an
d do
cum
ent a
ll tr
aini
ngs
rela
ted
to c
ontin
genc
y pl
anni
ng, m
anag
emen
t of e
mer
genc
y si
tuat
ions
, ris
k co
mm
unic
atio
ns, a
nd jo
int e
xerc
ises
for m
ultid
isci
plin
ary
team
s.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
nd im
plem
ent a
con
tinui
ng p
rofe
ssio
nal e
duca
tion
prog
ram
me
that
incl
udes
out
brea
k pr
epar
edne
ss a
nd c
ontro
l, fo
r at l
east
one
gro
up o
f pro
fess
iona
ls, s
uch
as p
ublic
hea
lth o
ffice
rs, s
urve
illan
ce o
ffice
rs, n
urse
s, m
idw
ives
, gen
eral
m
edic
al p
ract
ition
ers,
vet
erin
aria
ns, p
ara-
vete
rinar
ians
.
Dev
elop
and
impl
emen
t at l
east
at t
he n
atio
nal l
evel
sho
rt in
-ser
vice
trai
ning
s on
sur
veill
ance
, out
brea
k pr
epar
edne
ss a
nd
resp
onse
for s
peci
fic c
adre
s.
WHO BENCHMARKS FOR IHR CAPACITIES
84
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent a
t nat
iona
l and
sub
natio
nal l
evel
s sh
ort-
/long
-ter
m in
-ser
vice
trai
ning
pro
gram
mes
to h
elp
expa
nd th
e nu
mbe
r of
qua
lified
pub
lic h
ealth
pro
fess
iona
ls w
ithin
the
coun
try,
i.e.
Ph
ysic
ians
(pub
lic h
ealth
and
/or c
linic
al c
are)
;
Nur
ses
(pub
lic h
ealth
and
/or c
linic
al c
are)
;
Vete
rinar
ians
(pub
lic h
ealth
, agr
icul
tura
l and
/or p
rivat
e pr
actic
e) a
nd p
ara-
vete
rinar
ians
;
Bios
tatis
ticia
ns ;
O
ther
pub
lic h
ealth
offi
cers
/sur
veill
ance
offi
cers
;
Labo
rato
ry a
ssis
tant
s an
d sp
ecia
lists
;
Live
stoc
k pr
ofes
sion
als.
Im
plem
ent a
t nat
iona
l and
sub
natio
nal l
evel
s sh
ort i
n-se
rvic
e tr
aini
ngs
on s
urve
illan
ce, o
utbr
eak
prep
ared
ness
, res
pons
e,
inci
dent
com
man
d sy
stem
and
risk
com
mun
icat
ion
for s
peci
fic c
adre
s.
Recr
uit s
peci
alis
ts a
s pa
rt o
f IH
R im
plem
enta
tion
at th
e ne
xt re
crui
tmen
t to
stre
ngth
en h
uman
reso
urce
s.
Expl
ore
and
impl
emen
t mea
sure
s to
org
aniz
e an
d fin
ance
spe
cial
izat
ion
and
cont
inuo
us p
rofe
ssio
nal e
duca
tion
in p
ublic
he
alth
, inc
ludi
ng e
pide
mio
logy
, lab
orat
ory,
anim
al a
nd e
nviro
nmen
tal h
ealth
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
ocum
ent t
he re
view
of i
mpl
emen
tatio
n of
sho
rt-/
long
-ter
m in
-ser
vice
trai
ning
pro
gram
mes
.
Gua
rant
ee tr
aine
d st
aff a
nd re
sour
ces
for a
ll IH
R re
leva
nt e
mer
genc
ies/
haza
rds.
Co
ntin
ue a
nd e
xpan
d in
-ser
vice
trai
ning
and
rete
ntio
n pr
ogra
mm
es fo
r spe
cial
ized
hea
lth p
erso
nnel
invo
lved
in IH
R im
plem
enta
tion
in d
ifficu
lt to
acc
ess
area
s.
Mon
itor t
he m
edia
n nu
mbe
r of y
ears
that
pub
lic h
ealth
per
sonn
el h
ave
been
on
staf
f rol
ls w
ithin
the
min
istr
y an
d/or
nat
iona
l in
stitu
tes
and
post
a li
st o
f cur
rent
sta
ff (if
ava
ilabl
e), s
taff
turn
over
and
num
ber o
f sta
ff at
tend
ing
in-s
ervi
ce tr
aini
ng.
Ex
pand
cur
rent
pub
lic h
ealth
and
fiel
d ep
idem
iolo
gy tr
aini
ng p
rogr
amm
es to
incl
ude:
refre
sher
cou
rses
; an
indu
ctio
n pr
ogra
mm
e fo
r fiel
d ep
idem
iolo
gist
s; re
gula
r in-
serv
ice
prog
ram
mes
and
con
tinuo
us p
rofe
ssio
nal d
evel
opm
ent
prog
ram
mes
for a
nim
al h
ealth
sta
ff; a
nd a
sus
tain
able
met
hodo
logy
and
pro
cess
to p
rovi
de c
ontin
uous
and
regu
lar
educ
atio
n fo
r fiel
d ep
idem
iolo
gy s
taff
from
bot
h hu
man
and
ani
mal
hea
lth s
ecto
rs.
WHO BENCHMARKS FOR IHR CAPACITIES
85
CAPA
CITY
LEVE
L
Benc
hmar
k 10
.4: F
ield
epi
dem
iolo
gy tr
aini
ng p
rogr
amm
e or
oth
er a
pplie
d ep
idem
iolo
gy tr
aini
ng p
rogr
amm
e is
in p
lace
O
bjec
tive:
To
esta
blis
h a
sust
aina
ble
field
epi
dem
iolo
gy tr
aini
ng p
rogr
amm
e or
oth
er a
pplie
d ep
idem
iolo
gy tr
aini
ng
prog
ram
me
01N
O C
APAC
ITY
No
field
epi
dem
iolo
gy tr
aini
ng p
rogr
amm
e or
app
lied
epid
emio
logy
trai
ning
pro
gram
me
is e
stab
lishe
d.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t eng
agem
ent m
eetin
g w
ith th
e he
alth
min
istr
y, ag
ricul
ture
min
istr
y an
d ot
her r
elev
ant s
take
hold
ers
to d
eter
min
e re
adin
ess
for a
fiel
d or
app
lied
epid
emio
logy
pro
gram
me
and
pote
ntia
l car
eer p
aths
for i
ts g
radu
ates
.
Doc
umen
t the
nee
d fo
r app
lied
epid
emio
logy
com
pete
ncie
s by
revi
ewin
g th
e ed
ucat
iona
l sys
tem
, pub
lic h
ealth
trai
ning
pr
ogra
mm
es, w
orkf
orce
gap
s an
d st
akeh
olde
r int
eres
ts.
Re
view
and
doc
umen
t cur
rent
fiel
d ep
idem
iolo
gy c
apac
ity in
the
coun
try.
Ev
alua
te e
xist
ing
field
or a
pplie
d ep
idem
iolo
gy p
rogr
amm
es in
the
regi
onal
con
text
and
iden
tify
the
host
cou
ntry
whe
re
natio
nal p
ublic
hea
lth p
rofe
ssio
nals
can
be
sent
for t
rain
ing.
Se
cure
an
agre
emen
t with
ano
ther
cou
ntry
to h
ost p
artic
ipan
ts a
nd e
stab
lish
fund
ing
mec
hani
sms
to s
uppo
rt th
e tr
aini
ng.
Co
nduc
t rec
ruitm
ent a
nd s
elec
tion
of p
artic
ipan
ts fo
r fiel
d or
app
lied
epid
emio
logy
trai
ning
in h
ost c
ount
ry.
Tr
ack
the
trai
ning
and
rost
erin
g of
fiel
d or
app
lied
epid
emio
logy
par
ticip
ants
and
gra
duat
es in
hos
t cou
ntry
.
Ensu
re a
vaila
bilit
y of
at l
east
one
trai
ned
epid
emio
logi
st p
er tw
o m
illio
n po
pula
tion.
WHO BENCHMARKS FOR IHR CAPACITIES
86
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nven
e a
field
or a
pplie
d ep
idem
iolo
gy te
chni
cal w
orki
ng g
roup
and
est
ablis
h go
als
for p
rogr
amm
e st
affin
g (b
oth
tech
nica
l an
d ad
min
istr
ativ
e), w
ith ro
les
and
resp
onsi
bilit
ies
incl
udin
g le
ader
ship
role
s an
d m
ento
rshi
p of
trai
nees
.
Dev
elop
a s
trat
egic
pla
n fo
r dev
elop
men
t of fi
eld
or a
pplie
d ep
idem
iolo
gy p
rogr
am th
at in
clud
es a
n ad
viso
ry g
roup
and
go
vern
ance
str
uctu
re w
ith s
take
hold
ers,
that
allo
ws
the
deve
lopm
ent o
f goa
ls a
nd o
bjec
tives
of n
atio
nal (
or p
artic
ipat
ion
in
regi
onal
) app
lied
epid
emio
logi
sts.
Es
tabl
ish
an a
dvis
ory
com
mitt
ee to
mai
ntai
n br
oad-
base
d su
ppor
t fro
m s
take
hold
ers
and
part
ners
.
Secu
re a
n ac
cept
able
loca
tion
for fi
eld
or a
pplie
d ep
idem
iolo
gy m
anag
emen
t.
Iden
tify
a su
stai
nabl
e fu
ndin
g m
echa
nism
for fi
eld
or a
pplie
d ep
idem
iolo
gy; c
onsi
der b
asic
leve
l fiel
d or
app
lied
epid
emio
logy
with
a p
lan
for e
xpan
sion
into
inte
rmed
iate
and
adv
ance
d le
vels
of fi
eld
or a
pplie
d ep
idem
iolo
gy, a
s de
term
ined
by
coun
try
need
s.
Dev
elop
cou
rse
curr
icul
um, m
aint
ain
scie
ntifi
c ex
celle
nce
in tr
aini
ng, m
onito
ring
and
eval
uatin
g tr
aine
es, a
nd c
onsu
lt on
ep
idem
iolo
gica
l met
hods
.
Des
igna
te fi
eld
supe
rvis
ors
and
men
tors
for fi
eld
or a
pplie
d ep
idem
iolo
gy a
nd p
repa
re g
uide
lines
for m
ento
rshi
p de
sign
ated
to
mon
itor t
rain
ee a
ctiv
ity, d
evel
opm
ent o
f pro
ject
s, b
arrie
rs to
trai
ning
, am
ong
othe
rs.
D
evel
op tr
aini
ng a
nd S
OPs
for m
ento
rs a
nd s
uper
viso
rs.
D
isse
min
ate
field
or a
pplie
d ep
idem
iolo
gy tr
aini
ng m
ater
ials
, pro
toco
ls, S
OPs
and
tool
kits
.
Esta
blis
h ac
cred
itatio
n m
echa
nism
s fo
r hea
lth tr
aini
ng in
stitu
tes.
Co
nduc
t rec
ruitm
ent a
nd s
elec
tion
of c
andi
date
s fo
r tra
inin
g in
clud
ing
cons
ider
atio
n fo
r par
ticip
atio
n of
vet
erin
aria
ns in
the
epid
emio
logy
trai
ning
pro
gram
me.
Tr
ack
field
or a
pplie
d ep
idem
iolo
gy c
apac
ity in
the
coun
try
incl
udin
g gr
adua
tes
and
posi
tions
afte
r tra
inin
g.
Esta
blis
h a
part
ners
hip
with
oth
er c
ount
ries
in th
e re
gion
to s
hare
epi
dem
iolo
gy tr
aini
ng p
rogr
amm
e gr
adua
tes
durin
g em
erge
ncy
even
ts.
En
sure
ava
ilabi
lity
of a
t lea
st o
ne tr
aine
d ep
idem
iolo
gist
per
one
mill
ion
popu
latio
n.
WHO BENCHMARKS FOR IHR CAPACITIES
87
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent t
wo
leve
ls o
f fiel
d or
app
lied
epid
emio
logy
incl
udin
g th
e ba
sic,
inte
rmed
iate
and
/or a
dvan
ced
leve
l at d
esig
nate
d si
tes
that
com
pris
e tr
aine
es fr
om h
uman
and
ani
mal
hea
lth p
rofe
ssio
nals
.
Inte
grat
e a
trai
ned
epid
emio
logi
st in
to c
ore
publ
ic h
ealth
com
pete
ncie
s (fr
ontli
ne s
urve
illan
ce, e
pide
mio
logy
, bio
stat
istic
s,
labo
rato
ry a
nd b
iosa
fety
, vet
erin
ary,
com
mun
icat
ion)
.
Map
fiel
d or
app
lied
epid
emio
logy
cap
acity
at i
nter
med
iate
leve
l/dis
tric
t (or
oth
er s
imila
r adm
inis
trat
ive
divi
sion
) and
trac
k to
info
rm u
pdat
es to
the
natio
nal p
ublic
hea
lth w
orkf
orce
str
ateg
y.
Ensu
re a
vaila
bilit
y of
at l
east
one
trai
ned
epid
emio
logi
st p
er 5
00 0
00 p
opul
atio
n.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
onito
r and
eva
luat
e th
e pe
rfor
man
ce o
f the
epi
dem
iolo
gy w
orkf
orce
with
in h
ealth
care
sys
tem
s in
clud
ing
vete
rinar
y se
rvic
es.
Co
nduc
t eng
agem
ent m
eetin
gs w
ith th
e he
alth
min
istr
y, ag
ricul
ture
min
istr
y, pa
rtne
rs a
nd s
take
hold
ers
to s
treng
then
op
tions
for fi
eld
plac
emen
ts, a
nd to
sus
tain
fund
ing
for e
pide
mio
logy
trai
ning
pro
gram
me
man
agem
ent.
Im
plem
ent e
pide
mio
logy
trai
ning
trac
ks fo
r rel
evan
t car
eer t
rack
s.
Expa
nd e
pide
mio
logy
trai
ning
pro
gram
mes
into
thre
e le
vels
of t
rain
ing
prog
ram
mes
with
car
eer t
rack
s es
tabl
ishe
d fo
r gr
adua
tes
in a
dditi
onal
juris
dict
ions
.
Secu
re s
usta
inab
le fu
ndin
g fo
r epi
dem
iolo
gy tr
aini
ng p
rogr
amm
es a
nd c
aree
r tra
cks
and
purs
ue a
ccre
dita
tion.
En
sure
ava
ilabi
lity
of a
t lea
st o
ne tr
aine
d ep
idem
iolo
gist
per
200
000
pop
ulat
ion.
Es
tabl
ish
alum
ni a
ssoc
iatio
n fo
r epi
dem
iolo
gy g
radu
ates
(all
leve
ls).
TOO
LS:
W
HO
glo
bal s
trat
egy
on h
uman
reso
urce
s fo
r hea
lth: w
orkf
orce
203
0
TEPH
INET
Acc
redi
tatio
n of
FET
Ps a
nd re
sour
ces
for F
ETPs
U
S CD
C Fi
eld
Epid
emio
logy
Tra
inin
g Pr
ogra
m
WHO BENCHMARKS FOR IHR CAPACITIES
88
47 “E
mer
genc
y pr
epar
edne
ss” (
defin
ed a
s, th
e kn
owle
dge,
cap
aciti
es a
nd o
rgan
izat
iona
l sys
tem
s de
velo
ped
by g
over
nmen
ts, r
espo
nse
and
reco
very
org
aniz
atio
ns, a
nd c
omm
uniti
es a
nd
indi
vidu
als
to e
ffect
ivel
y an
ticip
ate,
resp
ond
to, a
nd re
cove
r fro
m th
e im
pact
s of
like
ly, i
mm
inen
t, em
ergi
ng o
r cur
rent
em
erge
ncie
s) is
a c
ombi
natio
n of
pla
nnin
g, a
lloca
tion
of re
sour
ces,
tr
aini
ng, e
xerc
isin
g, a
nd o
rgan
izin
g to
bui
ld, s
usta
in a
nd im
prov
e op
erat
iona
l cap
abili
ties
at n
atio
nal,
inte
rmed
iate
and
loca
l or p
rimar
y re
spon
se le
vels
bas
ed o
n st
rate
gic
risk
asse
ssm
ents
. M
ultis
ecto
ral a
ctor
s at
nat
iona
l and
sub
natio
nal (
loca
l and
inte
rmed
iate
) lev
els
have
a c
omm
on u
nder
stan
ding
of t
he p
riorit
y ris
ks a
nd a
re re
ady
for t
imel
y, ef
fect
ive
and
effic
ient
em
erge
ncy
resp
onse
ope
ratio
ns fo
r out
brea
ks a
nd o
ther
em
erge
ncie
s. R
isk
base
d pl
ans
for e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se, r
obus
t em
erge
ncy
man
agem
ent s
truc
ture
s an
d m
obili
zatio
n of
re
sour
ces
durin
g an
em
erge
ncy
are
criti
cal f
or a
tim
ely
resp
onse
to p
ublic
hea
lth e
mer
genc
ies.
EMER
GEN
CY P
REPA
REDN
ESS
11
IMPA
CT:
Mul
tisec
tora
l act
ors
at n
atio
nal a
nd s
ubna
tiona
l (lo
cal a
nd in
term
edia
te) l
evel
s ha
ve a
com
mon
und
erst
andi
ng o
f the
prio
rity
risks
and
are
read
y fo
r tim
ely,
effe
ctiv
e an
d ef
ficie
nt e
mer
genc
y re
spon
se o
pera
tions
for o
utbr
eaks
and
oth
er e
mer
genc
ies.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Exi
sten
ce o
f nat
iona
l str
ateg
ic m
ultih
azar
d em
erge
ncy
risk
asse
ssm
ents
(ris
k pr
ofile
s) a
nd re
sour
ce m
appi
ng. (
2) E
xist
ence
of m
ultih
azar
d em
erge
ncy
resp
onse
pla
ns. (
3) E
vide
nce
from
exe
rcis
es a
s w
ell a
s af
ter-
actio
n an
d ot
her r
evie
ws
of e
ffect
ive
and
effic
ient
mul
tisec
tora
l em
erge
ncy
resp
onse
ope
ratio
ns fo
r out
brea
ks a
nd o
ther
pub
lic h
ealth
em
erge
ncie
s.
Stat
e Pa
rtie
s ar
e in
“em
erge
ncy
prep
ared
ness
” 47 (d
efine
d as
, the
kno
wle
dge,
cap
aciti
es a
nd o
rgan
izat
iona
l sys
tem
s de
velo
ped
by g
over
nmen
ts, r
espo
nse
and
reco
very
org
aniz
atio
ns, c
omm
uniti
es a
nd in
divi
dual
s to
effe
ctiv
ely
antic
ipat
e, re
spon
d to
and
reco
ver f
rom
the
impa
cts
of li
kely
, im
min
ent,
emer
ging
or
cur
rent
em
erge
ncie
s), w
hich
is a
com
bina
tion
of p
lann
ing,
allo
catio
n of
reso
urce
s, tr
aini
ng, e
xerc
isin
g an
d or
gani
zing
to b
uild
, sus
tain
and
impr
ove
oper
atio
nal c
apab
ilitie
s at
nat
iona
l, in
term
edia
te a
nd lo
cal o
r prim
ary
resp
onse
leve
ls b
ased
on
stra
tegi
c ris
k as
sess
men
ts. S
trat
egic
risk
ass
essm
ent
iden
tifies
, ana
lyse
s an
d ev
alua
tes
the
rang
e of
risk
s in
a c
ount
ry a
nd e
nabl
es th
e ris
ks to
be
assi
gned
a le
vel o
f prio
rity.
It in
clud
es a
naly
ses
of p
oten
tial
haza
rds
expo
sure
s an
d vu
lner
abili
ties,
iden
tifica
tion
and
map
ping
of a
vaila
ble
reso
urce
s, a
nd a
naly
ses
of c
apac
ities
(rou
tine
and
surg
e) a
t the
nat
iona
l, in
term
edia
te a
nd lo
cal o
r prim
ary
leve
ls to
man
age
the
risks
of o
utbr
eaks
and
oth
er e
mer
genc
ies.
Em
erge
ncy
prep
ared
ness
app
lies
to a
ny h
azar
d th
at m
ay
caus
e an
em
erge
ncy
and
incl
udes
bio
logi
cal,
chem
ical
, rad
iolo
gica
l and
nuc
lear
, nat
ural
, oth
er te
chno
logi
cal a
nd s
ocie
tal h
azar
ds.
WHO BENCHMARKS FOR IHR CAPACITIES
89
CAPA
CITY
LEVE
L
Benc
hmar
k 11
.1: S
trat
egic
em
erge
ncy
risk
asse
ssm
ents
con
duct
ed, a
nd e
mer
genc
y re
sour
ces
iden
tified
, map
ped
and
utili
zed
Obj
ectiv
e: T
o as
sess
and
ass
ign
prio
ritie
s to
risk
s ba
sed
on a
naly
ses
of h
azar
ds e
xpos
ures
and
vul
nera
bilit
ies
and
capa
citie
s, a
nd d
evel
op in
vent
orie
s an
d m
aps
of a
vaila
ble
reso
urce
s fo
r em
erge
ncy
prep
ared
ness
and
resp
onse
.
01N
O C
APAC
ITY
Coun
try
does
not
hav
e ca
paci
ty fo
r em
erge
ncy
risk
asse
ssm
ents
and
reso
urce
map
ping
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
exi
stin
g st
rate
gic
heal
th e
mer
genc
y ris
k as
sess
men
ts, i
nclu
ding
for e
pide
mic
s (i.
e. c
omm
unic
able
dis
ease
s,
zoon
oses
and
em
ergi
ng in
fect
ious
dis
ease
s), n
atur
al a
nd te
chno
logi
cal h
azar
ds a
nd o
ther
eve
nts
that
hav
e th
e po
tent
ial t
o ca
use
heal
th e
mer
genc
ies.
Id
entif
y po
tent
ial g
aps
or a
reas
in s
trat
egic
risk
ass
essm
ents
that
requ
ire u
pdat
ing.
D
evel
op a
mec
hani
sm to
ens
ure
part
icip
atio
n of
the
heal
th s
ecto
r and
oth
er s
take
hold
ers
in th
e ab
ove
proc
esse
s, in
clud
ing
in w
orks
hops
to re
view
and
agr
ee o
n ou
tput
s.
Co
nduc
t a c
ompr
ehen
sive
mul
tihaz
ard
heal
th e
mer
genc
y ris
k as
sess
men
t at t
he n
atio
nal l
evel
; inc
lude
ana
lysi
s of
ge
ogra
phic
are
as a
nd v
ulne
rabl
e su
bpop
ulat
ions
that
may
be
at h
ighe
r ris
k.
Cond
uct a
prio
ritiz
atio
n ex
erci
se to
ass
ign
prio
ritie
s to
thos
e ris
k sc
enar
ios
desc
ribed
in th
e st
rate
gic
heal
th e
mer
genc
y ris
k as
sess
men
ts, i
nclu
ding
thos
e th
at p
ose
the
grea
test
thre
ats
to p
ublic
hea
lth.
M
ap c
urre
nt n
atio
nal l
evel
reso
urce
s to
sup
port
the
emer
genc
y re
spon
se o
f the
hea
lth s
ecto
r at t
he n
atio
nal l
evel
, inc
ludi
ng
hum
an re
sour
ces,
fina
nces
, inf
rast
ruct
ure,
logi
stic
s an
d su
pplie
s (s
uch
as h
ealth
faci
litie
s, e
mer
genc
y op
erat
ion
cent
res,
tr
ansp
ort,
vehi
cles
, col
d ch
ain
capa
city
, tel
ecom
mun
icat
ions
, war
ehou
sing
, sup
ply
rout
es).
WHO BENCHMARKS FOR IHR CAPACITIES
90
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
mpl
ete
stra
tegi
c he
alth
em
erge
ncy
risk
asse
ssm
ents
incl
udin
g ha
zard
s, e
xpos
ures
, vul
nera
bilit
ies
and
capa
citie
s, a
nd
risk
prio
ritiz
atio
n ex
erci
ses
in a
ll re
leva
nt s
ecto
rs a
t the
nat
iona
l lev
el.
M
ap c
urre
nt re
sour
ces
to s
uppo
rt e
mer
genc
y re
spon
se in
all
rele
vant
sec
tors
at t
he n
atio
nal l
evel
.
Revi
ew lo
gist
ic a
nd w
areh
ouse
cap
acity
bas
ed o
n th
e na
tiona
l mul
tihaz
ard
resp
onse
pla
n an
d th
e as
sess
ed n
eed
for
stoc
kpili
ng a
nd p
repo
sitio
ning
of s
uppl
ies,
and
iden
tify
gaps
in c
apac
ity th
at re
quire
sup
port
.
Dev
elop
or r
evis
e th
e pl
an fo
r man
agem
ent a
nd d
istr
ibut
ion
of n
atio
nal s
tock
pile
s.
Impl
emen
t mea
sure
s fo
r the
man
agem
ent a
nd d
istr
ibut
ion
of s
tock
pile
s at
the
natio
nal l
evel
.
Dev
elop
a tr
aini
ng p
lan
for r
apid
logi
stic
s ne
eds
ases
smen
ts, a
nd p
lann
ing,
man
agem
ent a
nd d
istr
ibut
ion
of s
tock
pile
s fo
r pu
blic
hea
lth e
vent
s.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
mpl
ete
stra
tegi
c he
alth
em
erge
ncy
risk
asse
ssm
ents
incl
udin
g ha
zard
s, e
xpos
ures
, vul
nera
bilit
ies
and
capa
citie
s, a
nd
risk
prio
ritiz
atio
n ex
erci
ses
in a
ll se
ctor
s at
the
subn
atio
nal l
evel
.
Map
cur
rent
reso
urce
s to
sup
port
em
erge
ncy
resp
onse
in a
ll re
leva
nt s
ecto
rs a
t the
sub
natio
nal l
evel
and
iden
tify
gaps
in
capa
citie
s th
at re
quire
sup
port
.
Impl
emen
t mea
sure
s fo
r the
man
agem
ent a
nd d
istr
ibut
ion
of s
tock
pile
s at
the
subn
atio
nal l
evel
.
Impl
emen
t rap
id n
eeds
ass
essm
ents
, pla
nnin
g, m
anag
emen
t and
dis
trib
utio
n of
sto
ckpi
les
for p
ublic
hea
lth e
vent
s.
Com
plet
e tr
aini
ngs
to s
uppo
rt th
e m
anag
emen
t and
dis
trib
utio
n of
sto
ckpi
les
for p
ublic
hea
lth e
vent
s.
Revi
ew n
atio
nal l
evel
reso
urce
s (c
ritic
al s
tock
leve
ls fo
r prio
rity
risks
) on
an a
nnua
l bas
is o
r whe
n ne
eded
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
and
upd
ate
natio
nal a
nd s
ubna
tiona
l str
ateg
ic h
ealth
em
erge
ncy
risk
asse
ssm
ents
and
reso
urce
map
s re
gula
rly.
Se
cure
fund
ing
to c
ondu
ct ra
pid
need
s as
sess
men
ts in
em
erge
ncy
situ
atio
ns.
Te
st s
tock
pile
man
agem
ent r
egul
arly
and
upd
ate
plan
s an
d st
reng
then
cap
aciti
es a
ccor
ding
ly.
D
ocum
ent a
nd d
isse
min
ate
findi
ngs
on ri
sk a
sses
smen
t and
exp
erie
nce,
add
ress
ing
susp
ecte
d or
con
firm
ed h
ealth
thre
ats.
WHO BENCHMARKS FOR IHR CAPACITIES
91
CAPA
CITY
LEVE
L
Benc
hmar
k 11
.2: M
ultis
ecto
ral p
lann
ing
for h
ealth
em
erge
ncy
prep
ared
ness
and
resp
onse
is in
pla
ce
Obj
ectiv
e: D
evel
opm
ent a
nd im
plem
enta
tion
of m
ultis
ecto
ral a
nd m
ultih
azar
d em
erge
ncy
prep
ared
ness
mea
sure
s in
clud
ing
emer
genc
y re
spon
se p
lans
01N
O C
APAC
ITY
The
coun
try
has
to d
evel
op a
nd im
plem
ent a
ll ac
tiviti
es li
sted
in le
vel 2
to a
chie
ve th
e lim
ited
capa
city
for e
ach
func
tion.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
ap k
ey s
take
hold
ers
and
min
istr
ies
invo
lved
in m
ultih
azar
d em
erge
ncy
prep
ared
ness
and
resp
onse
incl
udin
g hu
man
, an
imal
(dom
estic
and
wild
life)
and
env
ironm
enta
l hea
lth s
ecto
rs, m
eteo
rolo
gy, b
orde
r con
trol,
food
and
dru
g ag
ency
, m
ilita
ry, p
rivat
e ag
ricul
tura
l sec
tor,
emer
genc
y se
rvic
es, d
efen
ce, t
rans
port
, med
ia a
nd fi
nanc
e.
Cond
uct c
apac
ity a
sses
smen
ts o
f eac
h st
akeh
olde
r to
supp
ort e
mer
genc
y pr
epar
edne
ss fo
r prio
rity
risks
at t
he n
atio
nal
leve
l, as
app
ropr
iate
.
Iden
tify
key
mea
sure
s fo
r all
sect
ors
to s
treng
then
em
erge
ncy
prep
ared
ness
for p
riorit
y ris
ks a
t the
nat
iona
l lev
el.
Re
view
cur
rent
hea
lth s
ecto
r mul
tihaz
ard
emer
genc
y re
spon
se p
lans
and
oth
er re
spon
se p
lans
for s
peci
fic h
azar
ds.
D
evel
op o
r upd
ate
the
natio
nal h
ealth
sec
tor m
ultih
azar
d em
erge
ncy
resp
onse
pla
n.
WHO BENCHMARKS FOR IHR CAPACITIES
92
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent e
mer
genc
y pr
epar
edne
ss m
easu
res
at th
e na
tiona
l lev
el b
y hu
man
hea
lth, a
nim
al h
ealth
and
oth
er re
leva
nt
sect
ions
, inc
ludi
ng fo
r poi
nts
of e
ntry
and
mas
s ga
ther
ing
even
ts.
D
evel
op o
r upd
ate
natio
nal m
ultis
ecto
ral m
ultih
azar
d em
erge
ncy
resp
onse
pla
ns.
Re
view
and
upd
ate
curr
ent m
ultis
ecto
ral m
ultih
azar
d em
erge
ncy
resp
onse
pla
ns a
nd o
ther
resp
onse
pla
ns fo
r spe
cific
ha
zard
s at
the
natio
nal l
evel
.
Cond
uct a
nat
iona
l lev
el s
imul
atio
n ex
erci
se to
test
the
mul
ti ha
zard
resp
onse
pla
n an
d ad
just
the
plan
bas
ed o
n th
e ou
tcom
es o
f the
sim
ulat
ion
or c
ompl
ete
an a
fter-
actio
n re
view
of a
n ac
tual
eve
nt.
As
sess
the
need
for a
dditi
onal
em
erge
ncy
prep
ared
ness
mea
sure
s, in
clud
ing
polic
ies,
pro
cedu
res,
SO
Ps a
nd fi
nanc
ial
mec
hani
sms,
requ
ired
to s
treng
then
em
erge
ncy
prep
ared
ness
.
Impl
emen
t the
mul
ti ha
zard
resp
onse
pla
n at
the
natio
nal l
evel
.
Dev
elop
and
impl
emen
t a tr
aini
ng p
lan
for s
treng
then
ing
emer
genc
y pr
epar
edne
ss m
easu
res
and
the
mul
ti ha
zard
resp
onse
pl
an a
t the
nat
iona
l lev
el.
Se
cure
cap
acity
requ
ired
for e
mer
genc
y pr
epar
edne
ss m
easu
res
for s
peci
fic h
azar
ds o
r ris
k sc
enar
ios,
incl
udin
g co
ntin
genc
y pl
anni
ng, a
dditi
onal
trai
ning
and
equ
ipm
ent.
D
evel
op m
echa
nism
s an
d SO
Ps fo
r im
plem
entin
g do
mes
tic a
nd in
tern
atio
nal s
urge
cap
acity
as
part
of t
he m
ultih
azar
d re
spon
se p
lan.
Es
tabl
ish
a pe
rfor
man
ce-m
onito
ring
fram
ewor
k in
clud
ing
indi
cato
rs, c
riter
ia a
nd ti
mel
ines
for e
mer
genc
y re
spon
se.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Im
plem
ent e
mer
genc
y pr
epar
edne
ss m
easu
res
at n
atio
nal,
subn
atio
nal a
nd lo
cal l
evel
s by
hum
an h
ealth
, ani
mal
hea
lth a
nd
othe
r rel
evan
t sec
tors
, inc
ludi
ng a
t poi
nts
of e
ntry
and
mas
s ga
ther
ing
even
ts.
D
evel
op o
r upd
ate
mul
tisec
tora
l mul
tihaz
ard
subn
atio
nal a
nd lo
cal m
ultih
azar
d re
spon
se p
lans
.
Cond
uct s
imul
atio
ns o
r afte
r-ac
tion
revi
ews
at n
atio
nal a
nd s
ubna
tiona
l lev
els
to te
st th
e m
ultih
azar
d re
spon
se p
lan
with
a
focu
s on
coo
rdin
atio
n an
d co
mm
unic
atio
n be
twee
n th
e na
tiona
l and
sub
natio
nal l
evel
s of
gov
ernm
ent a
nd s
ecto
rs; a
nd
adju
st p
lans
bas
ed o
n ou
tcom
es.
Im
plem
ent t
rain
ing
for e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se a
t sub
natio
nal l
evel
s.
Revi
ew a
nd d
evel
op e
mer
genc
y re
spon
se p
lans
for c
ross
-bor
der a
nd m
ultic
ount
ry e
vent
s w
ith re
gion
al c
ount
erpa
rts
and
inte
rnat
iona
l par
tner
s.
WHO BENCHMARKS FOR IHR CAPACITIES
93
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t reg
ular
sim
ulat
ion
exer
cise
s or
afte
r-ac
tion
revi
ews
to te
st m
ultih
azar
d em
erge
ncy
resp
onse
pla
ns a
t nat
iona
l and
su
bnat
iona
l lev
els
and
impl
emen
t mea
sure
s to
bui
ld c
apac
ities
bas
ed o
n ou
tcom
es a
nd re
com
men
datio
ns.
Co
nduc
t int
erna
tiona
l sim
ulat
ion
exer
cise
s to
test
mul
tihaz
ard
emer
genc
y re
spon
se p
lans
for m
ultip
le c
ount
ry e
vent
s.
Adju
st e
mer
genc
y re
spon
se p
lans
and
stre
ngth
en e
mer
genc
y pr
epar
edne
ss b
ased
on
outc
omes
and
reco
mm
enda
tions
.
Assi
gn d
edic
ated
hum
an re
sour
ces
and
allo
cate
regu
lar b
udge
t fun
ding
to s
uppo
rt c
oord
inat
ion
and
impl
emen
tatio
n of
em
erge
ncy
prep
ared
ness
mea
sure
s by
hum
an h
ealth
, ani
mal
hea
lth a
nd o
ther
rele
vant
sec
tors
.
Dev
elop
a m
echa
nism
to e
nsur
e th
at d
edic
ated
reso
urce
s ar
e in
pla
ce fo
r tes
ting
and
impl
emen
tatio
n of
mul
tisec
tora
l, m
ultih
azar
d em
erge
ncy
resp
onse
pla
ns, c
ontin
genc
y pl
ans
and
SOPs
at n
atio
nal a
nd s
ubna
tiona
l lev
els
incl
udin
g an
em
erge
ncy
finan
cing
mec
hani
sm fo
r em
erge
ncy
resp
onse
.
TOO
LS:
A
stra
tegi
c fr
amew
ork
for e
mer
genc
y pr
epar
edne
ss
Emer
genc
y an
d di
sast
er ri
sk m
anag
emen
t for
hea
lth
Emer
genc
ies
prep
ared
ness
and
resp
onse
– R
esou
rces
Pa
ndem
ic p
repa
redn
ess
- Re
sour
ces
WHO BENCHMARKS FOR IHR CAPACITIES
94
EMER
GEN
CY R
ESPO
NSE
OPE
RATI
ON
S
12
IMPA
CT:
Effe
ctiv
e co
ordi
natio
n an
d im
prov
ed m
anag
emen
t of t
he re
spon
se to
out
brea
ks a
nd e
mer
genc
ies
as e
vide
nced
by
shor
ter t
imes
from
ear
ly
war
ning
and
det
ectio
n to
act
ivat
ion
and
impl
emen
tatio
n of
a c
oord
inat
ed m
ultis
ecto
ral r
espo
nse
acro
ss a
ll lev
els
resu
lting
in fe
wer
cas
es, d
eath
s an
d ot
her h
ealth
and
soc
ieta
l im
pact
s.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Est
ablis
hmen
t of a
n em
erge
ncy
resp
onse
coo
rdin
atio
n m
echa
nism
or i
ncid
ent m
anag
emen
t sys
tem
. (2)
Dev
elop
men
t of n
atio
nal h
ealth
EO
C pl
ans
and
proc
edur
es. (
3) E
mer
genc
y re
spon
se s
yste
ms
and
deci
sion
-mak
ing
have
bee
n te
sted
and
are
ope
ratin
g ef
ficie
ntly
and
effe
ctiv
ely.
Coun
tries
will
: hav
e a
coor
dina
tion
mec
hani
sm, in
cide
nt m
anag
emen
t sys
tem
s, e
xerc
ise
man
agem
ent p
rogr
amm
es a
nd p
ublic
hea
lth e
mer
genc
y op
erat
ion
cent
res
(EO
Cs) f
unct
ioni
ng a
ccor
ding
to m
inim
um c
omm
on s
tand
ards
; and
mai
ntai
n tr
aine
d, fu
nctio
ning
, mul
tisec
tora
l rap
id re
spon
se te
ams
and
trai
ned
EOC
staf
f cap
able
of a
ctiv
atin
g a
coor
dina
ted
emer
genc
y re
spon
se w
ithin
120
min
utes
of t
he id
entifi
catio
n of
an
emer
genc
y.
WHO BENCHMARKS FOR IHR CAPACITIES
95
CAPA
CITY
LEVE
L
Benc
hmar
k 12
.1: F
unct
iona
l em
erge
ncy
resp
onse
coo
rdin
atio
n is
in p
lace
O
bjec
tive:
To
deve
lop
coor
dina
tion
mec
hani
sms
for e
mer
genc
y re
spon
se
01N
O C
APAC
ITY
An e
mer
genc
y re
spon
se c
oord
inat
ion
mec
hani
sm is
not
ava
ilabl
e.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a na
tiona
l hea
lth e
mer
genc
y co
ordi
natio
n de
part
men
t or u
nit t
hat m
aint
ains
regu
lar c
onta
ct w
ith e
xper
ts fr
om
hum
an, a
nim
al (d
omes
tic a
nd w
ildlif
e), a
nd e
nviro
nmen
tal h
ealth
as
wel
l as
othe
r sec
tors
.
Prov
ide
key
pote
ntia
l inf
orm
ants
and
resp
onse
par
tner
s fo
r hea
lth e
mer
genc
y op
erat
ions
that
can
hav
e 24
/7 c
over
age
in a
ll m
ajor
hea
lth s
yste
ms.
D
evel
op a
cap
acity
to e
nsur
e th
at th
e IH
R N
FP a
nd o
ther
resp
onsi
ble
part
ies
are
avai
labl
e 24
/7 to
rece
ive
info
rmat
ion
abou
t po
tent
ial h
ealth
thre
ats
and
to re
port
a p
ublic
hea
lth e
mer
genc
y of
inte
rnat
iona
l con
cern
as
outli
ned
in IH
R (2
005)
.
Dev
elop
and
impl
emen
t SO
Ps fo
r an
ad-h
oc e
mer
genc
y co
ordi
natio
n m
echa
nism
dur
ing
the
even
ts.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
an in
cide
nt m
anag
emen
t sys
tem
for m
anag
ing
emer
genc
y re
spon
se a
t the
nat
iona
l lev
el, i
nclu
ding
par
ticip
atio
n
of re
leva
nt s
ecto
rs.
D
evel
op a
pla
n an
d SO
Ps, in
clud
ing
thre
shol
ds a
nd le
vels
for a
ctiv
atin
g th
e em
erge
ncy
resp
onse
coo
rdin
atio
n m
echa
nism
.
Esta
blis
h an
d m
aint
ain
a ro
ster
of e
mer
genc
y op
erat
ions
sta
ff w
ith d
efine
d ro
les
and
func
tions
.
Dev
elop
a tr
aini
ng p
lan
for e
mer
genc
y re
spon
se s
taff,
incl
udin
g on
the
inci
dent
man
agem
ent s
yste
m, a
nd im
plem
ent i
t at
leas
t at t
he n
atio
nal l
evel
.
Fina
lize
SOPs
for c
oord
inat
ion
of k
ey h
ealth
sec
tor a
ctor
s (s
uch
as s
urve
illan
ce, h
ealth
faci
litie
s, e
mer
genc
y m
edic
al te
ams,
m
enta
l hea
lth d
epar
tmen
ts).
Id
entif
y, tr
ain
and
rost
er a
poo
l of s
urge
sta
ff fo
r em
erge
ncy
resp
onse
coo
rdin
atio
n.
WHO BENCHMARKS FOR IHR CAPACITIES
96
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a he
alth
sec
tor e
mer
genc
y re
spon
se c
oord
inat
ion
mec
hani
sm w
ith p
artic
ipat
ion
from
hea
lth a
nd o
ther
sec
tors
for
man
agin
g em
erge
ncy
resp
onse
at t
he s
ubna
tiona
l and
loca
l lev
els.
Tr
ain
subn
atio
nal a
nd lo
cal l
evel
hea
lth s
ecto
r sta
ff on
the
emer
genc
y re
spon
se c
oord
inat
ion
mec
hani
sm.
Co
nduc
t, at
leas
t eve
ry tw
o ye
ars,
an
emer
genc
y re
spon
se e
xerc
ise
or a
fter-
actio
n re
view
with
a fo
cus
on c
oord
inat
ion
betw
een
natio
nal a
nd s
ubna
tiona
l lev
els.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
and
sust
ain
rout
ine
and
emer
genc
y co
mm
unic
atio
ns b
etw
een
natio
nal,
subn
atio
nal a
nd in
tern
atio
nal c
oord
inat
ion
mec
hani
sms
thro
ugh
the
foca
l poi
nts
and
allo
cate
sus
tain
able
fund
ing
for t
hese
act
iviti
es.
Te
st c
oord
inat
ion
mec
hani
sms
at a
ll le
vels
ann
ually
and
doc
umen
t and
impl
emen
t act
iona
ble
impr
ovem
ents
.
Eval
uate
, doc
umen
t and
dis
sem
inat
e in
form
atio
n on
act
ivat
ions
, and
if d
one,
incl
ude
exer
cise
s to
pro
mot
e co
ntin
uous
im
prov
emen
t in
com
mun
icat
ion
and
coor
dina
tion.
WHO BENCHMARKS FOR IHR CAPACITIES
97
CAPA
CITY
LEVE
L
Benc
hmar
k 12
.2: E
mer
genc
y op
erat
ions
cen
tre
(EO
C) c
apac
ities
, pro
cedu
res
and
plan
s ar
e in
pla
ce
Obj
ectiv
e: D
evel
op e
mer
genc
y op
erat
ion
capa
citie
s
01N
O C
APAC
ITY
An E
OC
has
not b
een
iden
tified
and
no
EOC
plan
s/pr
oced
ures
are
in p
lace
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t a b
asel
ine
asse
ssm
ent o
f em
erge
ncy
oper
atio
ns c
apac
ity in
clud
ing
infra
stru
ctur
e, s
yste
ms,
wor
kfor
ce a
nd le
gisl
atio
n.
Dev
elop
a h
ealth
EO
C ac
tivat
ion
plan
that
incl
udes
sca
led
leve
l of r
espo
nse
with
hea
lth, c
omm
unic
atio
n an
d ot
her r
esou
rce
requ
irem
ents
at t
he n
atio
nal l
evel
.
Esta
blis
h a
func
tioni
ng h
ealth
EO
C w
ith th
e ca
paci
ty to
coo
rdin
ate
emer
genc
y op
erat
ions
in th
e ev
ent o
f an
emer
genc
y.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Fo
rm a
ste
erin
g co
mm
ittee
or o
ther
man
agem
ent s
truc
ture
to d
evel
op o
bjec
tives
, ess
entia
l fun
ctio
ns a
nd c
ore
com
pone
nts;
ov
erse
e th
e EO
C an
d m
onito
r and
eva
luat
e its
use
.
Dev
elop
an
EOC
impl
emen
tatio
n pl
an th
at in
clud
es b
oth
the
plan
ning
and
dev
elop
men
t of t
he E
OC
(as
outli
ned
in p
ublic
he
alth
em
erge
ncy
oper
atio
ns c
entre
net
wor
k fr
amew
ork)
and
the
cost
ing,
fund
ing
and
sust
aina
bilit
y of
the
EOC.
D
evel
op a
n EO
C ac
tivat
ion
plan
that
incl
udes
sca
led
leve
l of r
espo
nse
with
reso
urce
requ
irem
ents
at e
ach
leve
l.
Dev
elop
a m
echa
nism
to e
nsur
e th
at th
e na
tiona
l em
erge
ncy
resp
onse
pla
n la
ys o
ut th
e co
ncep
t of o
pera
tions
for t
he e
ntire
em
erge
ncy
resp
onse
sys
tem
.
Esta
blis
h a
func
tiona
l nat
iona
l EOC
that
incl
udes
ded
icat
ed p
lan
and
proc
edur
es, a
sec
ure
phys
ical
spa
ce, a
n in
form
atio
n an
d co
mm
unic
atio
n te
chno
logy
infra
stru
ctur
e fo
r inf
orm
atio
n m
anag
emen
t and
sup
port
of e
mer
genc
y op
erat
ions
, and
trai
ned
staf
f.
Deve
lop
and
impl
emen
t a tr
aini
ng p
rogr
amm
e fo
r nat
iona
l EOC
sta
ff in
clud
ing
man
agem
ent,
com
mun
icat
ions
, fina
nce
and
logi
stic
s.
Dev
elop
sta
ndar
dize
d fo
rms
and
tem
plat
es fo
r dat
a/in
form
atio
n m
anag
emen
t, re
port
ing,
brie
fing
and
reco
rd-k
eepi
ng.
D
evel
op a
dat
abas
e of
sub
ject
mat
ter e
xper
ts fo
r con
sulta
tion
on p
riorit
y ha
zard
s.
Iden
tify
criti
cal p
iece
s of
info
rmat
ion
to in
form
em
erge
ncy
resp
onse
, suc
h as
epi
dem
ic in
telli
genc
e, a
nd d
evel
op s
yste
ms
to
capt
ure
and
man
age
this
info
rmat
ion.
D
evel
op p
lans
to li
nk la
bora
tory
and
sur
veill
ance
info
rmat
ion
to th
e em
erge
ncy
resp
onse
com
mun
icat
ions
str
uctu
re.
WHO BENCHMARKS FOR IHR CAPACITIES
98
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t a s
imul
ated
exe
rcis
e or
dem
onst
rate
in re
spon
se to
a re
al e
vent
that
the
natio
nal E
OC
can
be a
ctiv
ated
with
in
120
min
utes
of r
ecei
ving
an
early
war
ning
or i
nfor
mat
ion
of a
n em
erge
ncy
requ
iring
EO
C ac
tivat
ion.
D
evel
op E
OCs
at t
he s
ubna
tiona
l lev
el (b
ased
on
the
risks
and
geo
grap
hica
l nee
d) w
ith p
lans
and
SO
Ps.
Tr
ain
EOC
staf
f of s
ubna
tiona
l lev
els
on S
OPs
and
allo
cate
ded
icat
ed re
sour
ces.
D
evel
op a
nd im
plem
ent a
trac
king
of d
ecis
ion-
mak
ing
proc
edur
e fo
r the
act
ivat
atio
n of
an
EOC.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
aint
ain
a ne
twor
k of
fully
func
tiona
l, fu
nded
EO
Cs a
nd tr
aine
d st
aff o
n a
24/7
bas
is.
Te
st o
r upd
ate
EOC
func
tions
regu
larly
at a
ll le
vels
incl
udin
g fo
r lar
ge s
cale
and
con
curr
ent e
mer
genc
ies.
Ac
tivat
e th
e na
tiona
l EO
C ne
twor
k w
ithin
120
min
utes
, whi
ch in
clud
es a
ctiv
atio
n of
nat
iona
l, su
bnat
iona
l or m
ultis
ecto
ral
EOCs
ann
ually
, usi
ng re
al o
r sim
ulat
ed e
vent
s.
Iden
tify
and
secu
re re
sour
ces
for i
mpl
emen
ting
the
EOC
and
rela
ted
activ
ities
.
WHO BENCHMARKS FOR IHR CAPACITIES
99
CAPA
CITY
LEVE
L
Benc
hmar
k 12
.3: E
mer
genc
y ex
erci
se m
anag
emen
t pro
gram
me
is in
pla
ce
Obj
ectiv
e: D
evel
op th
e em
erge
ncy
exer
cise
man
agem
ent p
rogr
amm
e
01N
O C
APAC
ITY
No
exer
cise
s ha
ve b
een
com
plet
ed in
the
past
five
yea
rs.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
em
erge
ncy
exer
cise
man
agem
ent c
oord
inat
or a
nd te
am in
the
heal
th s
ecto
r.
Cond
uct e
ither
a s
truct
ured
afte
r-ac
tion
revi
ew fr
om a
n ac
tual
act
ivat
ion
or d
esig
n an
d co
nduc
t a n
atio
nal-l
evel
mul
tisec
tora
l he
alth
em
erge
ncy
tabl
e-to
p ex
erci
se th
at in
clud
es m
ultip
le s
ecto
rs/s
take
hold
ers
that
test
s th
e em
erge
ncy
resp
onse
pla
n an
d cr
itica
l cor
e ca
paci
ties
base
d on
prio
rity
risks
/haz
ards
at l
east
eve
ry fi
ve y
ears
.
Doc
umen
t rec
omm
ende
d ac
tiona
ble
impr
ovem
ents
bas
ed o
n th
e af
ter-
actio
n re
view
or e
xerc
ise.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
esig
n an
d co
nduc
t a n
atio
nal l
evel
mul
tisec
tora
l hea
lth e
mer
genc
y fu
nctio
nal e
xerc
ise
that
incl
udes
mul
tiple
sec
tors
/st
akeh
olde
rs a
nd te
sts
criti
cal c
ore
capa
citie
s ba
sed
on th
e pr
iorit
y ris
ks/h
azar
ds a
t lea
st e
very
two
year
s.
D
ocum
ent r
ecom
men
ded
actio
nabl
e im
prov
emen
ts b
ased
on
the
exer
cise
OR
cond
uct a
fter-
actio
n re
view
of e
vent
s an
d sh
are
the
resu
lts o
f afte
r-ac
tion
revi
ews
with
sta
keho
lder
s at
the
natio
nal l
evel
.
Dev
elop
and
impl
emen
t a c
orre
ctiv
e ac
tion
plan
bas
ed o
n th
e ex
erci
ses
and
afte
r-ac
tion
revi
ew fi
ndin
gs.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
esig
n an
d co
nduc
t var
ious
exe
rcis
es to
test
em
erge
ncy
prep
ared
ness
and
resp
onse
cap
aciti
es a
t nat
iona
l and
sub
natio
nal
leve
ls b
ased
on
prio
rity
risks
/haz
ards
at l
east
eve
ry y
ear.
Co
nduc
t a c
oord
inat
ed e
xerc
ise
at le
ast a
nnua
lly w
ith re
leva
nt s
ecto
rs b
ased
on
prio
rity
risks
/haz
ards
.
Doc
umen
t rec
omm
ende
d ac
tiona
ble
impr
ovem
ents
bas
ed o
n th
e ex
erci
se a
nd m
aint
ain
a re
cord
of r
ecom
men
datio
ns a
nd
the
stat
us o
f the
ir im
plem
enta
tion.
Co
nduc
t afte
r-ac
tion
revie
ws
of e
vent
s an
d sh
are
resu
lts o
f afte
r-ac
tion
revie
ws
with
sta
keho
lder
s at
sub
natio
nal a
nd n
atio
nal le
vels
.
Dev
elop
and
impl
emen
t the
cor
rect
ive
actio
n pl
an b
ased
on
the
exer
cise
s an
d af
ter-
actio
n re
view
find
ings
at n
atio
nal a
nd
subn
atio
nal l
evel
s.
WHO BENCHMARKS FOR IHR CAPACITIES
100
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t var
ied
exer
cise
s (o
r in
com
bina
tion)
to te
st e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se c
apac
ities
at n
atio
nal a
nd
subn
atio
nal l
evel
s ev
ery
year
.
Trac
k im
prov
emen
ts id
entifi
ed in
exe
rcis
es a
nd in
corp
orat
e in
to n
atio
nal e
mer
genc
y re
spon
se p
lans
and
pla
ns fo
r st
reng
then
ing
emer
genc
y pr
epar
edne
ss a
nd c
ore
capa
citie
s.
Cond
uct a
fter-
actio
n re
view
s of
any
eve
nts,
and
regu
larly
and
rout
inel
y sh
are
resu
lts o
f the
se re
view
s w
ith s
take
hold
ers
at
all l
evel
s.
Dev
elop
and
impl
emen
t cor
rect
ive
actio
n pl
ans
base
d on
the
exer
cise
s an
d af
ter-
actio
n re
view
find
ings
at a
ll le
vels
.
TOO
LS:
Fr
amew
ork
for a
pub
lic h
ealth
em
erge
ncy
oper
atio
ns c
entre
: thi
s do
cum
ent f
rom
WH
O o
utlin
es th
e ke
y co
ncep
ts a
nd e
ssen
tial r
equi
rem
ents
for
deve
lopi
ng a
nd m
anag
ing
a PH
EOC.
It p
rovi
des
an o
utlin
e fo
r dev
elop
ing
and
man
agin
g a
PHEO
C to
ach
ieve
a g
oal.
Su
stai
nabl
e m
odel
for p
ublic
hea
lth e
mer
genc
y op
erat
ions
cen
tres
for g
loba
l set
tings
: art
icle
from
US
CDC
on P
HEO
Cs w
ith c
ase
stud
ies
from
Vi
etna
m a
nd C
amer
oon
W
HO
Inci
dent
Man
agem
ent S
yste
m: a
trai
ning
cou
rse
from
WH
O th
at is
des
igne
d to
hel
p us
ers
gain
a fo
unda
tiona
l und
erst
andi
ng o
f the
Inci
dent
m
anag
emen
t sys
tem
str
uctu
re a
nd it
s pr
oced
ures
at W
HO.
N
atio
nal I
ncid
ent M
anag
emen
t Sys
tem
: fro
m th
e U
S Fe
dera
l Em
erge
ncy
Man
agem
ent A
genc
y is
a s
erie
s of
free
inte
ract
ive
onlin
e co
urse
s on
in
cide
nt m
anag
emen
t.
Publ
ic H
ealth
Inci
dent
Lea
ders
hip
Trai
ning
: fro
m th
e U
nive
rsity
of M
inne
sota
is a
trai
ning
for p
ublic
hea
lth p
ract
ition
ers
with
lead
ersh
ip
resp
onsi
bilit
ies
durin
g re
spon
ses
to d
isas
ters
and
eve
nts
with
pub
lic h
ealth
impl
icat
ions
.
WHO BENCHMARKS FOR IHR CAPACITIES
101
LIN
KIN
G PU
BLIC
HEA
LTH
AN
D SE
CURI
TY A
UTH
ORI
TIES
13
IMPA
CT:
Dev
elop
men
t and
impl
emen
tatio
n of
a m
emor
andu
m o
f und
erst
andi
ng o
r oth
er s
imila
r fra
mew
ork
outli
ning
role
s, re
spon
sibi
litie
s an
d be
st
prac
tices
for s
harin
g re
leva
nt in
form
atio
n am
ong
appr
opria
te h
uman
and
ani
mal
hea
lth, la
w e
nfor
cem
ent a
nd d
efen
se p
erso
nnel
, and
val
idat
ion
of th
e m
emor
andu
m o
f und
erst
andi
ng th
roug
h pe
riodi
c ex
erci
ses
and
sim
ulat
ions
. Cou
ntrie
s ha
ve s
yste
ms
to c
ondu
ct a
nd s
uppo
rt jo
int
epid
emio
logi
cal a
nd c
rimin
al in
vest
igat
ions
to id
entif
y an
d re
spon
d to
sus
pect
ed b
iolo
gica
l, ch
emic
al o
r rad
iolo
gica
l inc
iden
ts o
f sus
pect
ed
delib
erat
e or
igin
in c
olla
bora
tion
with
indi
vidu
al B
iolo
gica
l and
Tox
in W
eapo
ns C
onve
ntio
n (B
TWC)
of S
tate
s Pa
rtie
s, F
AO, I
nter
natio
nal A
tom
ic
Ener
gy A
genc
y (IA
EA),
Inte
rnat
iona
l Crim
inal
Pol
ice
Org
aniz
atio
n (IN
TERP
OL)
, OIE
, Org
anis
atio
n fo
r the
Pro
hibi
tion
of C
hem
ical
Wea
pons
(OPC
W),
the
Uni
ted
Nat
ions
Sec
reta
ry-G
ener
al’s
Mec
hani
sm fo
r Inv
estig
atio
n of
Alle
ged
Use
of C
hem
ical
and
Bio
logi
cal W
eapo
ns, W
HO
and
oth
er re
leva
nt
regi
onal
and
inte
rnat
iona
l org
aniz
atio
ns a
s ap
prop
riate
.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: Ev
iden
ce o
f at l
east
one
resp
onse
in th
e pr
evio
us y
ear t
hat e
ffect
ivel
y lin
ks p
ublic
hea
lth a
nd la
w e
nfor
cem
ent,
or a
form
al e
xerc
ise
or s
imul
atio
n in
volv
ing
lead
ersh
ip fr
om th
e co
untr
y’s
publ
ic h
ealth
and
law
enf
orce
men
t com
mun
ities
.
Coun
try
cond
ucts
a ra
pid,
mul
tisec
tora
l res
pons
e fo
r any
eve
nt o
f sus
pect
ed o
r con
firm
ed d
elib
erat
e or
igin
, incl
udin
g th
e ca
paci
ty to
link
pub
lic h
ealth
and
la
w e
nfor
cem
ent,
and
to p
rovi
de ti
mel
y in
tern
atio
nal a
ssis
tanc
e.
WHO BENCHMARKS FOR IHR CAPACITIES
102
CAPA
CITY
LEVE
L
Benc
hmar
k 13
.1: P
ublic
hea
lth a
nd s
ecur
ity a
utho
ritie
s (la
w e
nfor
cem
ent,
bord
er c
ontr
ol, c
usto
ms)
link
ed d
urin
g a
susp
ect
or c
onfir
med
bio
logi
cal,
chem
ical
or r
adio
logi
cal e
vent
O
bjec
tive:
Str
engt
heni
ng th
e lin
kage
bet
wee
n pu
blic
hea
lth a
nd s
ecur
ity a
utho
ritie
s du
ring
pote
ntia
l eve
nts
of n
atio
nal
conc
ern
01N
O C
APAC
ITY
No
legi
slat
ion,
rela
tions
hips
, pro
toco
ls, m
emor
anda
of u
nder
stan
ding
or o
ther
agr
eem
ents
exi
st b
etw
een
publ
ic h
ealth
, ani
mal
he
alth
, rad
iolo
gica
l saf
ety,
chem
ical
saf
ety
and
secu
rity
auth
oriti
es to
add
ress
all
haza
rds.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y se
ctor
s re
spon
sibl
e fo
r res
pons
e to
pot
entia
l IH
R re
late
d ha
zard
s (b
iolo
gica
l, che
mic
al a
nd ra
diat
ion)
.
Iden
tify
poin
ts-o
f-co
ntac
t to
assi
st w
ith th
e im
plem
enta
tion
of p
reve
ntio
n, d
etec
tion
and
resp
onse
act
iviti
es a
t gov
ernm
ent
agen
cies
acr
oss
mul
tiple
sec
tors
(suc
h as
pub
lic h
ealth
, ani
mal
hea
lth, s
ecur
ity a
utho
ritie
s, a
gric
ultu
re, c
hem
ical
, rad
iatio
n).
D
eter
min
e ro
les
and
resp
onsi
bilit
ies
for r
espo
ndin
g to
var
ious
thre
ats
and
othe
r inc
iden
ts o
f con
cern
thro
ugh
a re
view
of
natio
nal r
espo
nse
plan
s, p
olic
ies
and
proc
edur
es, o
r oth
er m
eans
, thr
ough
an
enga
gem
ent m
eetin
g or
oth
er m
eans
.
Asse
ss ri
sk o
f sig
nific
ant b
iolo
gica
l (an
d ch
emic
al o
r rad
iolo
gica
l) in
cide
nts
of c
once
rn to
the
coun
try.
D
evel
op tr
igge
rs fo
r sha
ring
info
rmat
ion
on b
iolo
gica
l thr
eats
or o
ther
inci
dent
s of
con
cern
(suc
h as
che
mic
al, r
adio
logi
cal)
with
rele
vant
mul
tisec
tora
l age
ncie
s.
Esta
blis
h an
info
rmal
or f
orm
al c
omm
unic
atio
ns p
roce
ss to
sha
re in
form
atio
n, b
ased
on
iden
tified
trig
gers
, rel
ated
to b
iolo
gica
l th
reat
s or
oth
er in
cide
nts
of c
once
rn (s
uch
as c
hem
ical
, rad
iolo
gica
l) am
ong
rele
vant
mul
tisec
tora
l age
ncie
s (s
uch
as p
ublic
he
alth
, ani
mal
hea
lth a
nd s
ecur
ity a
utho
ritie
s).
Tr
ain
staf
f on
join
t ris
k as
sess
men
t and
app
licat
ion
of tr
igge
rs, a
nd s
harin
g of
info
rmat
ion
amon
g al
l sec
tors
rele
vant
to
haza
rds.
WHO BENCHMARKS FOR IHR CAPACITIES
103
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
com
mun
icat
ion
amon
g pu
blic
hea
lth, a
nim
al h
ealth
and
sec
urity
/law
enf
orce
men
t poi
nts
of c
onta
ct w
ho w
ould
ne
ed to
col
labo
rate
in c
ase
of a
sus
pect
ed in
tent
iona
l eve
nt.
Id
entif
y ap
prop
riate
act
iviti
es (s
uch
as n
otifi
catio
ns, a
sses
smen
ts, i
nves
tigat
ion,
labo
rato
ry te
stin
g) fo
r res
pons
e to
bi
olog
ical
thre
ats
or o
ther
inci
dent
s of
con
cern
(suc
h as
che
mic
al, r
adio
logi
cal),
whi
ch w
ill b
e co
vere
d by
a w
ritte
n pr
otoc
ol
or m
emor
andu
m o
f und
erst
andi
ng b
etw
een
sect
ors.
D
evel
op lo
gist
ical
pla
ns to
incl
ude
mul
tisec
tora
l age
ncie
s, in
clud
ing
if ap
prop
riate
, law
enf
orce
men
t, in
the
publ
ic h
ealth
EO
C.
Det
erm
ine
sam
ple
colle
ctio
n, tr
ansp
ort,
stor
age,
sec
urity
and
test
ing
requ
irem
ents
am
ong
rele
vant
sec
tors
(i.e
. pub
lic
heal
th, s
ecur
ity a
utho
ritie
s, a
gric
ultu
re) f
or b
iolo
gica
l thr
eats
and
oth
er in
cide
nts
of c
once
rn (s
uch
as c
hem
ical
, rad
iolo
gica
l).
Fina
lize
a w
ritte
n pr
otoc
ol o
r mem
oran
dum
of u
nder
stan
ding
that
form
aliz
es a
nd in
stitu
tiona
lizes
inte
ract
ions
bet
wee
n re
leva
nt m
ultis
ecto
ral a
genc
ies
(pub
lic h
ealth
, ani
mal
hea
lth a
nd s
ecur
ity a
utho
ritie
s).
D
evel
op S
OPs
defi
ning
the
proc
ess
and
com
mun
icat
ion
mec
hani
sms
for a
sses
sing
and
resp
ondi
ng to
sus
pect
ed
inte
rnat
iona
l eve
nts.
D
evel
op tr
aini
ng c
urric
ulum
usi
ng c
ount
ry-s
peci
fic c
onte
nt (s
uch
as re
gula
tions
/aut
horit
ies,
age
ncy
role
s/re
spon
sibi
litie
s an
d ca
se s
tudi
es).
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t reg
ular
trai
ning
in re
leva
nt s
ecto
rs.
Co
nduc
t at l
east
one
pub
lic h
ealth
em
erge
ncy
resp
onse
or e
xerc
ise
per y
ear t
hat i
nclu
des
appr
opria
te in
form
atio
n sh
arin
g be
twee
n pu
blic
hea
lth a
nd s
ecur
ity a
utho
ritie
s us
ing
the
form
al p
roto
col o
r mem
oran
dum
of u
nder
stan
ding
.
Doc
umen
t find
ings
of t
he re
spon
se o
r exe
rcis
e, h
ighl
ight
the
gaps
and
bes
t pra
ctic
es, a
nd a
djus
t pro
toco
ls a
s ap
prop
riate
.
Cond
uct j
oint
trai
ning
of p
ublic
hea
lth, a
nim
al h
ealth
and
sec
urity
aut
horit
ies
to o
rient
, exe
rcis
e an
d in
stitu
tiona
lize
know
ledg
e of
mem
oran
dum
of u
nder
stan
ding
and
oth
er a
gree
men
ts re
late
d to
all
haza
rds.
WHO BENCHMARKS FOR IHR CAPACITIES
104
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
ocum
ent c
ondu
ctio
n of
regu
lar j
oint
trai
ning
/exe
rcis
e pr
ogra
mm
es a
t nat
iona
l, in
term
edia
te a
nd lo
cal l
evel
s fo
r pub
lic
heal
th, a
nim
al h
ealth
and
sec
urity
aut
horit
ies
to o
rient
, exe
rcis
e an
d in
stitu
tiona
lize
the
know
ledg
e of
mem
oran
dum
of
unde
rsta
ndin
g an
d ot
her a
gree
men
ts re
late
d to
all
haza
rds.
Ex
pand
the
join
t ris
k as
sess
men
t, ex
chan
ge o
f inf
orm
atio
n an
d re
port
ing
to a
ll le
vels
(nat
iona
l, in
term
edia
te a
nd lo
cal
leve
ls).
Co
nduc
t an
eval
uatio
n to
det
erm
ine
whe
ther
info
rmat
ion
abou
t eve
nts
of jo
int c
once
rn is
sha
red
in a
tim
ely
and
effe
ctiv
e m
anne
r at n
atio
nal,
inte
rmed
iate
and
loca
l lev
els
as o
utlin
ed in
form
al m
emor
anda
of u
nder
stan
ding
or o
ther
agr
eem
ents
/pr
otoc
ols,
and
that
the
resp
onse
is a
ppro
pria
te a
nd e
ffect
ive,
and
cor
rect
ive
actio
n is
take
n ba
sed
on th
is e
valu
atio
n.
TOO
LS:
W
HO
–O
IE o
pera
tiona
l fra
mew
ork
for g
ood
gove
rnan
ce a
t the
hum
an¬–
anim
al in
terf
ace:
Brid
ging
WH
O a
nd O
IE to
ols
for t
he a
sses
smen
t of
natio
nal c
apac
ities
. WH
O a
nd O
IE; 2
014.
Te
rres
tria
l ani
mal
hea
lth c
ode.
Cha
pter
3.4
Vet
erin
ary
legi
slat
ion.
Wor
ld O
rgan
isat
ion
for A
nim
al H
ealth
; 201
6
Conv
entio
n on
the
proh
ibiti
on o
f the
dev
elop
men
t, pr
oduc
tion,
sto
ckpi
ling
and
use
of c
hem
ical
wea
pons
and
on
thei
r des
truc
tion.
The
Hag
ue:
Org
anis
atio
n fo
r the
Pro
hibi
tion
of C
hem
ical
Wea
pons
Tr
eaty
on
the
non-
prol
ifera
tion
of n
ucle
ar w
eapo
ns. I
nter
natio
nal A
tom
ic E
nerg
y Ag
ency
[inf
orm
atio
n ci
rcul
ar] I
NFC
IRC/
140,
22
April
197
0
Join
t Crim
inal
and
Epi
dem
iolo
gica
l Inv
estig
atio
ns H
andb
ook
2016
. Int
erna
tiona
l Edi
tion
WHO BENCHMARKS FOR IHR CAPACITIES
105
MED
ICAL
CO
UN
TERM
EASU
RES
AND
PERS
ON
NEL
DEP
LOYM
ENT
14
IMPA
CT:
Coun
tries
will
hav
e th
e ne
cess
ary
lega
l and
regu
lato
ry p
roce
sses
and
logi
stic
al p
lans
to a
llow
for r
apid
nat
iona
l or c
ross
-bor
der d
eplo
ymen
t and
re
ceip
t of p
ublic
hea
lth a
nd m
edic
al p
erso
nnel
dur
ing
emer
genc
ies.
Reg
iona
l (in
tern
atio
nal)
colla
bora
tion
will
ass
ist c
ount
ries
in o
verc
omin
g th
e lo
gist
ical
and
regu
lato
ry c
halle
nges
to d
eplo
ymen
t of p
ublic
hea
lth a
nd m
edic
al p
erso
nnel
from
one
cou
ntry
to a
noth
er.
Coun
try
has
deve
lope
d ca
se m
anag
emen
t pro
cedu
res
and
impl
emen
ted
it du
ring
heal
th e
mer
genc
ies
due
to IH
R re
leva
nt h
azar
ds.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Evi
denc
e of
at l
east
one
resp
onse
to a
pub
lic h
ealth
em
erge
ncy
with
in th
e pr
evio
us y
ear t
hat d
emon
stra
tes
that
the
coun
try
sent
or r
ecei
ved
med
ical
cou
nter
mea
sure
s an
d pe
rson
nel a
ccor
ding
to w
ritte
n na
tiona
l or i
nter
natio
nal p
roto
cols
, or a
form
al e
xerc
ise
or s
imul
atio
n th
at
dem
onst
rate
s th
ese
mea
sure
s. (2
) Evi
denc
e of
dem
onst
ratin
g ap
plic
atio
n of
cas
e m
anag
emen
t pro
cedu
res
for e
vent
s du
e to
IHR
-rel
evan
t ha
zard
s. (3
) Evi
denc
e of
a s
tron
g na
tiona
l res
pons
e te
am/e
mer
genc
y m
edic
al te
am (E
MT)
str
uctu
res,
exe
rcis
es, t
rain
ings
, am
ong
othe
rs.
Nat
iona
l fra
mew
ork
for t
rans
ferr
ing
(sen
ding
and
rece
ivin
g) m
edic
al c
ount
erm
easu
res,
pub
lic h
ealth
and
med
ical
per
sonn
el fr
om u
naffe
cted
regi
ons
(rapi
d re
spon
se te
ams/
natio
nal e
mer
genc
y m
edic
al te
ams)
, and
inte
rnat
iona
l par
tner
s du
ring
publ
ic h
ealth
em
erge
ncie
s; a
nd p
roce
dure
s fo
r cas
e m
anag
emen
t of
eve
nts
due
to IH
R re
leva
nt h
azar
ds.
WHO BENCHMARKS FOR IHR CAPACITIES
106
CAPA
CITY
LEVE
L
Benc
hmar
k 14
.1: S
yste
m is
in p
lace
for a
ctiv
atin
g an
d co
ordi
natin
g m
edic
al c
ount
erm
easu
res
durin
g a
publ
ic h
ealth
em
erge
ncy
Obj
ectiv
e: T
o de
velo
p a
func
tiona
l sys
tem
for a
ctiv
atin
g an
d co
ordi
natin
g he
alth
per
sonn
el d
urin
g a
publ
ic h
ealth
em
erge
ncy
01N
O C
APAC
ITY
No
natio
nal c
ount
erm
easu
res
plan
has
bee
n dr
afte
d.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
nat
iona
l pre
pare
dnes
s an
d re
spon
se p
lans
, lega
l and
regu
lato
ry fr
amew
orks
, and
bas
elin
e ca
paci
ty fo
r sto
ckpi
ling
and
depl
oyin
g m
edic
al c
ount
erm
easu
res,
incl
udin
g se
ctor
role
s an
d re
spon
sibi
litie
s, in
volv
ing
all k
ey s
take
hold
ers.
Re
view
nat
iona
l law
s an
d re
gula
tions
for t
he re
gist
ratio
n, p
rocu
rem
ent a
nd u
se o
f med
ical
dev
ices
, vac
cine
s, d
rugs
, bio
logi
cals
an
d m
edic
al s
uppl
ies
from
nat
iona
l and
/or i
nter
natio
nal s
ourc
es d
urin
g pu
blic
hea
lth e
mer
genc
ies.
Co
mpl
ete
feas
ibilit
y as
sess
men
t for
est
ablis
hing
a m
edic
al c
ount
erm
easu
res
stoc
kpile
, incl
udin
g se
cure
and
func
tiona
l fa
cilit
ies
to s
tock
pile
med
ical
cou
nter
mea
sure
s at
all
leve
ls.
D
raft
a na
tiona
l pla
n to
sen
d, re
ceiv
e, s
tock
pile
and
dep
loy
med
ical
cou
nter
mea
sure
s.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ad
opt t
he n
atio
nal p
lan
to s
end,
rece
ive,
sto
ckpi
le a
nd d
eplo
y m
edic
al c
ount
erm
easu
res,
incl
udin
g m
appi
ng re
sour
ces
with
in th
e co
untr
y an
d w
ith p
artn
ers.
D
evel
op s
tand
ardi
zed
prot
ocol
s, p
lans
for s
tora
ge, d
eplo
ymen
t and
logi
stic
al a
nd a
dmin
istr
ativ
e su
ppor
t at a
ll le
vels
.
Esta
blis
h re
gula
tory
pat
hway
s fo
r use
of m
edic
al c
ount
erm
easu
res
incl
udin
g ap
prop
riate
aut
horiz
atio
ns, c
lear
ance
s, e
thic
al
norm
s, a
nd p
erm
issi
ons
durin
g in
vest
igat
ions
and
resp
onse
s.
Crea
te d
eplo
ymen
t pro
toco
ls, S
OPs
, tec
hnic
al g
uide
lines
and
tool
kits
incl
udin
g co
mm
unic
atio
n m
ater
ials
, tra
inin
gs a
nd
educ
atio
nal i
nfor
mat
ion
to in
form
sta
ff, th
e co
mm
unity
and
sta
keho
lder
s.
Trai
n ea
rly re
spon
ders
in th
e ap
prop
riate
use
and
man
agem
ent o
f cou
nter
mea
sure
s.
Dev
elop
and
con
duct
a ta
ble-
top
exer
cise
, if c
ount
erm
easu
res
(whi
ch in
clud
es s
endi
ng a
nd re
ceiv
ing
med
ical
co
unte
rmea
sure
s) h
ave
not b
een
depl
oyed
in th
e pr
evio
us y
ear.
WHO BENCHMARKS FOR IHR CAPACITIES
107
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
the
impl
emen
tatio
n pl
an o
f sen
ding
, rec
eivi
ng, s
tock
pilin
g an
d de
ploy
ing
med
ical
cou
nter
mea
sure
s in
at l
east
one
re
spon
se.
In
clud
e pr
ocur
emen
t of a
nim
al c
ount
erm
easu
res
in th
e co
untr
y pl
ans,
pro
cedu
res
or le
gal p
rovi
sion
s.
If th
ere
is n
o re
spon
se in
the
prev
ious
yea
r, th
en d
evel
op a
nd c
ondu
ct a
sim
ulat
ion
exer
cise
that
test
s th
e im
plem
enta
tion
plan
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
part
ners
hips
with
cou
ntrie
s, a
nd re
gion
al a
nd in
tern
atio
nal p
artn
ers,
that
incl
ude
proc
urem
ent,
shar
ing
and
dist
ribut
ion
of m
edic
al c
ount
erm
easu
res.
D
evel
op a
nd ro
utin
ely
appl
y cr
iteria
to d
ocum
ent p
rogr
ess
of s
endi
ng a
nd re
ceiv
ing
med
ical
cou
nter
mea
sure
s du
ring
a re
spon
se.
Ro
utin
ely
test
and
eva
luat
e th
e ca
paci
ty o
f em
erge
ncy
depl
oym
ent o
f med
ical
cou
nter
mea
sure
s an
d up
date
the
plan
.
Dev
elop
a ra
tiona
l and
evi
denc
e-ba
sed
stra
tegy
to p
riorit
ize
reso
urce
s an
d in
vest
men
ts in
med
ical
cou
nter
mea
sure
s at
the
natio
nal l
evel
.
WHO BENCHMARKS FOR IHR CAPACITIES
108
CAPA
CITY
LEVE
L
Benc
hmar
k 14
.2: S
yste
m is
in p
lace
for a
ctiv
atin
g an
d co
ordi
natin
g he
alth
per
sonn
el d
urin
g a
publ
ic h
ealth
em
erge
ncy
Obj
ectiv
e: T
o de
velo
p a
func
tiona
l sys
tem
for a
ctiv
atin
g an
d co
ordi
natin
g he
alth
per
sonn
el d
urin
g a
publ
ic h
ealth
em
erge
ncy
01N
O C
APAC
ITY
No
natio
nal p
erso
nnel
dep
loym
ent p
lan
has
been
dra
fted.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
nat
iona
l pre
pare
dnes
s an
d re
spon
se p
lans
, and
lega
l and
regu
lato
ry fr
amew
orks
for s
endi
ng a
nd re
ceiv
ing
heal
th
pers
onne
l with
key
sta
keho
lder
s.
Revi
ew n
atio
nal l
aws
and
regu
latio
ns fo
r the
regi
stra
tion
of E
MTs
.48
Co
nduc
t a s
take
hold
er m
eetin
g to
det
erm
ine
base
line
capa
city
/cap
abilit
ies
of re
leva
nt m
inis
tries
and
par
tner
ing
agen
cies
for
depl
oym
ent o
f EM
Ts.
Id
entif
y po
ints
of c
onta
ct a
t rel
evan
t mul
tisec
tora
l org
aniz
atio
ns.
D
evel
op p
roto
cols
, SO
Ps, t
echn
ical
gui
delin
es a
nd to
olki
ts fo
r sen
ding
and
rece
ivin
g he
alth
per
sonn
el, a
nd fo
r sha
ring
info
rmat
ion
as a
ppro
pria
te.
Id
entif
y an
d do
cum
ent b
arrie
rs to
regi
ster
ing,
as
wel
l as
rece
ivin
g an
d de
ploy
ing
natio
nal/i
nter
natio
nal h
ealth
per
sonn
el a
nd
team
s, in
clud
ing
safe
ty a
nd li
abilit
y gu
idan
ce fo
r per
sonn
el d
eplo
ymen
t.
Dev
elop
SO
Ps a
nd tr
aini
ng fo
r the
org
aniz
atio
n, tr
ansp
orta
tion
and
dist
ribut
ion
of p
erso
nal p
rote
ctiv
e eq
uipm
ent,
med
icat
ions
an
d su
pplie
s to
hea
lth p
erso
nnel
.
Dev
elop
sta
ndar
dize
d pl
ans
for t
reat
men
t cen
tres
for t
riage
, IPC
and
trea
tmen
t dur
ing
emer
genc
y in
cide
nts.
Es
tabl
ish
a co
mm
unic
atio
n ne
twor
k fo
r hea
lth p
erso
nnel
dur
ing
emer
genc
ies.
D
evel
op to
ols
for e
mer
genc
y he
alth
dis
aste
r edu
catio
n of
the
publ
ic fo
r com
mun
ity a
ccep
tanc
e of
dep
loye
d he
alth
per
sonn
el.
D
raft
a na
tiona
l pla
n to
sen
d an
d re
ceiv
e he
alth
per
sonn
el.
Ap
ply
to W
HO
EM
T se
cret
aria
t for
ass
ista
nce
in d
evel
opin
g na
tiona
l EM
Ts.
48 E
MTs
con
sist
of h
ealth
pro
fess
iona
ls p
rovi
ding
dire
ct c
linic
al c
are
to p
opul
atio
ns a
ffect
ed b
y ou
tbre
aks,
dis
aste
rs a
nd e
mer
genc
ies
as a
sur
ge c
apac
ity to
sup
port
the
loca
l hea
lth s
yste
m.
They
cou
ld b
e ci
vilia
n or
mili
tary
or n
ongo
vern
men
tal t
eam
s an
d in
clud
e bo
th n
atio
nal a
nd in
tern
atio
nal p
erso
nnel
.
WHO BENCHMARKS FOR IHR CAPACITIES
109
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ad
opt t
he n
atio
nal p
lan
on p
erso
nnel
dep
loym
ent a
nd d
evel
op p
roce
dure
s or
lega
l pro
visi
ons.
Co
nduc
t a ta
ble-
top
exer
cise
, if n
o re
spon
se h
as o
ccur
red
in th
e pa
st y
ear,
whi
ch in
clud
es s
endi
ng a
nd re
ceiv
ing
heal
th
pers
onne
l and
team
s, a
nd c
ompr
isin
g th
e cr
eatio
n of
an
EMT
coor
dina
tion
cell
and/
or c
ase
man
agem
ent p
illar
in th
e na
tiona
l hea
lth E
OC.
D
evel
op a
nd c
ondu
ct a
tabl
e-to
p ex
erci
se w
hich
incl
udes
sen
ding
and
rece
ivin
g he
alth
per
sonn
el in
an
emer
genc
y an
d re
view
the
pers
onne
l dep
loym
ent p
lan.
Ap
ply
to th
e W
HO
EM
T se
cret
aria
t for
men
tors
hip
and
verifi
catio
n as
an
inte
rnat
iona
lly c
lass
ified
EM
T.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
the
impl
emen
tatio
n pl
an o
f sen
ding
and
rece
ivin
g he
alth
per
sonn
el in
at l
east
one
eve
nt re
spon
se.
Co
nduc
t a s
imul
atio
n ex
erci
se, i
f no
resp
onse
has
occ
urre
d in
pas
t yea
r, to
test
the
send
ing
and
rece
ivin
g of
hea
lth
pers
onne
l.
Esta
blis
h an
d tr
ain
a ro
ster
of q
ualifi
ed p
erso
nnel
to b
e ac
tivat
ed in
a p
ublic
hea
lth e
mer
genc
y.
Achi
eve
cert
ifica
tion
as a
nat
iona
l or i
nter
natio
nal E
MT
from
WH
O to
sup
port
the
natio
nal r
espo
nse.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y an
d pa
rtne
r with
regi
onal
and
inte
rnat
iona
l (su
ch a
s G
loba
l Out
brea
k Al
ert a
nd R
espo
nse
Net
wor
k) p
artn
ers
for
mob
ilizi
ng h
ealth
per
sonn
el.
D
evel
op a
nd m
aint
ain
a ro
ster
of t
rain
ed a
nd c
ertifi
ed h
ealth
per
sonn
el.
Ro
utin
ely
test
and
eva
luat
e ca
paci
ty o
f em
erge
ncy
depl
oym
ent o
f hea
lth p
erso
nnel
(sen
ding
and
rece
ivin
g) in
clud
ing
the
set
up a
nd ru
nnin
g of
an
EMT
coor
dina
tion
cell
and/
or c
ase
man
agem
ent p
illar
with
in th
e na
tiona
l hea
lth E
OC.
WHO BENCHMARKS FOR IHR CAPACITIES
110
CAPA
CITY
LEVE
L
Benc
hmar
k 14
.3: C
ase
man
agem
ent p
roce
dure
s im
plem
ente
d fo
r rel
evan
t IH
R ha
zard
s O
bjec
tive:
Dev
elop
and
impl
emen
t cas
e m
anag
emen
t pro
cedu
res
for a
ll re
leva
nt IH
R ha
zard
s
01N
O C
APAC
ITY
No
case
man
agem
ent g
uide
lines
are
ava
ilabl
e fo
r prio
rity
epid
emic
-pro
ne d
isea
ses.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op s
tand
ardi
zed
case
man
agem
ent g
uide
lines
for p
riorit
y di
seas
es a
nd IH
R-re
leva
nt h
azar
ds.
D
evel
op tr
igge
rs fo
r sha
ring
info
rmat
ion
on d
isea
ses,
con
ditio
ns a
nd e
vent
s of
pub
lic h
ealth
em
erge
ncy
of in
tern
atio
nal
conc
ern
with
rele
vant
mul
tisec
tora
l age
ncie
s.
Dev
elop
the
diss
emin
atio
n pl
an (i
nclu
ding
trai
ning
pac
kage
) for
cas
e m
anag
emen
t gui
delin
es fo
r all
leve
ls.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
isse
min
ate
case
man
agem
ent g
uide
lines
to s
ubna
tiona
l lev
el a
nd p
oint
s of
ent
ry.
D
evel
op a
nd d
isse
min
ate
SOPs
for t
he m
anag
emen
t and
tran
spor
t of p
oten
tially
infe
ctio
us p
atie
nts,
incl
udin
g pa
tient
re
ferr
al a
nd tr
ansp
orta
tion
mec
hani
sms.
Id
entif
y th
e tr
ansp
orta
tion
mec
hani
sm a
nd re
ferr
al c
entre
s ba
sed
on p
riorit
y ris
ks.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
view
cas
e m
anag
emen
t, pa
tient
refe
rral a
nd tr
ansp
orta
tion,
and
man
agem
ent a
nd tr
ansp
orta
tion
of p
oten
tially
infe
ctio
us
patie
nts
in a
ccor
danc
e w
ith g
uide
lines
and
SOP
s ba
sed
on a
ctua
l exp
erie
nce
or a
spe
cific
exe
rcis
e to
eva
luat
e th
ese
proc
edur
es.
D
ocum
ent t
he re
view
of t
he im
plem
enta
tion
of th
ese
guid
elin
es a
nd S
OPs
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a m
echa
nism
to e
nsur
e co
ntin
uous
pre
senc
e of
trai
ned
staf
f and
reso
urce
s fo
r cas
e m
anag
emen
t, pa
tient
refe
rral
an
d tr
ansp
orta
tion
for a
ll IH
R re
leva
nt e
mer
genc
ies/
haza
rds.
Re
view
cas
e m
anag
emen
t, pa
tient
refe
rral
and
tran
spor
tatio
n of
IHR
rele
vant
em
erge
ncie
s, if
it o
ccur
red
in th
e pa
st tw
o ye
ars.
D
ocum
ent a
nd d
isse
min
ate
less
ons
lear
ned
from
the
man
agem
ent o
f IH
R-re
leva
nt e
mer
genc
ies.
WHO BENCHMARKS FOR IHR CAPACITIES
111
TOO
LS:
W
hat a
re m
edic
al c
ount
erm
easu
res?
Med
ical
cou
nter
mea
sure
s ar
e pr
oduc
ts (d
rugs
, bio
logi
cs, d
rugs
, dev
ices
) tha
t may
be
used
in th
e ev
ent o
f a
pote
ntia
l pub
lic h
ealth
em
erge
ncy
due
to IH
R ha
zard
s (li
ke in
fect
ious
, foo
d sa
fety
rela
ted
even
ts, c
hem
ical
eve
nts
and
radi
atio
n ev
ents
). Th
ese
can
be u
sed
to p
reve
nt, d
etec
t and
resp
ond
to e
vent
s as
soci
ated
with
abo
ve m
entio
ned
thre
ats
and
dise
ases
.
Inte
rnat
iona
l Coo
rdin
atin
g G
roup
on
Vacc
ine
Prov
isio
n fro
m In
tern
atio
nal F
eder
atio
n of
Red
Cro
ss a
nd R
ed C
resc
ent S
ocie
ties,
Méd
ecin
s Sa
ns
Fron
tière
s, U
nite
d N
atio
ns In
tern
atio
nal C
hild
ren’
s Em
erge
ncy
Fund
and
WH
O, h
as in
form
atio
n on
mec
hani
sms
to m
anag
e an
d co
ordi
nate
the
prov
isio
n of
em
erge
ncy
vacc
ine
supp
lies
and
antib
iotic
s to
cou
ntrie
s du
ring
maj
or o
utbr
eaks
. Thi
s in
clud
es v
acci
nes
for c
hole
ra, m
enin
gitis
and
ye
llow
feve
r.
Gui
ding
Prin
cipl
es fo
r Int
erna
tiona
l Out
brea
k Al
ert a
nd R
espo
nse
– fr
om th
e G
loba
l Out
brea
k Al
ert a
nd R
espo
nse
Net
wor
k (G
OAR
N),
prov
ides
in
form
atio
n on
how
to p
repa
re fo
r fiel
d ac
tivity
, to
activ
ate
inte
rnat
iona
l sup
port
, to
coor
dina
te re
spon
se in
the
field
, to
eval
uate
and
follo
w u
p ou
tbre
aks
of in
tern
atio
nal i
mpo
rtan
ce. C
lass
ifica
tion
and
min
imum
sta
ndar
ds fo
r for
eign
med
ical
team
s in
sud
den
onse
t dis
aste
rs-
from
th
e EM
T se
cret
aria
t WH
O, a
nd u
nder
goin
g re
-writ
e to
incl
ude
outb
reak
resp
onse
by
clin
ical
team
s an
d co
ordi
natio
n as
pect
s an
d av
aila
ble
in th
e “B
lue
Book
”
Emer
genc
y M
edic
al T
eam
s In
itiat
ive:
Sur
ge c
apac
ity in
hea
lth c
are
durin
g em
erge
ncie
s. 2
8–29
Nov
embe
r 201
7 Ba
ngko
k, T
haila
nd. T
he re
gula
tion
and
man
agem
ent o
f int
erna
tiona
l em
erge
ncy
med
ical
team
s: fr
om W
HO
and
IFRC
201
7, p
rovi
des
an o
verv
iew
of t
he is
sues
in re
gula
ting
and
man
agin
g in
tern
atio
nal e
mer
genc
y m
edic
al te
ams
in a
sel
ectio
n of
larg
e an
d sm
all-s
cale
sud
den
onse
t dis
aste
rs.
WHO BENCHMARKS FOR IHR CAPACITIES
112
RISK
CO
MM
UN
ICAT
ION
15
IMPA
CT:
Effe
ctiv
e ris
k co
mm
unic
atio
n al
low
s pe
ople
at r
isk
to u
nder
stan
d an
d ad
opt p
rote
ctiv
e be
havi
ours
. It a
llow
s au
thor
ities
and
exp
erts
to li
sten
to
and
addr
ess
peop
le’s
con
cern
s an
d ne
eds
so th
at th
e ad
vice
they
pro
vide
is re
leva
nt a
nd tr
uste
d. F
eedb
ack
from
at-
risk
com
mun
ity m
embe
rs
is u
sed
to tw
eak
broa
der r
espo
nse
mea
sure
s, m
akin
g th
em m
ore
likel
y to
be
acce
pted
.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) For
mal
gov
ernm
ent r
isk
com
mun
icat
ions
pla
ns, a
rran
gem
ents
and
sys
tem
s in
pla
ce. (
2) E
xist
ence
of r
isk
com
mun
icat
ion
coor
dina
tion
mec
hani
sms
for i
nter
nal a
nd p
artn
er c
omm
unic
atio
n. (3
) Evi
denc
e th
at th
e pu
blic
com
mun
icat
ion
unit
or te
am o
pera
tes
effic
ient
ly a
nd e
ffect
ivel
y.
(4) E
vide
nce
that
risk
com
mun
icat
ion
units
sys
tem
atic
ally
eng
age
popu
latio
ns a
t the
com
mun
ity le
vel d
urin
g em
erge
ncie
s. (5
) Exi
sten
ce o
f a
syst
em to
gat
her i
nfor
mat
ion
on p
erce
ptio
ns, r
isky
beh
avio
urs
and
mis
info
rmat
ion
to a
naly
se p
ublic
con
cern
s an
d fe
ars.
Ris
k co
mm
unic
atio
n ca
paci
ty a
t the
nat
iona
l and
sub
natio
nal l
evel
s sh
ould
ens
ure
timel
y an
d ef
fect
ive
two-
way
com
mun
icat
ion
betw
een
conc
erne
d au
thor
ities
and
the
popu
latio
n at
risk
. Thi
s in
clud
es b
oth
proa
ctiv
e di
ssem
inat
ion
of in
form
atio
n an
d ac
tive
liste
ning
. The
exc
hang
e of
info
rmat
ion,
adv
ice
and
opin
ion
shou
ld b
e do
ne th
roug
h ch
anne
ls a
nd p
latfo
rms
that
are
acc
esse
d an
d m
ost t
rust
ed b
y th
e at
-ris
k po
pula
tion
(suc
h as
the
med
ia, s
ocia
l med
ia,
mas
s aw
aren
ess
cam
paig
ns, h
ealth
pro
mot
ion,
soc
ial m
obili
zatio
n, s
take
hold
er o
r via
trus
ted
com
mun
ity le
ader
s).
WHO BENCHMARKS FOR IHR CAPACITIES
113
CAPA
CITY
LEVE
L
Benc
hmar
k 15
.1: R
isk
com
mun
icat
ion
syst
ems
for u
nusu
al e
vent
s an
d em
erge
ncie
s is
in p
lace
O
bjec
tive:
To
deve
lop
a sy
stem
for r
isk
com
mun
icat
ion
for u
nusu
al e
vent
s an
d em
erge
ncie
s
01N
O C
APAC
ITY
Coun
try
has
not y
et d
evel
oped
a s
yste
m fo
r ris
k co
mm
unic
atio
n fo
r unu
sual
eve
nts
and
emer
genc
ies.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y pe
ople
or u
nits
resp
onsi
ble
for r
isk
com
mun
icat
ion
with
in e
ach
rele
vant
min
istr
y an
d re
leva
nt s
ecto
rs, w
ith d
efine
d te
rms
of re
fere
nce
to w
ork
toge
ther
dur
ing
a pu
blic
hea
lth e
mer
genc
y.
Iden
tify
and
assi
gn s
poke
sper
sons
(hol
ding
a c
erta
in jo
b po
sitio
n) fo
r pub
lic h
ealth
em
erge
ncy.
Es
tabl
ish
a lis
t of k
ey s
take
hold
ers
in g
over
nmen
t min
istr
ies
and
amon
g im
plem
entin
g pa
rtne
rs. I
dent
ify p
oint
s of
con
tact
fo
r com
mun
icat
ion
incl
udin
g di
ffere
nt m
eans
for i
nter
nal i
nfor
mat
ion
shar
ing
(suc
h as
by
emai
l, SM
S or
pho
ne o
r clo
sed
grou
p so
cial
med
ia p
latfo
rms)
.
Esta
blis
h a
dedi
cate
d ris
k co
mm
unic
atio
n un
it or
team
to w
ork
on tw
o-w
ay c
omm
unic
atio
n w
ith th
e pu
blic
(inc
ludi
ng
affe
cted
at-
risk
com
mun
ities
) usi
ng S
OPs
, prio
rity
task
s an
d de
dica
ted
resp
onsi
bilit
ies
for c
omm
unic
atio
n an
d de
cisi
on-
mak
ing
auth
ority
dur
ing
a pu
blic
hea
lth e
vent
at t
he n
atio
nal l
evel
.
Dev
elop
a n
atio
nal m
ultih
azar
d, m
ultis
ecto
ral e
mer
genc
y ris
k co
mm
unic
atio
n pl
an.
As
sess
exi
stin
g ca
paci
ties
and
need
s w
ithin
gov
ernm
ent m
inis
trie
s an
d ke
y pa
rtne
r age
ncie
s, a
nd d
evel
op tr
aini
ng p
lans
for
prio
rity
skill
s id
entifi
ed fo
r car
ryin
g ou
t effe
ctiv
e ris
k co
mm
unic
atio
n.
WHO BENCHMARKS FOR IHR CAPACITIES
114
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Te
st th
e ex
istin
g sy
stem
and
pla
n th
roug
h ac
tual
exp
erie
nce
and/
or ta
ble-
top
or s
imul
atio
n ex
erci
ses.
D
evel
op ri
sk c
omm
unic
atio
n ca
paci
ties
thro
ugh
casc
ade
trai
ning
and
/or m
ento
rshi
p at
the
subn
atio
nal l
evel
on
info
rmat
ion
shar
ing
amon
g ke
y st
akeh
olde
rs, i
nclu
ding
thro
ugh
the
med
ia, s
ocia
l med
ia a
nd d
irect
inte
ract
ion
with
affe
cted
co
mm
uniti
es.
Co
mm
unic
ate
in lo
cal l
angu
ages
and
use
app
ropr
iate
tech
nolo
gy fo
r inf
orm
atio
n ex
chan
ge (d
isse
min
atio
n an
d re
ceiv
ing
feed
back
from
the
publ
ic).
D
evel
op a
mec
hani
sm fo
r sys
tem
atic
ally
col
lect
ing
feed
back
from
the
com
mun
ity (s
uch
as th
roug
h te
leph
one
hotli
ne, s
ocia
l m
edia
foru
ms,
dire
ct e
ngag
emen
t).
Dev
elop
a m
echa
nism
to c
ondu
ct b
asel
ine
surv
eys
on k
now
ledg
e, a
ttitu
des
and
prac
tices
on
prio
rity
heal
th th
reat
s an
d on
he
alth
see
king
pra
ctic
es.
Es
tabl
ish
a m
echa
nism
to e
nsur
e re
gula
r col
labo
ratio
n am
ong
staf
f res
pons
ible
for s
urve
illan
ce, r
isk
asse
ssm
ent a
nd ri
sk
com
mun
icat
ion.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a de
dica
ted,
ade
quat
ely
reso
urce
d co
re ri
sk c
omm
unic
atio
n te
am a
nd a
sur
ge m
echa
nism
to e
nsur
e th
at h
uman
re
sour
ces
capa
city
for r
isk
com
mun
icat
ion
is a
vaila
ble
befo
re, d
urin
g an
d af
ter a
n ev
ent/
emer
genc
y.
Allo
cate
requ
ired
reso
urce
s to
sup
port
the
core
risk
com
mun
icat
ion
team
bef
ore,
dur
ing
and
afte
r an
emer
genc
y.
Cond
uct a
n af
ter-
actio
n re
view
of r
isk
com
mun
icat
ion
follo
win
g a
real
eve
nt o
r a s
imul
atio
n ex
erci
se.
Im
plem
ent r
isk
com
mun
icat
ion
trai
ning
acr
oss
sect
ors
and
at s
ubna
tiona
l lev
els.
D
evel
op a
mec
hani
sm fo
r sys
tem
atic
exc
hang
e of
info
rmat
ion
amon
g di
ffere
nt fu
nctio
ns o
f an
emer
genc
y re
spon
se (s
uch
as s
urve
illan
ce, l
abor
ator
y, pa
tient
car
e, in
fect
ion
prev
entio
n an
d co
ntro
l, lo
gist
ics,
risk
com
mun
icat
ion,
hum
an re
sour
ces,
pl
anni
ng, b
udge
t and
fina
nce)
.
Esta
blis
h m
onito
ring
and
eval
uatio
n to
ols
to e
valu
ate
the
impl
emen
tatio
n of
risk
com
mun
icat
ion
activ
ities
dur
ing
publ
ic
heal
th e
mer
genc
ies.
Tr
ain
front
line
heal
thca
re s
taff
on e
ffect
ive
risk
com
mun
icat
ion.
WHO BENCHMARKS FOR IHR CAPACITIES
115
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
vise
the
risk
com
mun
icat
ion
plan
bas
ed o
n fin
ding
s or
resu
lts fr
om e
valu
atio
n of
the
real
eve
nt.
Es
tabl
ish
a m
echa
nism
with
ded
icat
ed re
sour
ces
for t
he fu
nctio
ning
of a
n ef
fect
ive
risk
com
mun
icat
ion
syst
em, i
nclu
ding
hu
man
and
fina
ncia
l res
ourc
es fo
r a d
edic
ated
team
with
bud
get f
or im
plem
entin
g ac
tiviti
es a
t the
nat
iona
l and
sub
natio
nal
leve
ls.
D
ocum
ent,
inco
rpor
ate
findi
ngs,
and
dis
sem
inat
e le
sson
s le
arne
d fro
m ri
sk c
omm
unic
atio
n ac
tiviti
es o
f an
even
t or
exer
cise
.
WHO BENCHMARKS FOR IHR CAPACITIES
116
CAPA
CITY
LEVE
L
Benc
hmar
k 15
.2: C
oord
inat
ion
of ri
sk c
omm
unic
atio
n is
eff
ectiv
e O
bjec
tive:
Str
engt
hen
coor
dina
tion
for r
isk
com
mun
icat
ion
01N
O C
APAC
ITY
Coun
try
does
not
hav
e ef
fect
ive
coor
dina
tion
for r
isk
com
mun
icat
ion.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y m
inis
tries
, org
aniz
atio
ns a
nd k
ey s
take
hold
ers
invo
lved
in ri
sk c
omm
unic
atio
n an
d co
mm
unity
eng
agem
ent.
Co
nsul
t with
and
con
duct
initi
al m
eetin
g w
ith id
entifi
ed o
rgan
izat
ions
and
min
istri
es to
defi
ne c
oord
inat
ion
mec
hani
sms
and
plat
form
s at
nat
iona
l and
sub
natio
nal l
evel
s.
Esta
blis
h ob
ject
ives
, com
mun
icat
ion
flow
cha
rts, S
OPs
and
way
s of
wor
king
bet
wee
n un
its, a
genc
ies/
orga
niza
tions
, for
risk
co
mm
unic
atio
n an
d co
mm
unity
eng
agem
ent.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
pla
tform
or m
echa
nism
for r
egul
ar in
form
atio
n sh
arin
g w
ith re
leva
nt s
ecto
rs in
clud
ing
min
istr
ies,
par
tner
s an
d ot
her s
take
hold
ers.
Es
tabl
ish
a re
gula
r ris
k co
mm
unic
atio
n co
ordi
natio
n m
echa
nism
bet
wee
n re
leva
nt k
ey s
take
hold
ers
at n
atio
nal a
nd
subn
atio
nal l
evel
s.
Dev
elop
app
ropr
iate
act
ion
plan
s th
at id
entif
y pr
iorit
y in
terv
entio
ns, l
angu
ages
and
com
mun
icat
ion
of p
refe
renc
e to
key
po
pula
tions
at r
isk.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Ex
pand
info
rmat
ion
shar
ing
mec
hani
sm w
ith o
ther
sec
tors
incl
udin
g m
edia
, civ
il soc
iety
and
the
priv
ate
sect
or.
Co
nduc
t reg
ular
risk
com
mun
icat
ion
coor
dina
tion
mee
tings
at n
atio
nal a
nd s
ubna
tiona
l leve
ls. D
ocum
ent a
nd s
hare
out
com
es o
f th
e m
eetin
gs.
Im
plem
ent r
egul
ar ri
sk c
omm
unic
atio
n co
ordi
natio
n am
ong
rele
vant
key
sta
keho
lder
s at
nat
iona
l and
sub
natio
nal le
vels
.
Eval
uate
the
effe
ctiv
enes
s of
the
coor
dina
tion
mec
hani
sm a
mon
g al
l par
tner
s ei
ther
thro
ugh
a re
al e
vent
or s
imul
atio
n ex
erci
se.
WHO BENCHMARKS FOR IHR CAPACITIES
117
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
M
aint
ain
a re
gula
r coo
rdin
atio
n m
echa
nism
.
Asse
ss p
erfo
rman
ce o
f the
coo
rdin
atio
n m
echa
nism
regu
larly
thro
ugh
sim
ulat
ion
exer
cise
s or
afte
r-ac
tion
revi
ews
and
shar
e re
sults
with
par
tner
s.
Upd
ate
actio
n pl
ans
with
rele
vant
sta
keho
lder
s w
ith c
lear
ly d
efine
d ro
les
and
prov
isio
n of
reso
urce
s.
WHO BENCHMARKS FOR IHR CAPACITIES
118
CAPA
CITY
LEVE
L
Benc
hmar
k 15
.3: E
ffec
tive
com
mun
icat
ion
with
com
mun
ites
Obj
ectiv
e: S
tren
gthe
n co
mm
unic
atio
n en
gage
men
t with
com
mun
ities
01N
O C
APAC
ITY
Coun
try
does
not
hav
e ef
fect
ive
com
mun
icat
ion
with
com
mun
ities
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
a lis
t of k
ey s
take
hold
ers
– c
ivil
soci
ety
grou
ps, k
ey n
ongo
vern
men
tal o
rgan
izat
ions
, key
relig
ious
and
trad
ition
al
lead
ers
– a
t the
nat
iona
l lev
el.
Co
nduc
t a n
eeds
ana
lysi
s fo
r effe
ctiv
ely
enga
ging
with
civ
il so
ciet
y gr
oups
and
key
non
gove
rnm
enta
l org
aniz
atio
ns (i
nclu
ding
fe
mal
e-or
ient
ed o
rgan
izat
ions
), an
d re
ligio
us a
nd tr
aditi
onal
lead
ers
at th
e na
tiona
l lev
el.
Id
entif
y ke
y in
tern
al re
sour
ces
with
in a
ll re
leva
nt m
inis
tries
to h
elp
enga
ge w
ith k
ey s
take
hold
ers
at th
e na
tiona
l lev
el.
D
evel
op a
pla
n to
eng
age
key
stak
ehol
ders
at t
he n
atio
nal l
evel
.
Iden
tify
foca
l poi
nts
for c
omm
unity
eng
agem
ent a
t the
nat
iona
l and
sub
natio
nal l
evel
s.
Dev
elop
and
dis
sem
inat
e tra
inin
g on
com
mun
ity e
ngag
emen
t at t
he n
atio
nal a
nd s
ubna
tiona
l lev
els.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y tr
uste
d co
mm
unity
lead
ers
and
cham
pion
s at
the
subn
atio
nal l
evel
to s
uppo
rt c
omm
unity
eng
agem
ent (
such
as
relig
ious
lead
ers,
trad
ition
al h
eale
rs, c
omm
unity
net
wor
ks).
Id
entif
y fo
cal p
oint
s fro
m th
e m
inis
try
and
part
ners
for c
omm
unity
eng
agem
ent a
t the
sub
natio
nal l
evel
.
Dev
elop
and
dis
sem
inat
e tr
aini
ng o
n co
mm
unity
eng
agem
ent a
t the
sub
natio
nal l
evel
.
Dev
elop
tool
s, p
roce
dure
s an
d m
etho
ds fo
r com
mun
ity e
ngag
emen
t to
obta
in c
omm
unity
feed
back
thro
ugh
surv
eys,
ho
tline
s, c
omm
unity
dia
logu
e or
oth
er m
eans
.
Iden
tify
and
trai
n co
mm
unity
out
reac
h gr
oups
, inc
ludi
ng v
olun
teer
s.
WHO BENCHMARKS FOR IHR CAPACITIES
119
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
mec
hani
sms
for s
yste
mat
ical
ly re
ceiv
ing
com
mun
ity fe
edba
ck th
roug
h m
ultip
le c
hann
els
incl
udin
g so
cial
med
ia
and
dire
ct d
ialo
gue.
Co
nduc
t reg
ular
refre
sher
trai
ning
, brie
fing,
sup
ervi
sion
and
eng
agem
ent o
f soc
ial m
obili
zers
and
com
mun
ity e
ngag
ers.
D
evel
op m
echa
nism
s to
sys
tem
atic
ally
inte
grat
e fe
edba
ck o
n co
mm
unity
con
cern
s an
d is
sues
of i
nter
est i
nto
com
mun
ity
enga
gem
ent a
ctiv
ities
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
dedi
cate
d hu
man
and
fina
ncia
l res
ourc
es fo
r com
mun
ity e
ngag
emen
t inc
ludi
ng c
ore
staf
f and
impl
emen
tatio
n bu
dget
at n
atio
nal a
nd s
ubna
tiona
l lev
els.
Re
gula
rly a
sses
s pe
rfor
man
ce o
f com
mun
ity e
ngag
emen
t and
sha
re re
sults
obt
aine
d th
roug
h af
ter-
actio
n re
view
s or
si
mul
atio
n ex
erci
ses.
TOO
LS:
W
HO
gui
danc
e on
Ris
k Co
mm
unic
atio
n
Com
mun
icat
ing
Risk
in P
ublic
Hea
lth E
mer
genc
ies
Ri
sk c
omm
unic
atio
n tr
aini
ng c
ours
es
Risk
com
mun
icat
ion
reso
urce
s –
WH
O w
ebsi
te
WHO BENCHMARKS FOR IHR CAPACITIES
120
POIN
TS O
F EN
TRY
16
IMPA
CT:
Tim
ely
dete
ctio
n of
and
effe
ctiv
e re
spon
se to
any
pot
entia
l haz
ards
that
occ
ur a
t or m
ay b
e sp
read
via
poi
nts
of e
ntry
.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Pub
lic h
ealth
em
erge
ncy
cont
inge
ncy
plan
for e
ach
desi
gnat
ed p
oint
s of
ent
ry in
an
all-h
azar
d an
d m
ultis
ecto
ral a
ppro
ach.
(2) E
vide
nce
confi
rms
core
cap
aciti
es p
resc
ribed
in th
e IH
R An
nex
1B a
re e
stab
lishe
d fo
r res
pond
ing
to e
vent
s th
at m
ay c
onst
itute
a p
ublic
hea
lth e
mer
genc
y of
inte
rnat
iona
l con
cern
, and
func
tioni
ng in
an
all-h
azar
d an
d m
ultis
ecto
ral a
ppro
ach.
Stat
es P
artie
s de
sign
ate
and
mai
ntai
n co
re c
apac
ities
at i
nter
natio
nal a
irpor
ts a
nd p
orts
(and
whe
re ju
stifi
ed fo
r pub
lic h
ealth
reas
ons,
a S
tate
Par
ty m
ay
desi
gnat
e gr
ound
cro
ssin
gs) t
hat i
mpl
emen
t pub
lic h
ealth
mea
sure
s re
quire
d to
pre
vent
, det
ect a
nd m
anag
e a
varie
ty o
f pub
lic h
ealth
risk
s in
a m
ultis
ecto
ral
appr
oach
(IH
R An
nex
1b).
WHO BENCHMARKS FOR IHR CAPACITIES
121
CAPA
CITY
LEVE
L
Benc
hmar
k 16
.1: R
outin
e ca
paci
ties
at p
oint
s of
ent
ry a
re in
pla
ce
Obj
ectiv
e: E
stab
lishm
ent o
f rou
tine
capa
citie
s at
des
igna
ted
poin
ts o
f ent
ry
01N
O C
APAC
ITY
Coun
try
does
not
hav
e ca
paci
ty fo
r app
ropr
iate
sur
veill
ance
or m
edic
al s
ervi
ces
at d
esig
nate
d po
ints
of e
ntry
.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t cap
acity
ass
essm
ent a
t key
poi
nts
of e
ntry
to in
form
sel
ectio
n fo
r IH
R de
sign
atio
n.
Des
igna
te p
oint
s of
ent
ry a
ccor
ding
to th
e re
quire
men
ts o
f IH
R.
Iden
tify
key
rele
vant
sta
keho
lder
s th
at a
re re
late
d to
est
ablis
h ca
paci
ties
at e
ach
desi
gnat
ed p
oint
of e
ntry
.
Iden
tify
com
pete
nt a
utho
ritie
s at
eac
h de
sign
ated
poi
nt o
f ent
ry.
Co
nduc
t rev
iew
of a
ppro
pria
te m
edic
al s
ervi
ces
incl
udin
g di
agno
stic
faci
litie
s fo
r the
pro
mpt
ass
essm
ent a
nd c
are
of s
ick
trave
llers
as
per A
nnex
1B,
1(a
), an
d id
entif
y ga
ps a
nd c
orre
ctiv
e ac
tions
.
Dev
elop
SO
Ps fo
r med
ical
ser
vice
s (id
entifi
catio
n of
dia
gnos
tic fa
cilit
ies
to c
olla
bora
te w
ith c
are
of s
ick
trave
llers
and
refe
rral
).
Trai
n st
aff o
n m
edic
al s
ervi
ces
SOPs
and
ens
ure
the
prov
isio
n of
ade
quat
e re
sour
ces
incl
udin
g sp
ace,
equ
ipm
ent a
nd
prem
ises
as
per A
nnex
1B,
1(a
), 1(
b).
Es
tabl
ish
capa
citie
s at
des
igna
ted
poin
ts o
f ent
ry o
f app
ropr
iate
med
ical
ser
vice
s as
per
IHR
Anne
x 1B
, 1(a
).
Dev
elop
a s
trate
gy to
est
ablis
h al
l the
rout
ine
capa
citie
s pr
escr
ibed
in th
e IH
R An
nex
1B, 1
.
Dev
elop
a s
trate
gy to
inte
grat
e de
sign
ated
poi
nts
of e
ntry
into
nat
iona
l sur
veilla
nce
syst
ems.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op S
OPs
as
per A
nnex
1B,
1 a
nd tr
ain
staf
f of d
esig
nate
d po
ints
of e
ntry
.
Allo
cate
ade
quat
e re
sour
ces
to d
esig
nate
d po
ints
of e
ntry
to e
stab
lish
rout
ine
capa
citie
s fo
r bio
logi
cal h
azar
ds a
t all
desi
gnat
ed p
oint
s of
ent
ry.
Im
plem
ent t
he s
trat
egy
to h
ave
all t
he ro
utin
e ca
paci
ties
pres
crib
ed in
IHR
Anne
x 1B
, in
plac
e an
d fu
nctio
ning
, for
bio
logi
cal
haza
rds.
Im
plem
ent t
he s
trat
egy
with
ade
quat
e re
sour
ces
to in
tegr
ate
desi
gnat
ed p
oint
s of
ent
ry in
to n
atio
nal s
urve
illan
ce s
yste
ms.
WHO BENCHMARKS FOR IHR CAPACITIES
122
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Re
gula
rly tr
ain
staf
f on
guid
elin
es a
nd S
OPs
as
per A
nnex
1B,
1 a
t all
desi
gnat
ed p
oint
s of
ent
ry.
Al
loca
te a
dequ
ate
reso
urce
s to
des
igna
ted
poin
ts o
f ent
ry to
est
ablis
h ro
utin
e ca
paci
ties
for a
ll-ha
zard
pre
vent
ion,
det
ectio
n an
d re
spon
se.
Im
plem
ent t
he s
trat
egy
to h
ave
all r
outin
e ca
paci
ties
pres
crib
ed in
IHR
Anne
x 1B
in p
lace
and
func
tioni
ng, f
or a
ll-ha
zard
s su
ch a
s ac
cess
to a
ppro
pria
te m
edic
al s
ervi
ces
and
tran
spor
tatio
n of
sic
k tr
avel
lers
to a
n ap
prop
riate
med
ical
faci
lity
for
biol
ogic
al, c
hem
ical
and
radi
atio
n su
spec
ted
or c
onfir
med
eve
nts.
In
tegr
ate
desi
gnat
ed p
oint
s of
ent
ry in
to n
atio
nal s
urve
illan
ce s
yste
ms
for a
ll-ha
zard
s w
ith th
e in
volv
emen
t of a
ll re
leva
nt
sect
ors.
D
evel
op a
str
ateg
y fo
r con
tinuo
us im
prov
emen
t and
regu
larly
mon
itor a
nd e
valu
ate
rout
ine
capa
citie
s at
poi
nts
of e
ntry
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Al
loca
te s
usta
inab
le fu
nds
and
mob
ilize
sta
ff fo
r all
key
func
tions
.
Dem
onst
rate
bes
t pra
ctic
es o
f fun
ctio
ning
of a
ll ro
utin
e ca
paci
ties
for a
ll-ha
zard
s an
d di
ssem
inat
e to
key
sta
keho
lder
s.
Doc
umen
t con
tinuo
us im
prov
emen
ts e
ither
thro
ugh
self-
eval
uatio
n or
ext
erna
l eva
luat
ion.
WHO BENCHMARKS FOR IHR CAPACITIES
123
CAPA
CITY
LEVE
L
Benc
hmar
k 16
.2: E
ffec
tive
publ
ic h
ealth
resp
onse
at p
oint
s of
ent
ry
Obj
ectiv
e: S
tren
gthe
n ca
paci
ty fo
r eff
ectiv
e pu
blic
hea
lth re
spon
se a
t poi
nts
of e
ntry
01N
O C
APAC
ITY
Publ
ic h
ealth
em
erge
ncy
cont
inge
ncy
plan
for e
ach
desi
gnat
ed p
oint
of e
ntry
for r
espo
ndin
g to
pub
lic h
ealth
em
erge
ncie
s is
no
t in
plac
e.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y ke
y st
akeh
olde
rs fo
r eac
h de
sign
ated
poi
nt o
f ent
ry fo
r all-
haza
rds.
Re
view
the
stat
us o
f the
em
erge
ncy
resp
onse
pla
n at
eac
h de
sign
ated
poi
nt o
f ent
ry.
D
evel
op a
pub
lic h
ealth
em
erge
ncy
cont
inge
ncy
plan
, incl
udin
g SO
Ps a
nd g
uida
nce
in s
ome
of th
e de
sign
ated
poi
nts
of e
ntry
, pr
iorit
ized
by
volu
me
and
frequ
ency
of i
nter
natio
nal t
raffi
c, p
ublic
hea
lth ri
sks
exis
ting
in a
reas
in w
hich
the
inte
rnat
iona
l tra
ffic
orig
inat
es, o
r thr
ough
whi
ch it
pas
ses,
acc
ordi
ng to
Ann
ex 1
B.2.
Tr
ain
staf
f of a
ll de
sign
ated
poi
nts
of e
ntry
on
guid
ance
and
SO
Ps fo
r res
pond
ing
to a
t lea
st e
vent
s du
e to
bio
logi
cal h
azar
ds.
Al
loca
te re
sour
ces
incl
udin
g fu
nds
to a
ll de
sign
ated
poi
nts
of e
ntry
for i
mpl
emen
tatio
n of
the
plan
dur
ing
the
even
ts.
In
tegr
ate
all d
esig
nate
d po
ints
of e
ntry
into
the
natio
nal e
mer
genc
y pr
epar
edne
ss a
nd re
spon
se p
lan
with
the
invo
lvem
ent o
f re
leva
nt s
ecto
rs a
nd s
ervi
ces.
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
pub
lic h
ealth
em
erge
ncy
cont
inge
ncy
plan
for b
iolo
gica
l haz
ards
in a
ll th
e de
sign
ated
poi
nts
of e
ntry
.
Trai
n st
aff o
f all
desi
gnat
ed p
oint
s of
ent
ry o
n gu
idan
ce a
nd S
OPs
for r
espo
ndin
g to
eve
nts
due
to b
iolo
gica
l haz
ards
.
Allo
cate
reso
urce
s in
clud
ing
fund
s to
all
desi
gnat
ed p
oint
s of
ent
ry fo
r im
plem
enta
tion
of th
e pl
an d
urin
g th
e ev
ents
.
Dem
onst
rate
cap
acity
to a
pply
ad
hoc
mea
sure
s re
late
d to
trav
elle
rs a
t poi
nts
of e
ntry
(suc
h as
med
ical
refe
rral
, tra
nspo
rt)
for e
arly
det
ectio
n, a
sses
smen
t and
saf
e tr
ansf
er o
f sic
k tr
avel
lers
to a
ppro
pria
te m
edic
al fa
cilit
ies
at a
ll de
sign
ated
poi
nts
of e
ntry
.
Inte
grat
e al
l des
igna
ted
poin
ts o
f ent
ry in
to th
e na
tiona
l em
erge
ncy
prep
ared
ness
and
resp
onse
pla
n.
WHO BENCHMARKS FOR IHR CAPACITIES
124
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
pub
lic h
ealth
em
erge
ncy
cont
inge
ncy
plan
for a
ll-ha
zard
s in
all
the
desi
gnat
ed p
oint
s of
ent
ry.
Tr
ain
staf
f of a
ll de
sign
ated
poi
nts
of e
ntry
on
guid
ance
and
SO
Ps fo
r res
pond
ing
to e
vent
s du
e to
any
type
of h
azar
d,
incl
udin
g ca
re o
f affe
cted
ani
mal
s an
d re
ferr
al m
echa
nism
in c
olla
bora
tion
with
the
anim
al s
ecto
r.
Allo
cate
reso
urce
s in
clud
ing
fund
s to
all
desi
gnat
ed p
oint
s of
ent
ry fo
r im
plem
enta
tion
of th
e pl
an d
urin
g th
e ev
ent,
incl
udin
g ca
re o
f affe
cted
ani
mal
s an
d re
ferr
al m
echa
nism
to v
eter
inar
y se
rvic
es.
D
emon
stra
te c
apac
ity to
app
ly re
com
men
ded
mea
sure
s to
dis
infe
ct, d
e-ra
t, di
sins
ect,
deco
ntam
inat
e or
oth
erw
ise
treat
ba
ggag
e, c
argo
, con
tain
ers,
con
veya
nces
, goo
ds a
nd p
osta
l par
cels
.
Regu
larly
mon
itor o
r eva
luat
e th
e ca
paci
ty fo
r pre
pare
dnes
s an
d re
spon
se m
easu
res
at p
oint
s of
ent
ry e
ither
dur
ing
real
ev
ents
or t
hrou
gh s
imul
atio
n ex
erci
ses
and
upda
te th
e co
ntin
genc
y pl
an a
nd re
spon
se m
echa
nism
.
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t afte
r-ac
tion
revi
ew o
r a s
imul
atio
n ex
erci
se to
test
and
revi
ew re
spon
se c
apac
ities
of a
ll de
sign
ated
poi
nts
of e
ntry
.
Doc
umen
t the
resu
lts o
f the
afte
r-ac
tion
revi
ew/s
imul
atio
n ex
erci
se, a
nd d
emon
stra
te a
ctio
n to
add
ress
reco
mm
enda
tions
fo
r im
prov
emen
t.
Upd
ate
the
mec
hani
sms,
gui
danc
e, S
OPs
and
pla
n, b
ased
on
the
findi
ngs
of th
ese
eval
uatio
ns a
nd te
sts.
Sh
are
best
pra
ctic
es fo
r con
tinuo
us im
prov
emen
t with
all
rele
vant
sta
keho
lder
s.
TOO
LS:
As
sess
men
t too
l for
cor
e ca
paci
ty re
quire
men
ts a
t des
igna
ted
airp
orts
, por
ts a
nd g
roun
d cr
ossi
ngs.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
009.
Th
is d
ocum
ent w
as d
evel
oped
to s
uppo
rt S
tate
s Pa
rtie
s in
ass
essi
ng e
xist
ing
capa
citie
s an
d ca
paci
ty n
eeds
at p
oint
s of
ent
ry w
hen
deci
ding
w
hich
airp
orts
, por
ts a
nd g
roun
d cr
ossi
ngs
to d
esig
nate
und
er A
rtic
le 2
0.1
and
Anne
x 1B
. It i
nclu
des
an E
xcel
spr
eads
heet
file
mod
el fo
r IH
R co
re
capa
citie
s as
sess
men
t at p
orts
, airp
orts
and
gro
und
cros
sing
s.
Coor
dina
ted
publ
ic h
ealth
sur
veill
ance
bet
wee
n po
ints
of e
ntry
and
nat
iona
l hea
lth s
urve
illan
ce s
yste
ms:
adv
isin
g pr
inci
ples
. Ist
edi
tion.
Gen
eva:
W
orld
Hea
lth O
rgan
izat
ion;
201
4. T
his
docu
men
t pro
vide
s st
eps
for i
mpl
emen
ting/
stre
ngth
enin
g co
mm
unic
atio
n m
echa
nism
s an
d de
fines
crit
eria
fo
r dec
idin
g w
hat a
nd h
ow e
vent
s sh
ould
be
repo
rted
bet
wee
n po
ints
of e
ntry
and
the
natio
nal h
ealth
sur
veill
ance
sys
tem
.
WHO BENCHMARKS FOR IHR CAPACITIES
125
H
andb
ook
for t
he m
anag
emen
t of p
ublic
hea
lth e
vent
s in
air
tran
spor
t. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
201
5. T
his
docu
men
t is
com
plem
enta
ry to
oth
er W
HO
pub
licat
ions
add
ress
ing
risk
asse
ssm
ent a
t a n
atio
nal l
evel
, con
tinge
ncy
plan
ning
at p
oint
s of
ent
ry, e
stab
lishm
ent
of c
apac
ities
and
app
licat
ion
of e
mer
genc
y pl
ans
at th
e ai
rpor
t lev
el.
H
andb
ook
for m
anag
emen
t of p
ublic
hea
lth e
vent
s on
boa
rd s
hips
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
016.
Thi
s do
cum
ent a
ims
to p
rovi
de
tech
nica
l adv
ice
to c
ompe
tent
aut
horit
ies
at th
e po
rt le
vel f
or m
anag
emen
t of p
ublic
hea
lth e
vent
s on
boa
rd s
hips
. It c
ompl
emen
ts o
ther
WH
O
publ
icat
ions
add
ress
ing
risk
asse
ssm
ent a
t the
nat
iona
l lev
el, c
ontin
genc
y pl
anni
ng a
t por
ts, a
irpor
ts a
nd g
roun
d cr
ossi
ngs,
and
est
ablis
hmen
t of
capa
citie
s an
d ap
plic
atio
n of
em
erge
ncy
plan
s at
the
port
leve
l.
Han
dboo
k fo
r ins
pect
ion
of s
hips
and
issu
ance
of s
hip
sani
tatio
n ce
rtifi
cate
s. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
201
1. T
his
hand
book
is
base
d on
the
IHR
(200
5) p
rovi
sion
s re
gard
ing
ship
insp
ectio
ns a
nd is
sue
of S
hip
Sani
tatio
n Ce
rtifi
cate
s. It
pro
vide
s gu
idan
ce fo
r pre
parin
g an
d pe
rfor
min
g in
spec
tion,
com
plet
ing
the
cert
ifica
tes
and
appl
ying
pub
lic h
ealth
mea
sure
s w
ithin
the
fram
ewor
k of
the
IHR
(200
5).
Ve
ctor
sur
veill
ance
and
con
trol a
t por
ts, a
irpor
ts, a
nd g
roun
d cr
ossi
ngs.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
016.
Thi
s ha
ndbo
ok p
rovi
des
tech
nica
l adv
ice
for d
evel
opin
g a
com
preh
ensi
ve p
rogr
amm
e fo
r sys
tem
atic
mon
itorin
g of
dis
ease
vec
tors
and
inte
grat
ed v
ecto
r con
trol a
t poi
nts
of e
ntry
, bas
ed o
n IH
R re
quire
men
ts.
Eb
ola
publ
icat
ions
: Tra
vel a
nd p
oint
s of
ent
ry. [
WH
O w
ebsi
te] T
echn
ical
gui
danc
e se
t on
Ebol
a vi
rus
dise
ase
prep
ared
ness
and
resp
onse
aim
s to
: (i)
pro
vide
ear
ly d
etec
tion
of p
oten
tially
infe
cted
per
sons
; (ii)
ass
ist i
n im
plem
entin
g W
HO
reco
mm
enda
tions
rela
ted
to E
bola
man
agem
ent;
and
(iii)
prev
ent t
he in
tern
atio
nal s
prea
d of
the
dise
ase
whi
le a
llow
ing
auth
oriti
es to
avo
id u
nnec
essa
ry re
stric
tions
and
del
ays
at p
oint
s of
ent
ry.
G
uide
to s
hip
sani
tatio
n: G
loba
l ref
eren
ce o
n he
alth
requ
irem
ents
for s
hip
cons
truc
tion
and
oper
atio
n. T
hird
edi
tion.
Gen
eva:
Wor
ld H
ealth
O
rgan
izat
ion;
201
1. T
he p
rimar
y ai
m o
f the
revi
sed
guid
e to
shi
p sa
nita
tion
is to
pre
sent
the
publ
ic h
ealth
sig
nific
ance
of s
hips
in te
rms
of d
isea
se
and
to h
ighl
ight
the
impo
rtan
ce o
f app
lyin
g ap
prop
riate
con
trol m
easu
res.
G
uide
to h
ygie
ne a
nd s
anita
tion
in a
viat
ion.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
009.
Thi
s do
cum
ent a
ddre
sses
wat
er, a
nd c
lean
ing
and
disi
nfec
tion
of fa
cilit
ies
with
gui
delin
es th
at p
rovi
de p
roce
dure
s an
d qu
ality
spe
cific
atio
ns th
at a
re to
be
achi
eved
.
Gui
de fo
r pub
lic h
ealth
em
erge
ncy
cont
inge
ncy
plan
ning
at d
esig
nate
d po
ints
of e
ntry
. Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 2
012.
Thi
s gu
ide
was
de
sign
ed to
ass
ist W
HO
Mem
ber S
tate
s, b
oth
larg
e an
d sm
all,
to b
ridge
the
gap
betw
een
the
lega
l req
uire
men
ts o
f IH
R (2
005)
, and
the
prag
mat
ic
read
ines
s an
d re
spon
se c
apac
ity fo
r pub
lic h
ealth
em
erge
ncie
s at
des
igna
ted
poin
ts o
f ent
ry.
WHO BENCHMARKS FOR IHR CAPACITIES
126
CHEM
ICAL
EVE
NTS
17
IMPA
CT:
Tim
ely
dete
ctio
n of
and
effe
ctiv
e re
spon
se to
pot
entia
l che
mic
al ri
sks
and/
or e
vent
s in
col
labo
ratio
n w
ith o
ther
sec
tors
resp
onsi
ble
for c
hem
ical
sa
fety
, indu
strie
s, tr
ansp
orta
tion
and
safe
was
te d
ispo
sal.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: M
echa
nism
s an
d an
ena
blin
g en
viro
nmen
t est
ablis
hed
and
func
tioni
ng fo
r det
ectin
g an
d re
spon
ding
to c
hem
ical
eve
nts
or e
mer
genc
ies.
Stat
es P
artie
s ha
ve in
pla
ce s
urve
illan
ce a
nd re
spon
se c
apac
ity fo
r che
mic
al ri
sks
or e
vent
s. T
his
requ
ires
effe
ctiv
e co
mm
unic
atio
n an
d co
llabo
ratio
n am
ong
the
sect
ors
resp
onsi
ble
for c
hem
ical
saf
ety,
incl
udin
g he
alth
, ind
ustr
y, tr
ansp
orta
tion,
was
te d
ispo
sal,
anim
al h
ealth
and
the
envi
ronm
ent.
WHO BENCHMARKS FOR IHR CAPACITIES
127
CAPA
CITY
LEVE
L
Benc
hmar
k 17
.1: M
echa
nism
s ar
e in
pla
ce fo
r sur
veill
ance
, ale
rt a
nd re
spon
se to
che
mic
al e
vent
s or
em
erge
ncie
s O
bjec
tive:
Est
ablis
h po
licie
s, le
gisl
atio
n, p
lans
and
cap
aciti
es fo
r sur
veill
ance
, ale
rt a
nd re
spon
se to
che
mic
al e
vent
s or
em
erge
ncie
s
01N
O C
APAC
ITY
No
mec
hani
sm to
det
ect a
nd re
spon
d to
che
mic
al e
vent
s, p
oiso
ning
s or
em
erge
ncie
s.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
As
sess
exi
stin
g po
licie
s, le
gisl
atio
n an
d pl
ans
for c
hem
ical
eve
nt s
urve
illanc
e, a
lert
and
resp
onse
.
Dev
elop
a s
trate
gy to
fill
gaps
.
Iden
tify
key
stak
ehol
ders
in a
ll se
ctor
s an
d es
tabl
ish
foca
l poi
nts
for c
oord
inat
ion
and
colla
bora
tion
for c
hem
ical
eve
nt
surv
eilla
nce,
ale
rt an
d re
spon
se.
Id
entif
y an
d de
scrib
e pr
iorit
y ch
emic
al e
vent
s49 to
info
rm p
lann
ing,
a p
roce
ss w
hich
can
incl
ude
cond
uctin
g an
inve
ntor
y of
po
tent
ially
haz
ardo
us c
hem
ical
site
s an
d m
anuf
actu
ring
faci
litie
s an
d a
revi
ew o
f pas
t che
mic
al e
vent
s.
Asse
ss c
apac
ities
for c
hem
ical
eve
nt s
urve
illanc
e, a
lert
and
resp
onse
at a
ll le
vels
(nat
iona
l, sub
natio
nal).
Dev
elop
a s
trate
gy a
nd a
ctio
n pl
an to
incr
ease
cap
aciti
es.
D
evel
op g
uide
lines
and
SO
Ps fo
r sur
veilla
nce,
ale
rt an
d re
spon
se to
che
mic
al e
vent
s an
d em
erge
ncie
s in
clud
ing
for
labo
rato
ries,
and
dev
elop
trai
ning
pac
kage
s on
thes
e gu
idel
ines
and
SO
Ps.
D
evel
op c
apac
ities
for d
iagn
osis
and
trea
tmen
t of c
hem
ical
poi
soni
ngs
and
esta
blis
h a
pois
on in
form
atio
n se
rvic
e th
at
oper
ates
at l
east
dur
ing
offic
e ho
urs.
As
sess
exi
stin
g la
bora
tory
cap
aciti
es fo
r the
ana
lysi
s of
hum
an a
nd e
nviro
nmen
tal s
ampl
es to
info
rm th
e as
sess
men
t and
m
anag
emen
t inv
estig
atio
n of
che
mic
al e
vent
s an
d po
ison
ings
.
49 T
his
proc
ess
can
incl
ude
carr
ying
out
an
inve
ntor
y of
haz
ardo
us c
hem
ical
site
s an
d a
revi
ew o
f pas
t che
mic
al e
vent
s.
WHO BENCHMARKS FOR IHR CAPACITIES
128
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
evel
op a
ll th
e ne
cess
ary
polic
ies
and
legi
slat
ion
for c
hem
ical
eve
nt s
urve
illan
ce, a
lert
and
resp
onse
.
Dev
elop
eve
nt re
spon
se p
lans
at a
ll le
vels
(nat
iona
l, su
bnat
iona
l, lo
cal)
with
the
invo
lvem
ent o
f rel
evan
t sta
keho
lder
s an
d en
sure
the
follo
win
g:
Map
and
revi
ew a
ll ha
zard
ous
site
s an
d fa
cilit
ies
;
Defi
ne ro
les
and
resp
onsi
bilit
ies
of re
leva
nt a
genc
ies
for r
espo
nse
durin
g ev
ents
;
Prep
are
prot
ocol
s fo
r the
inve
stig
atio
n an
d ve
rifica
tion
of c
hem
ical
eve
nts
and
pois
onin
g, in
clud
ing
thro
ugh
labo
rato
ry
test
ing
;
Asse
ss tr
aini
ng n
eeds
and
dev
elop
a tr
aini
ng p
lan
;
Cond
uct t
rain
ing
of p
erso
nnel
at r
elev
ant a
genc
ies
and
faci
litie
s ;
Im
plem
ent S
OPs
for c
oord
inat
ion
and
colla
bora
tion
durin
g ch
emic
al e
vent
s.
Esta
blis
h a
surv
eilla
nce
syst
em b
ased
on
the
abov
e st
rate
gy a
nd g
uide
lines
for s
urve
illan
ce a
nd a
lert
.
Prov
ide
adeq
uate
reso
urce
s to
the
natio
nal p
oiso
n in
form
atio
n se
rvic
e50 to
ope
rate
on
a 24
/7 b
asis
, and
inte
grat
e th
e po
ison
s in
form
atio
n se
rvic
e in
to th
e pu
blic
hea
lth s
urve
illan
ce s
yste
m.
Pu
t in
plac
e ag
reem
ents
with
des
igna
ted
qual
ity a
ssur
ed la
bora
torie
s (n
atio
nal o
r lab
orat
orie
s in
oth
er c
ount
ries)
for t
imel
y an
alys
is o
f bio
logi
cal a
nd e
nviro
nmen
tal s
ampl
es w
ith s
uspe
cted
che
mic
al e
xpos
ure.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Es
tabl
ish
links
with
key
inte
rnat
iona
l che
mic
al/t
oxic
olog
y ne
twor
ks51
for s
uppo
rt in
the
man
agem
ent o
f che
mic
al e
vent
s an
d po
ison
ings
.
Ensu
re a
ll re
leva
nt p
erso
nnel
rece
ive
regu
lar t
rain
ing
on s
urve
illan
ce, a
lert
and
resp
onse
to c
hem
ical
eve
nts
and
pois
onin
gs.
Sh
are
on a
rout
ine
basi
s, in
form
atio
n on
che
mic
al e
vent
s, c
hem
ical
eve
nt ri
sk a
sses
smen
ts a
nd re
spon
se a
ctio
n w
ith
rele
vant
age
ncie
s.
Mon
itor o
n a
rout
ine
basi
s, th
e tim
elin
ess
of th
e in
form
atio
n sh
arin
g m
echa
nism
abo
ut e
vent
s an
d po
tent
ial r
isk.
50 T
he p
oiso
ns c
entre
sho
uld
be s
uffic
ient
ly s
taffe
d an
d re
sour
ced
to p
rovi
de a
robu
st a
nd re
liabl
e 24
/7 s
ervi
ce. T
he p
oiso
ns c
entre
sho
uld
be w
ell u
sed
by th
e po
pula
tion
it se
rves
(che
ck
num
ber o
f cal
ls p
er d
ay).
Refe
r to
Gui
delin
es fo
r poi
sons
con
trol.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 1
997.
51
Exa
mpl
es in
clud
e th
e W
HO
glo
bal a
nd re
gion
al to
xico
logy
net
wor
ks a
nd o
ther
regi
onal
net
wor
ks, s
uch
as in
the
Euro
pean
Uni
on, p
rofe
ssio
nal t
oxic
olog
y as
soci
atio
ns.
WHO BENCHMARKS FOR IHR CAPACITIES
129
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t afte
r-ac
tion
revi
ews
follo
win
g de
tect
ion
and
resp
onse
to c
hem
ical
eve
nts,
or i
n th
e ab
senc
e of
real
eve
nts,
con
duct
ex
erci
ses.
D
ocum
ent a
nd u
se th
e fin
ding
s to
ass
ess,
revi
ew a
nd s
treng
then
sur
veill
ance
, ale
rt a
nd re
spon
se in
clud
ing
coor
dina
tion
and
com
mun
icat
ion.
Al
loca
te a
dequ
ate
reso
urce
s in
clud
ing
fund
s to
poi
son
cent
re(s
).
Dev
elop
a m
echa
nism
to in
tegr
ate
the
syst
ems
of p
ublic
hea
lth s
urve
illan
ce a
nd e
nviro
nmen
tal m
onito
ring
that
cap
ture
s an
d as
sess
es c
hem
ical
exp
osur
es fr
om d
iffer
ent s
ourc
es.
Su
stai
n a
mec
hani
sm to
ens
ure
resp
onse
cap
acity
52 a
t nat
iona
l, su
bnat
iona
l and
loca
l lev
els.
52 T
his
incl
udes
set
ting
min
imum
requ
irem
ents
for:
loca
l em
erge
ncy
plan
ning
and
resp
onse
act
iviti
es (i
.e. a
rran
gem
ents
for s
calin
g up
cap
abili
ties
of lo
cal e
mer
genc
y re
spon
se, n
atio
nal
supp
ort m
echa
nism
s, a
nd in
fras
truc
ture
and
ale
rtin
g m
echa
nism
s); i
nspe
ctio
n of
haz
ardo
us s
ites
and
asse
ssm
ent o
f em
erge
ncy
plan
s; a
nd o
pera
tors
to c
ompl
y an
d lia
ison
with
loca
l go
vern
men
ts (s
ee a
lso:
WH
O m
anua
l: Th
e pu
blic
hea
lth m
anag
emen
t of c
hem
ical
inci
dent
s. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
200
9 (a
cces
sed
30 J
anua
ry 2
019)
).
TOO
LS:
Th
e pu
blic
hea
lth m
anag
emen
t of c
hem
ical
inci
dent
s. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
200
9
Chem
ical
rele
ases
cau
sed
by n
atur
al h
azar
d ev
ents
and
dis
aste
rs: i
nfor
mat
ion
for p
ublic
hea
lth a
utho
ritie
s. G
enev
a: W
orld
Hea
lth O
rgan
izat
ion;
20
18 a
cces
sed
8 O
ctob
er 2
018)
.
Gui
delin
es fo
r poi
sons
con
trol.
Gen
eva:
Wor
ld H
ealth
Org
aniz
atio
n; 1
997.
WHO BENCHMARKS FOR IHR CAPACITIES
130
RADI
ATIO
N E
MER
GEN
CIES
18
IMPA
CT:
Tim
ely
dete
ctio
n an
d ef
fect
ive
resp
onse
to p
oten
tial r
adio
logi
cal e
mer
genc
ies
and
nucl
ear i
ncid
ents
with
cro
ss-s
ecto
ral c
oord
inat
ion.
MO
NIT
ORI
NG
AN
D E
VALU
ATI
ON
: (1
) Mec
hani
sms
esta
blis
hed
and
func
tioni
ng fo
r det
ectin
g an
d re
spon
ding
to ra
diol
ogic
al e
mer
genc
ies.
Stat
es P
artie
s sh
ould
hav
e su
rvei
llanc
e an
d re
spon
se c
apac
ity fo
r rad
iolo
gica
l em
erge
ncie
s an
d nu
clea
r inc
iden
ts. T
his
requ
ires
effe
ctiv
e co
ordi
natio
n am
ong
all s
ecto
rs in
volv
ed in
radi
atio
n em
erge
ncy
prep
ared
ness
and
resp
onse
.
WHO BENCHMARKS FOR IHR CAPACITIES
131
CAPA
CITY
LEVE
L
Benc
hmar
k 18
.1: M
echa
nism
is in
pla
ce fo
r det
ectin
g an
d re
spon
ding
to ra
diol
ogic
al a
nd n
ucle
ar e
mer
genc
ies
emer
genc
ies
Obj
ectiv
e: E
stab
lish
a m
echa
nism
to d
etec
t and
resp
ond
to ra
diol
ogic
al a
nd n
ucle
ar e
mer
genc
ies
01N
O C
APAC
ITY
No
mec
hani
sm (s
uch
as p
olic
ies,
pla
ns a
nd c
oord
inat
ion
proc
ess)
is in
pla
ce fo
r the
det
ectio
n, a
sses
smen
t and
resp
onse
to
radi
atio
n em
erge
ncie
s.
02 LIM
ITED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y ke
y st
akeh
olde
rs a
nd d
esig
nate
foca
l poi
nts
resp
onsi
ble
for r
adia
tion-
rela
ted
haza
rds
and
emer
genc
ies,
esp
ecia
lly
from
radi
atio
n au
thor
ities
and
pub
lic h
ealth
uni
ts.
D
evel
op S
OPs
or p
roto
cols
for c
oord
inat
ion
and
com
mun
icat
ion
with
nat
iona
l aut
horit
ies,
cle
arly
indi
catin
g ro
les
and
resp
onsi
bilit
ies,
incl
udin
g fo
r the
hea
lth m
inis
try a
nd IH
R fo
cal p
oint
s.
Conv
ene
a m
eetin
g w
ith k
ey s
take
hold
ers
to re
view
, ass
ess,
map
and
dev
elop
pol
icie
s, s
trate
gies
and
pla
ns fo
r det
ectio
n,
asse
ssm
ent a
nd re
spon
se to
radi
atio
n em
erge
ncie
s.
Dis
sem
inat
e th
ese
polic
ies,
pla
ns a
nd le
gisl
atio
n fo
r rad
iolo
gica
l eve
nt s
urve
illanc
e, a
lert
and
resp
onse
to re
leva
nt
stak
ehol
ders
.
Cond
uct a
risk
ass
essm
ent f
or ra
diat
ion
haza
rds.
D
evel
op a
radi
atio
n m
onito
ring
mec
hani
sm w
ith re
quire
d SO
Ps a
nd g
uide
lines
, and
est
ablis
h a
mec
hani
sm to
sha
re
info
rmat
ion
amon
g th
e re
leva
nt s
take
hold
ers.
Tr
ain
rele
vant
sta
ff on
thes
e SO
Ps, g
uide
lines
and
info
rmat
ion
shar
ing.
Pr
ocur
e lo
gist
ics
for r
obus
t rad
iatio
n m
onito
ring
syst
ems.
D
esig
nate
or s
ecur
e ac
cess
to la
bora
tory
cap
acity
to m
onito
r, id
entif
y an
d as
sess
exp
osur
e.
WHO BENCHMARKS FOR IHR CAPACITIES
132
03DE
VELO
PED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Id
entif
y ke
y te
chni
cal e
xper
ts fr
om re
leva
nt s
ecto
rs to
dev
elop
tech
nica
l gui
delin
es o
r SO
Ps fo
r the
man
agem
ent o
f rad
iatio
n em
erge
ncie
s (in
clud
ing
risk
asse
ssm
ent,
repo
rtin
g, e
vent
con
firm
atio
n, n
otifi
catio
n an
d in
vest
igat
ion)
.
Dev
elop
trai
ning
pac
kage
(s) o
n th
ese
guid
elin
es/S
OPs
for t
he m
anag
emen
t of r
adia
tion
emer
genc
ies
and
trai
n re
leva
nt s
taff
at le
ast a
t the
nat
iona
l lev
el.
D
evel
op p
olic
ies,
pro
toco
ls a
nd s
trat
egie
s fo
r nat
iona
l and
inte
rnat
iona
l tra
nspo
rt o
f rad
ioac
tive
mat
eria
ls, s
ampl
es a
nd
was
te m
anag
emen
t, an
d en
sure
logi
stic
requ
irem
ents
for t
rans
port
atio
n.
Proc
ure
or e
nsur
e ac
cess
to s
tock
pile
to s
uppo
rt ra
diat
ion
emer
genc
y pr
epar
edne
ss a
nd re
spon
se, a
nd d
evel
op a
di
strib
utio
n pl
an fo
r the
eve
nt o
f an
emer
genc
y.
Dev
elop
gui
delin
es fo
r man
agem
ent o
f rad
iolo
gica
l was
te in
clud
ing
that
from
the
hosp
itals
and
med
ical
ser
vice
s.
Esta
blis
h a
was
te m
anag
emen
t site
with
the
requ
ired
capa
city
for m
onito
ring
it.
Dev
elop
cas
e m
anag
emen
t gui
delin
es to
man
age
case
s of
radi
atio
n em
erge
ncie
s (e
ither
as
a st
and-
alon
e gu
idel
ine
or a
s pa
rt o
f the
cas
e m
anag
emen
t gui
delin
es fo
r all
haza
rds
(refe
r to
Benc
hmar
k 14
.3)).
Id
entif
y he
alth
faci
litie
s th
at c
an m
anag
e pa
tient
s in
the
even
t of a
radi
atio
n em
erge
ncy.
Tr
ain
rele
vant
hea
lthca
re w
orke
rs o
n th
ese
prot
ocol
s an
d gu
idel
ines
.
Dev
elop
a m
echa
nism
for s
yste
mat
ic in
form
atio
n ex
chan
ge b
etw
een
com
pete
nt ra
diol
ogic
al a
utho
ritie
s an
d hu
man
hea
lth
surv
eilla
nce
units
abo
ut ra
diol
ogic
al e
vent
s an
d po
tent
ial r
isks
.
04DE
MON
STRA
TED
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
Co
nduc
t afte
r-ac
tion
revi
ews
or s
imul
atio
n ex
erci
ses
in th
e ab
senc
e of
real
eve
nts
to:
ev
alua
te/t
est t
he g
uide
lines
/SO
Ps (c
ondu
ct jo
intly
with
the
com
pete
nt ra
diat
ion
auth
oriti
es a
nd th
e pu
blic
hea
lth u
nit);
te
st c
oord
inat
ion
and
com
mun
icat
ion
mec
hani
sms
betw
een
rele
vant
nat
iona
l com
pete
nt a
utho
rity
for n
ucle
ar
regu
lato
ry c
ontro
l/saf
ety
and
rele
vant
sec
tors
;
test
cas
e m
anag
emen
t cap
acity
; and
up
date
gui
delin
es/S
OPs
and
coo
rdin
atio
n an
d co
mm
unic
atio
n m
echa
nism
s ba
sed
on th
e fin
ding
s.
Resp
ond
to a
ny ra
diol
ogic
al th
reat
s w
ith jo
int r
isk
asse
ssm
ent,
inve
stig
atio
n an
d im
plem
enta
tion
of th
e re
spon
se p
lan.
En
sure
that
if S
OPs
cal
l for
pre
posi
tioni
ng o
f log
istic
s to
add
ress
a ra
diat
ion
emer
genc
y, di
strib
ute
thes
e lo
gist
ics
in a
ll de
sign
ated
pla
ces
at a
ll tim
es.
Sh
are
info
rmat
ion
with
rele
vant
sta
keho
lder
s re
gula
rly o
n th
e ris
k an
d th
reat
s th
at a
re p
oten
tial f
or e
mer
genc
ies.
WHO BENCHMARKS FOR IHR CAPACITIES
133
05SU
STAI
NAB
LE
CAPA
CITY
ACTI
ON
S TO
ACH
IEVE
TH
IS L
EVEL
:
D
ocum
ent a
nd d
isse
min
ate
best
pra
ctic
es o
f tes
t res
ults
and
revi
ews.
Co
nduc
t reg
ular
trai
ning
of s
taff
of h
ealth
faci
litie
s to
man
age
patie
nts
in th
e ev
ent o
f a ra
diat
ion
emer
genc
y.
Dev
elop
and
con
duct
em
erge
ncy
resp
onse
dril
ls a
nd o
ther
exe
rcis
es o
n ra
diat
ion
emer
genc
y an
d up
date
the
resp
onse
pla
n,
mec
hani
sms
and
guid
elin
es a
ccor
ding
ly.
Su
stai
n a
mec
hani
sm to
ens
ure
resp
onse
cap
acity
at n
atio
nal,
subn
atio
nal a
nd lo
cal l
evel
s.
TOO
LS:
H
ealth
Em
erge
ncy
and
Dis
aste
r Ris
k M
anag
emen
t - R
adia
tion
Emer
genc
ies
D
evel
opm
ent o
f WH
O G
uide
lines
on
Publ
ic H
ealth
Res
pons
e to
Rad
iolo
gica
l and
Nuc
lear
Em
erge
ncie
s (2
012-
2016
)
Med
ical
Rad
iatio
n ex
posu
re
Radi
atio
n Em
erge
ncie
s -
WH
O W
ebpa
ge
Inci
dent
and
Em
erge
ncy
Cent
er –
Inte
rnat
iona
l Ato
mic
Ene
rgy
Agen
cy
Reso
urce
s fro
m In
tern
atio
nal A
tom
ic E
nerg
y Ag
ency
WHO BENCHMARKS FOR IHR CAPACITIES
134
ANNEX 1: GLOSSARY
Biosafety. Laboratory biosafety describes the containment principles, technologies and practices that are implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release.
Biosecurity. Laboratory biosecurity describes the protection, control and accountability for valuable biological materials within laboratories as well as information related to these materials and dual-use research, to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release.
Case. A person who has the particular disease, health disorder or condition that meets the case definitions for surveillance and outbreak investigation purposes. The definition of a case for surveillance and outbreak investigation purpose is not necessarily the same as the ordinary clinical definition (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Case definition. A set of diagnostic criteria that must be fulfilled for an individual to be regarded as a case of a particular disease for surveillance and outbreak investigation purposes. Case definitions can be based on clinical criteria, laboratory criteria or a combination of the two with the elements of time, place and person. (In the IHR, case definitions are published on the WHO website53 for the four diseases for which all cases must be notified by States Parties to WHO, regardless of circumstances, under the IHR as provided in Annex 2.)
Chemical event. A manifestation of a disease or an occurrence, which creates a potential for a disease as a result of exposure to or contamination by a chemical agent.
Cluster. An aggregation of relatively uncommon events or diseases in space and/or time in amounts that are believed or perceived to be greater than that expected by chance (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Communicable disease (infectious disease). An illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal or reservoir to a susceptible host, either directly or indirectly through an intermediate plant or animal host, vector or the inanimate environment (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Competent authority. An authority responsible for the implementation and application of health measures under the IHR.
Note: These terms and definitions have been provided for use within the context of this tool and may differ from those used in other documents. The purpose is to clarify key terms that are NAPHS relevant.
53 http://www.who.int/ihr/survellance_response/case_definitions/en/
WHO BENCHMARKS FOR IHR CAPACITIES
135
Contamination. The presence of an infectious or toxic agent or matter on the body surface of a human or animal, in or on a product prepared for consumption or on other inanimate objects, including conveyances that may constitute a public health risk.
Dangerous pathogens and toxins. These are biological agents and toxins that have the potential to pose a severe threat to both human and animal health. While some select agents are normally found in the environment and don’t cause human disease, many of them – if manipulated or released in large quantities – can cause serious health threats. The informal Australia Group provides a List of human and animal pathogens and toxins for export control (http://www.australiagroup.net/en/human_animal_pathogens.html, accessed 28 August 2016).
Designated laboratories. These are laboratories designated to perform specific laboratory services by national, WHO or other authorities because of their proven capacities and capabilities, such as for AMR testing.
Designated points of entry. These refer to a port, airport and potentially a ground crossing that is designated by a State Party to strengthen, develop and maintain the capacities as per main IHR articles 19, 20 and 21, and as described in Annex 1 of the IHR:
the capacities at all times concerning access to medical services for prompt assessment and care of ill travellers, a safe environment for travellers (e.g. water, food, waste), personnel for inspection and vector control functions; and
the capacities to respond specifically to events that may constitute a public health emergency of international concern.
Disease. An illness or medical condition, irrespective of origin or source, that presents or could present significant harm to humans.
Early warning system. A specific procedure in disease surveillance to detect any abnormal occurrence, or departure from the usual or normally observed frequency of phenomena (such as one case of Ebola fever), as early as possible. An early warning system is only useful if it is linked to mechanisms for early response (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Epidemic. The occurrence in a community or region of cases of an illness, specific health-related behaviours, or other health-related events clearly in excess of normal expectancy. The community or region and the period in which the cases occur are specified precisely. The number of cases indicating the presence of an epidemic varies according to the agent, size and type of population exposed, previous experience or lack of exposure to the disease, and time and place of occurrence (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Event. A manifestation of disease or an occurrence that creates a potential for disease.
Event-based surveillance. The organized and rapid capture of information about events that are a potential risk to public health. This information can be rumours and other ad hoc reports transmitted through formal channels (i.e. established routine reporting systems) and informal channels (i.e. the media, health workers and reports from nongovernmental organizations), including events related to the occurrence of disease in humans and events related to potential human exposure.
WHO BENCHMARKS FOR IHR CAPACITIES
136
Feedback. The regular process of sending analyses and reports about surveillance data back through all levels of the surveillance system so that all participants can be informed of trends and performance.
Field Epidemiology Training Program
FETP Basic Level Training is for local health staff and consists of limited classroom hours interspersed throughout as a three-to-five month on-the-job field assignment to build capacity in conducting timely outbreak detection, public health response and public health surveillance.
FETP Intermediate Level Training is for district/region/state-level epidemiologists, and consists of limited classroom hours interspersed throughout as a six-to-nine month on-the-job mentored field assignment to build capacity in conducting outbreak investigations, planned epidemiologic studies, and public health surveillance analyses and evaluations.
FETP Advanced Level Training is for advanced epidemiologists and consists of limited classroom hours interspersed throughout the 24 months of mentored field assignments to build capacity in outbreak investigations, planned epidemiologic studies, public health surveillance analyses and evaluations, scientific communication, and evidence-based decision making for development of effective public health programming with a national focus. Animal health professionals can be engaged in these FETP trainings.
Functional exercise. A fully simulated interactive exercise that tests the capability of an organization to respond to a simulated event. The exercise tests multiple functions of the organization’s operational plan. It is a coordinated response to a situation in a time pressured realistic situation as described in WHO Simulation Exercise Manual 5. A functional exercise focuses on the coordination, integration and interaction of an organization’s policies, procedures, roles and responsibilities before, during or after the simulated event (WHO Simulation Exercise Manual. HO-WHE-CPI-2017.10 (http://apps.who.int/iris/bitstream/10665/254741/1/WHO-WHE-CPI-2017.10-eng.pdf?ua=1, accessed 13 August 2017).
Ground crossing. A point of land entry into a State Party, including those utilized by road vehicles and trains.
Hazard. The inherent capability of an agent or situation to have an adverse effect; a factor or exposure that may adversely affect health (similar concept to risk factor).
Health care worker. Any employee in a health care facility who has close contact with patients, patient-care areas or patient-care items; also referred to as “health care personnel”.
Health event. Any event relating to the health of an individual, such as the occurrence of a case of a specific disease or syndrome, the administration of a vaccine or an admission to hospital.
Health measure. A procedure applied to prevent the spread of disease or contamination; it does not include law enforcement or security measures.
Incidence. The number of instances of illness commencing, or of persons falling ill, during a given period in a specified population (Prevalence and incidence. WHO Bulletin 1966;35:783-784).
Indicator-based surveillance. The routine reporting of cases of disease, including from notifiable diseases surveillance, sentinel surveillance, laboratory based surveillance. This routine reporting is commonly health care facility based with reporting done on a weekly or monthly basis.
Infection. The entry and development or multiplication of an infectious agent in the body of humans and animals that may constitute a public health risk.
WHO BENCHMARKS FOR IHR CAPACITIES
137
Infectious disease. see Communicable disease.
International Health Regulations (2005) (IHR or the Regulations). This is a legally-binding instrument of international law which has its origin in the International Sanitary Conventions of 1851, concluded in response to increasing concern about the links between international trade and spread of diseases (cross-border health risks).
Legislation. The range of legal, administrative or other governmental instruments that may be available for States Parties to implement the IHR. This includes legally binding instruments, such as state constitutions, laws, acts, decrees, orders, regulations and ordinances; legally non-binding instruments, such as guidelines, standards, operating rules, administrative procedures or rules; and other types of instruments, such as protocols, resolutions and inter-sectoral or inter-ministerial agreements. This encompasses legislation in all sectors, such as health, agriculture, transportation, environment, ports and airports, and at all applicable governmental levels (national, intermediate, local and other).
Logistics. Pharmaceuticals, medical and surgical supplies, medical devices and equipment, and other products needed to support healthcare providers.
Multisectoral. A holistic approach involving the efforts of multiple organizations, institutes and agencies. It encourages interdisciplinary participation, collaboration and coordination of people of concern and resources from these key organizations for promoting health security, to achieve a specific goal.
National legislation. see Legislation.
National IHR Focal Point. The national centre designated by each State Party, which shall be accessible at all times for communications with WHO IHR contact points under the IHR.
Notifiable disease. A disease that, by statutory/legal requirements, must be reported to a public health or other competent authority in the pertinent jurisdiction when the diagnosis is made (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Notification. The processes by which cases or outbreaks are brought to the knowledge of the health authorities. In the context of the IHR, notification is the official communication of a disease/health event to the WHO by the health administration of the Member State affected by the disease/health event.
One Health. Defined by WHO as an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes (http://www.who.int/features/qa/one-health/en/, accessed 28 November 2017)
In the context of the WHO IHR monitoring and evaluation framework, taking a One Health approach means including, from all relevant sectors, national information, expertise, perspectives and experience necessary to conduct assessments, evaluations and reporting for the implementation of the IHR.
Other governmental instruments. Agreements, protocols and resolutions of any government authority or body.
Outbreak. An epidemic limited to localized increase in the incidence of a disease, such as in a village, town or closed institution (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Point of entry. A passage for international entry or exit of travellers, baggage, cargo, containers, conveyances,
WHO BENCHMARKS FOR IHR CAPACITIES
138
goods and postal parcels, and the agencies and areas providing services to them upon entry or exit.
Port. A seaport or a port on an inland body of water where ships on an international voyage arrive or depart.
Public health emergency of international concern (PHEIC). An extraordinary event (as provided in the IHR) that: (i) constitutes a public health risk to other states through the international spread of disease; and (ii) potentially requires a coordinated international response.
Public health risk. The likelihood of an event that may adversely affect the health of human populations, with an emphasis on whether it may spread internationally or present a serious and direct danger.
Rapid response team. A group of trained individuals that is ready to respond quickly to an event. The composition and terms of reference are determined by the concerned country.
Readiness. It is the ability to quickly and appropriately respond when required to any emergencies.
Regulations or administrative requirements. All regulations, procedures, rules and standards.
Relevant sectors. Private and public sectors: such as all levels of the health care system (national, subnational and community/primary public health); NGOs; ministries of agriculture (zoonosis, veterinary laboratory), transport (transport policy, civil aviation, ports and maritime transport), trade and/or industry (food safety and quality control), foreign trade (consumer protection, control of compulsory standard enforcement), communication, defence, treasury or finance (customs), environment, interior, health, tourism; the home office; media; and regulatory bodies.
Risk communication. For public health emergencies includes the range of communication capacities required through the preparedness, response and recovery phases of a serious public health event to encourage informed decision making, positive behaviour change and the maintenance of trust.
Surveillance. The systematic ongoing collection, collation and analysis of data for public health purposes and the timely dissemination of public health information for assessment and public health response, as necessary.
Syndrome. A symptom complex in which the symptoms and/or signs coexist more frequently than would be expected by chance independently (adapted from Last JM, Spasoff RA, Harris, editors. A dictionary of epidemiology, fourth edition. International Epidemiological Association, Inc. New York: Oxford University Press; 2001).
Table top exercise. A facilitated discussion of an emergency situation, generally in an informal, low-stress environment. It is designed to elicit constructive discussion between participants; to identify and resolve problems; and to refine existing operational plans. This is the only type of simulation exercise that does not require an existing response plan in place. (WHO Simulation Exercise Manual. HO-WHE-CPI-2017.10 (http://apps.who.int/iris/bitstream/10665/254741/1/WHO-WHE-CPI-2017.10-eng.pdf?ua=1, accessed 30 November 2017).
Trained staff. Individuals that have educational credentials and/or received specific instruction that is applicable to a task or situation.
Vector. An insect or other animal that normally transports an infectious agent that constitutes a public health risk.
Verification. The provision of information by a State Party to WHO confirming the status of an event within the territory or territories of that State Party.
WHO BENCHMARKS FOR IHR CAPACITIES
139
WHO IHR contact point. The unit within WHO that is accessible at all times for communications with the National IHR Focal Point.
Zoonotic diseases (or zoonoses). Any infection or infectious disease that is naturally transmissible from vertebrate animals to humans (http://www.who.int/topics/zoonoses/en, accessed 28 November 2017).
Zoonotic event. A manifestation of a disease in animals that creates a potential for a disease in humans as a result of human exposure to the animal source.
WHO BENCHMARKS FOR IHR CAPACITIES
140