Mr. Nicolas Isla, WHO EURO, at One Health Security Conference, 14-15 Oct 2019, THL, Helsinki

1. Photo: WHO/C. Haskew
Action Plan to Improve Public Health
Preparedness and Response in the WHO
European Region
One Health Security Conference
14-15 October
Nicolas Isla
WHO European Regional Office

2. The European Region is vulnerable
to health threats
• Measles epidemics
• Outbreaks of West Nile Virus (WNV)
and Crimean-Congo haemorrhagic
fever (CCHF)
• Natural disasters (earthquakes,
floods, forest fires, landslides)
• Man-made disasters (chemical or
radiation leaks)
• Armed conflicts and spill over from
neighbouring emergencies

3. Health emergencies affect
lives and livelihoods
In a typical year, Europe
suffers economic losses of €
10 billion* from disasters and
emergencies, and hundreds
of people die or become
severely ill
March 2018.
* Estimate quoted in EFDRR. High-Level Dialogue Communiqué from 2017. European Forum for Disaster Risk
Reduction, Istanbul, 26–28 March 2017.

4. The cost of epidemics
Source: Global Preparedness Monitoring Board Annual Report

5. Health emergency preparedness:
a “best buy” health investment
• Many emergencies are
preventable, or can be mitigated
• Well-prepared countries see
fewer deaths and less disruption
Analysis by WHO shows $ 1 spent on health
emergency capacity produces a return of $ 8.30*
*WHO. A Healthier Humanity: The WHO Investment Case for 2019–2023, pp. 24–28. Geneva: World Health
Organization; 2018.

6. 2014-
2015
Ebola outbreak in
West Africa
May
2016
Global implementation plan
for the recommendations of
the Review Committee on
the Role of the IHR during
the EVD outbreak discussed
at WHA69
May
2018
WHA71 agrees a five-year
Global Strategic Plan and
Member States of the WHO
European Region recommend
to development of a Regional
Action plan
Sept
2018
Resolution on Regional
Action Plan adopted at
68th session of the
Regional Committee,
Rome, Italy
Action Plan to Improve Public Health Preparedness and
Response in the WHO European Region
Development timeline
Feb
2019
Ministerial consultation
and high-level technical
meeting for the
implementation of the
action plan, Istanbul,
Turkey

7. Public health needs to
be protected across
the whole health
emergency cycle
Guiding Principles

8. Robust, resilient and
responsive health systems
must include adequate
capacities to manage all public
health hazards according to
the IHR (2005), and provide
comprehensive and effective
life saving operations in public
health emergencies
STRENGTHENED
HEALTH SYSTEMS
UNIVERSAL HEALTH
COVERAGE
HEALTH
SECURITY
AND IHR

9. Focus on priority countries
Albania
Bosnia & Herzegovina
North Macedonia
Republic of Moldova
Serbia (including
Kosovo1)
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
Tajikistan
Uzbekistan
Turkey
Ukraine
1All references to Kosovo in this document should be understood to be in the context of United Nations Security Council resolution 1244 (1999)

10. Focus on IHR
1. Protect lives and livelihoods
2. Preparedness has proven return on
investment
3. Shows leadership & commitment
4. Contributes to mutual accountability

11. Building on Regional
partnerships and
Intersectoral collaboration
All-hazard & One Health
approach

12. Transportation
Complexity of health security
Border
control
Food &
water
safety
Industry
Interior
affairs
Trade
Foreign
affairs
EnvironmentAgriculture
Radionuclear
Chemical
Veterinary
Aviation
Emergency
management
Public health
Ports and
maritime

13. Regional Action plan: Vision and Goal
VISION A WHO European Region where the impact of
health emergencies is prevented or minimized
GOAL Strengthen and maintain adequate capacities in
the European Region to effectively prevent,
prepare for, detect and respond to public health
threats and to provide assistance to affected
countries, when necessary, through three
strategic pillars

14. Strategic Pillar 1
To build, strengthen and maintain States Parties’ core capacities required under the
IHR (2005)

15. Strategic Pillar 2
To strengthen event management and compliance with the requirements
under the IHR (2005)

16. Strategic Pillar 3
To measure progress and promote accountability

17. • Countries prepared for health
emergencies
• Epidemics & pandemics prevented
• Health emergencies rapidly
detected & responded to
• Improved access to quality essential health services
• Reduced number of people suffering financial
hardships
• Improved access to essential medicines, vaccines,
diagnostics and devices for primary healthcare
• Determinants of health addressed
• Risk factors reduced through
multisectoral action
• Health setting and Health-in-All policies
WHO General Programme of Work
2019-2023
Regional Action plan as the vehicle for
the implementation of Strategic
Priority 2 of the GPW13

18. CURRENT STATUS OF PREPAREDNESS IN
THE WHO EUROPEAN REGION

19. Three weakest capacities
– average values
• Points of Entry
• Chemical events
• Risk communication
IHR Monitoring and Evaluation Framework
State Party Annual Reporting 2018
93 %
3 %4 %
SPAR 2018
Submitted
Submitted other
format
Not submitted

20. IHR Monitoring and Evaluation Framework –
Status on voluntary activities
Joint External Evaluation (JEE)
After Action Review (AAR)
Simulation Exercises
• Albania, 2016
• Armenia, 2016
• Belgium, 2017
• Finland, 2017
• Kyrgyzstan, 2016
• Latvia, 2017
• Liechtenstein, 2017
• Slovenia, 2017
• Switzerland, 2017
• Turkmenistan, 2016
• Republic of Moldova, 2018
• Serbia, 2018
• Lithuania, 2018
• North Macedonia, 2019
• Montenegro, 2019
• Georgia, 2019
• Iceland, 2016, 2019
• Romania, 2018
• Serbia, 2019
• Kyrgyzstan, 2019
• Iceland, 2016, 2019
• Kazakhstan, 2018
• Romania, 2018
• Jade2018
• Kyrgyzstan, 2019
• Tajikistan, 2019
• Turkmenistan, 2016, 2017
AAR and SimEx that WHO has been involved in or have been reported as part of the IHRMEF activities

21. • Surveillance: establish an
electronic reporting and
surveillance data management
system (12 MS)
• Immunization: improve
reporting and data
management on immunization
effort (11 MS)
• Medical countermeasures:
develop and formalize
deployment protocols (11 MS)
Top most common JEE recommendations

22. Joint Assessment & Detection of Events (JADE)
Exercise JADE is a regional functional
simulation exercise involving a disease outbreak
and its consequences requiring multisectoral
coordination.
To practice National IHR Focal Points’
assessment of public health events and
communication between Member States and
the WHO Regional Contact Point.
Exercise JADE will be held November 2019
with invites to all 55 State Parties of the
EURO Region.

23. Key achievements in 2019
• Mass Casualty Incident Management training developed and
delivered in 2 countries
• Legal Epidemiology project mapping IHR legislation conducted in 3
countries
• Operationalizing Emergency Preparedness training in 13 priority
countries
• Strategic Risk Prioritization in 7 countries
• 12 hospital assessed using the Hospital Safety Index in 2 countries
• Training for the Assessment tool for core capacity requirements at
designated airports, ports and ground crossings delivered for 14
countries
• Emergency operations planning initiated in 4 countries.

24. IHR-PVS National Bridging Working
• Sharing of information: Discussion around case studies
and sharing of IHR and PVS results
• Diagnosis: Identification of strengths and weaknesses in
the intersectoral collaboration
• Strategic planning: road-map of joint activities to
implement to improve intersectoral collaboration
Promotion of ‘One Health approaches’ and
strengthening of collaboration between sectors
6 NBWS conducted in the WHO European Region

25. Graded emergencies in
Europe
G3 - Armed conflict in Syria / Refugee
response in Turkey
P2 - Armed conflict in Eastern Ukraine
G2 – Measles resurgence in Europe

26. Outbreaks and emergency response
50 graded emergencies in 47 countries and
territories

27. All 53 Member States in the WHO
European Region are exposed to complex
public health risks driven by a wide variety
of interrelated factors.
“The world is not prepared for the
next global pandemic” Global Preparedness
Monitoring Board (GPMB) Report, September 2019

28. SEVEN URGENT ACTIONS TO PREPARE THE
WORLD FOR HEALTH EMERGENCIES
1. Heads of government must commit and invest
2. Countries and regional organizations must lead by example
3. All countries must build strong systems
4. Countries, donors and multilateral institutions must be prepared for
the worst
5. Financing institutions must link preparedness with financial risk
planning
6. Development assistance funders must create incentives and
increase funding for preparedness
7. The United Nations must strengthen coordination mechanisms

29. THANK YOU!