1. Tehran,
Islamic Republic of Iran
14 –17 October 2019
Richard Brennan, Director (acting),
Health Emergencies Programme
Update on emergencies in the Eastern
Mediterranean Region
2. DISEASE OUTBREAKS
19 major disease outbreaks in
2018
MERS – case fatality rate
34.5%
Cholera – world’s largest
outbreak
HIV, arboviruses, zoonoses,
typhoid, etc.
2
Enormous scale of needs and risks
CONFLICT & FRAGILITY
70 million people need
humanitarian assistance
(53.3% of global total)
10 countries (45% of countries
in Region) classified as FCV
by World Bank
REFUGEES & INTERNALLY
DISPLACED PEOPLE
24.1 million people forcibly
displaced (34.1% of global
total)
Sources: OCHA, UNHCR, World
Bank, WHO
NATURAL DISASTERS
Floods – Islamic Republic of
Iran, Sudan
Drought – Afghanistan,
Pakistan
Earthquake – Islamic Republic
of Iran, Iraq
Storms – Yemen
3. WEEKLY SIGNALS AND EVENTS TOTAL NUMBER OF GRADED
EMERGENCIES
39 1 1 18
3
Grade 3
8
Grade 2
2
Grade 1
15
Signals
Detected
Signal
Followed-
up
New
Events
Ongoing
Events
0
Protracte
d 3
2
Protracte
d 2
0
Protracte
d 1
Total number
of graded
emergencies
and events
4. 4
… and it’s not getting any better
Climate
change
Emerging
diseases
State
fragility
Travel
Demographic
shifts
Urbanization
Terrorism Migration
5. Detection
Comprehensive emergency management
approach
Detection Strengthen country and WHO
capacities in health emergency
preparedness – IHR (2005) and all
hazards
Detect emergencies rapidly and
respond effectively
PROGRAMME OBJECTIVES
Prevent and prepare for the
emergence of high-threat pathogens
6. Guiding principles
Country focused — support to countries for
greater impact
Partnership
Multisectoral and interdisciplinary approach
Vulnerability-sensitive – gender, age, ethnicity,
disabled
Evidence- and knowledge-based programming
Humanitarian principles – humanity,
impartiality, neutrality and independence
8. Prevention – High-threat pathogens
8
8.3 million
vaccinated in Sudan
Generating the
evidence base
Epidemiological
and laboratory
studies on
incidence and
severity of
emerging and
epidemic-prone
infectious
diseases, e.g.
CCHF, dengue,
chikungunya,
cholera,
influenza
> 80% of countries with functioning
influenza surveillance
> 100% increase in positive
seasonal influenza viruses shared
improved global influenza vaccine
selection
Millions vaccinated
in Somalia and
Yemen
12. 12
Preparedness – major gaps
GAPS IN PREVENTION, DETECTION AND RESPONSE
IHR (2005) capacities; health
workforce; governance;
community
National level
Regional level
International level
Regional capacities for
response and coordination
IHR (2005) monitoring; WHO
capacities; system-wide
capacities for a collective
response
13. 13
Preparedness – IHR (2005) core capacities
Joint External Evaluation = 18
countries
— Generating the evidence base
National Action Plan for Health
Security = 17 countries
Simulations = 6 at country level and 2
at regional level
After-action reviews = 3 countries
14. All-hazards emergency preparedness
14
4
Risk profiling
In 14 countries.
Remaining countries: Djibouti, Egypt, Iraq, Jordan, Libya, Palestine,
Somalia, Syrian Arab Republic
In 12 countries.
Remaining countries: Djibouti, Iran (Islamic Republic of), Iraq, Libya,
Morocco, Pakistan, Syrian Arab Republic, Somalia, Tunisia, Yemen
Emergency planning
In 7 countries: Egypt, Jordan, Iran (Islamic Republic of), Pakistan,
Qatar, Sudan, Tunisia
Emergency care assessment
system/hospital safety
In 22 countries: rapid response teams
Emergency medical team awareness raising and development
Emergency rapid response
teams/emergency medical
teams
Five-year regional strategic plan to improve all-hazards public
health preparedness and response
Regional plan
Operationalization of Sendai Framework for health sector and
development of disaster reduction plans
Sendai Framework
15. 15
Detection of public health events
Detection and monitoring of public
health events that could pose a risk
– new events: 44
– rapid risk assessment: 17
Contribute to the global
Epidemic Intelligence from
Open Sources (EIOS) system
7 countries with Early Warning
Alert and Response Network
(EWARN) system for
humanitarian emergencies
16. 16
Improving information management
Standardizing indicators
– reporting on rates,
trends, standards and
targets
Geographical information
systems – capacity-building
and training of trainers
Health resource availability
mapping
17. 17
Response: strengthening emergency
management
Best practice –
incident
management
system
Strengthening
emergency
operations centres
Advancing the
science and
practice of
emergency
management
18. 18
Response: acute emergencies
Iranian floods – Grade 2
Rapid deployment of emergency
kits
Contribution to rapid assessment
Libya conflict – Grade 2
Trauma; NCDs; Interagency
Emergency Health Kit
732 surgeries; mobile medical
teams
Pakistan HIV – Grade 2
Rapid surge team
Investigation; technical support;
resources
19. Responding to protracted emergencies:
a new way of working
19
Define collective outcomes
Life-saving
assistance and
protection
Integration into
the national
health system
UHC and
resilience: health
system
strengthening
and
preparedness
‘Joined Up’
Programming
Humanitarian Development
Joint analysis Joint planning
20. 20
Response: achieving impact in protracted
emergencies
Syrian Arab Republic – 13 million
in need
1.1 consultations/person/year
Polio outbreak stopped
Palestine – 2.5 million in need
1700 lives saved – trauma
> 95% facility-based
deliveries
Yemen – 22.2 million in
need
0.27% cholera case fatality
rate
> 85% cure rate for severe
acute malnutrition
21. 21
The Dubai Hub: a game changer
14 000m2 temperature-
controlled space
Rapid response and large
volumes
Medical supplies to 24
countries across three WHO
regions
Strategic forecasting to
enhance preparedness
Supply chain dashboard
22. 22
Other programmes and areas of activity
Recover
y
Mass
gatherings
Migrant health
Attacks on health care
facilities and
personnel
23. Conclusion and requests
23
We urge Member States to:
invest in domestic capacities
–IHR (2005)
–All-hazards emergency preparedness
identify, report and declare outbreaks early
contribute to WHO surveillance and information
products
facilitate field operations by WHO and partners.
Despite the enormous needs and risks,
emergency management and its impact
across the Region have improved
But we need to do more!