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Strengthening public health
readiness for mass gatherings in the
Eastern Mediterranean Region
Dr Dalia Samhouri
Programme Area Manager, Emergency Preparedness
and International Health Regulations
11 October 2023
Types
• Concentration of people with potential to strain
resources
• Planned, spontaneous
• Seasonal, once in a lifetime
Diverse experiences
• Religious, sports, cultural
• Routine and emergency situations
Obligations under International Health Regulations
2005 (IHR)
• Control potential public health threats posed by
mass gatherings and prevent cross-border spread
of disease
What is a mass gathering?
Mass gatherings are associated with threats
They can lead to urgent and complex health situations
Public health Environmental Psychological Individual Management
• 53% infectious
diseases
(obstructive
pulmonary
disease)
• 24% NCDs and
injuries
• 10% traumatic
injuries
• 267 admitted
due to heat
stroke in Hajj
• 56% of mass
casualties from
crowd
movement
• 769 deaths and
934 injuries due
to stampedes in
Hajj
• Literacy and
awareness of
risks and
prevention
(chronic diseases,
gender, old age)
• Limited personnel
and planning
• Deliberate events
(mass shooting,
explosions)
Enhanced health system
capacities
Accelerated IHR implementation
1
2
Generated legacy for evidence
base and country support
Increased awareness of risks and
preventive measures
3
4
4
Mass gatherings create opportunities for success
No reported disease outbreaks
5
▪ Multisectoral coordination
▪ Risk-based approach
▪ Operational plans
▪ Risk communication and infodemics
▪ Early warning and contact tracing
▪ Surveillance and health information system
▪ Documentation
But they are still surrounded by many challenges…
WHO support for mass gatherings
▪ Risk assessment
▪ Building capacities of workforce
▪ Use of public health emergency operation centre
▪ Mass causality management and simulation exercises
▪ Developing tools and guidance
▪ After Action Reviews and legacy generation
▪ WHO Collaborating Centre in Saudi Arabia advancing
evidence-based knowledge
Examples include support for Ramadan and Eid during COVID-19, the Hajj in Saudi
Arabia, Ashura and Arba’een in Iraq, COP27 in Egypt, Dubai Expo 2020 in United
Arab Emirates, 2021 FIFA Arab Cup and 2022 FIFA World Cup in Qatar
 Hajj: travel advice, application of digital
tools
 Arba’een: trained medical teams and
community engagement
 FIFA tournaments: primary health care-
based model of care, emergency
operations centre, multi-hazard bank of
messages
 EXPO 2020: multisectoral coordination
cells and committees and risk assessment
 COP27: multisectoral coordination cells
and committees and triage plans
 Islamic Republic of Iran and Iraq: Cross-
border collaboration
Great examples adopted during mass gatherings
Regional framework to enhance readiness for mass
gatherings
To guide countries to establish institutional
arrangements and capacities to safely host mass
gatherings
Consultation with countries, literature review,
After Action Review reports, country missions
Sharing of expertise by WHO collaborating
centres for mass gatherings
Guiding
principles
Guiding
principles
Health system strengthening Multisectoral coordination Partnerships Planning and preparation
Gender, rights and equity
• Early warning
• Service provision
• Digital applications
• Risk assessment
• Risk mitigation plans
Five strategic objectives and areas of work
Strategic
objectives
Establish
standardized
approach to risk
assessment
Strengthen public health
and health system capacity
Improve multisectoral
coordination
• Stakeholder mapping
• Incident management
system and public
health emergency
operation centres
(PHEOCs)
Establish cross-
border
collaboration
• Joint activities
• Points of entry
• Travel advice
• Research priorities
• Documentation
Develop public health
research agenda
8
To move forward, we invite the Regional Committee to
endorse the Framework and adopt the related resolution
WHO Regional Director
Member States
• Multisectoral risk assessment
and planning
• Integrated public health and
health system capacity
• Capacity-building programmes
• International collaboration
• Research agenda
• Operational plans
• Technical support
• Evidence and legacy
generation
• Resource mobilization
• Cross-border collaboration
Much is already in place.
Let us join forces for enhanced
readiness to mitigate the risks and
ensure safer mass gatherings
Thank you

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Strengthening public health readiness for mass gatherings in the Eastern Mediterranean Region

  • 1. Strengthening public health readiness for mass gatherings in the Eastern Mediterranean Region Dr Dalia Samhouri Programme Area Manager, Emergency Preparedness and International Health Regulations 11 October 2023
  • 2. Types • Concentration of people with potential to strain resources • Planned, spontaneous • Seasonal, once in a lifetime Diverse experiences • Religious, sports, cultural • Routine and emergency situations Obligations under International Health Regulations 2005 (IHR) • Control potential public health threats posed by mass gatherings and prevent cross-border spread of disease What is a mass gathering?
  • 3. Mass gatherings are associated with threats They can lead to urgent and complex health situations Public health Environmental Psychological Individual Management • 53% infectious diseases (obstructive pulmonary disease) • 24% NCDs and injuries • 10% traumatic injuries • 267 admitted due to heat stroke in Hajj • 56% of mass casualties from crowd movement • 769 deaths and 934 injuries due to stampedes in Hajj • Literacy and awareness of risks and prevention (chronic diseases, gender, old age) • Limited personnel and planning • Deliberate events (mass shooting, explosions)
  • 4. Enhanced health system capacities Accelerated IHR implementation 1 2 Generated legacy for evidence base and country support Increased awareness of risks and preventive measures 3 4 4 Mass gatherings create opportunities for success No reported disease outbreaks
  • 5. 5 ▪ Multisectoral coordination ▪ Risk-based approach ▪ Operational plans ▪ Risk communication and infodemics ▪ Early warning and contact tracing ▪ Surveillance and health information system ▪ Documentation But they are still surrounded by many challenges…
  • 6. WHO support for mass gatherings ▪ Risk assessment ▪ Building capacities of workforce ▪ Use of public health emergency operation centre ▪ Mass causality management and simulation exercises ▪ Developing tools and guidance ▪ After Action Reviews and legacy generation ▪ WHO Collaborating Centre in Saudi Arabia advancing evidence-based knowledge Examples include support for Ramadan and Eid during COVID-19, the Hajj in Saudi Arabia, Ashura and Arba’een in Iraq, COP27 in Egypt, Dubai Expo 2020 in United Arab Emirates, 2021 FIFA Arab Cup and 2022 FIFA World Cup in Qatar
  • 7.  Hajj: travel advice, application of digital tools  Arba’een: trained medical teams and community engagement  FIFA tournaments: primary health care- based model of care, emergency operations centre, multi-hazard bank of messages  EXPO 2020: multisectoral coordination cells and committees and risk assessment  COP27: multisectoral coordination cells and committees and triage plans  Islamic Republic of Iran and Iraq: Cross- border collaboration Great examples adopted during mass gatherings
  • 8. Regional framework to enhance readiness for mass gatherings To guide countries to establish institutional arrangements and capacities to safely host mass gatherings Consultation with countries, literature review, After Action Review reports, country missions Sharing of expertise by WHO collaborating centres for mass gatherings
  • 9. Guiding principles Guiding principles Health system strengthening Multisectoral coordination Partnerships Planning and preparation Gender, rights and equity
  • 10. • Early warning • Service provision • Digital applications • Risk assessment • Risk mitigation plans Five strategic objectives and areas of work Strategic objectives Establish standardized approach to risk assessment Strengthen public health and health system capacity Improve multisectoral coordination • Stakeholder mapping • Incident management system and public health emergency operation centres (PHEOCs) Establish cross- border collaboration • Joint activities • Points of entry • Travel advice • Research priorities • Documentation Develop public health research agenda
  • 11. 8 To move forward, we invite the Regional Committee to endorse the Framework and adopt the related resolution WHO Regional Director Member States • Multisectoral risk assessment and planning • Integrated public health and health system capacity • Capacity-building programmes • International collaboration • Research agenda • Operational plans • Technical support • Evidence and legacy generation • Resource mobilization • Cross-border collaboration
  • 12. Much is already in place. Let us join forces for enhanced readiness to mitigate the risks and ensure safer mass gatherings