Update on the emergencies in the Eastern Mediterranean Region

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
31 2 1 21
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. Achieving
universal health
coverage
Promoting
healthier
populations
Addressing
health
emergencies
Thirteenth Global Programme of Work 2019-
23

6. 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

7. Guiding principles
 Country focused — support to countries for
greater impact
 Partnership & collective action
 Multisectoral and interdisciplinary approach
 Vulnerability-sensitive – gender, age, ethnicity,
disabled
 Evidence- and knowledge-based programming
 Humanitarian principles – humanity,
impartiality, neutrality and independence

8. 8
Recent progress in
implementation

9. Prevention – High-threat pathogens
9
 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

10. 10

11. 11

12. 12

13. 13
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

14. 14
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

15. All-hazards emergency preparedness
15
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

16. 16
Detection of public health events
 Detection and monitoring of public
health events that could pose a risk
– 2065 signals; 80 verification
– rapid risk assessment: 15
 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

17. 17
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

18. 18
Response: strengthening emergency
management
 Best practice –
incident
management
system
 Strengthening
emergency
operations centres
 Advancing the
science and
practice of
emergency
management

19. 19
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

20. Responding to protracted emergencies:
a new way of working
20
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

21. 21
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
 0.13% cholera CFR
 > 85% cure rate for severe
acute malnutrition
 1.1 consultations/person/yr

22. 22
The Dubai Hub: a global asset
 14 000m2 temperature-
controlled space
 Strategic forecasting to
enhance preparedness
 Rapid response and large
volumes
 Medical supplies to 24
countries across 3 WHO
regions

23. 23
Other programmes and areas of activity
Recover
y
Mass
gatherings
Migrant health
Attacks on health care
facilities and
personnel

24. Conclusion and requests
24
We urge Member States to:
 invest in domestic capacities
–NAPHS IHR (2005)
–All-hazards emergency preparedness
 identify, report and declare outbreaks early
 facilitate field operations by WHO and partners
 preserve the right to health of all, especially the most
vulnerable
Despite the enormous needs and risks,
emergency management and its impact
across the Region have improved
But we need to do more!

25. 25
Thank you