JOINT EXTERNAL EVALUATION TOOL - extranet.who.int · INTERNATIONAL EALT REULATIONS 2005 7 - Joint...

JOINT EXTERNAL EVALUATION TOOL

SECOND EDITION - January 2018

TECHNICAL FRAMEWORK IN SUPPORT TO IHR (2005) MONITORING AND EVALUATION

INTERNATIONAL HEALTH REGULATIONS (2005)

JOINT EXTERNAL EVALUATION TOOL

SECOND EDITION - January 2018

TECHNICAL FRAMEWORK IN SUPPORT TO IHR (2005) MONITORING AND EVALUATION

© World Health Organization 2018

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Design: crayonbleu - France

Joint external evaluation tool: International Health Regulations (2005), second editionISBN 978-92-4-155022-2

CONTENTSAbbreviations 6Background 7

International Health Regulations (2005) 7The IHR Review Committee on Second Extensions 7Technical Framework for IHR Monitoring and Evaluation post 2016 7Voluntary Joint External Evaluation (JEE) 7Revision of the JEE tool 8Purpose of the JEE 9The JEE process 9The JEE format 10Colour scoring system 10Contextual questions 10Technical questions 10

COUNTRY EVALUATION TOOL 11 PREVENT 13

National legislation, policy and financing 13IHR coordination, communication and advocacy 19Antimicrobial resistance 22Zoonotic disease 30Food safety 34Biosafety and biosecurity 38Immunization 45

DETECT 49 National laboratory system 49Surveillance 56Reporting 60Human resources 63

RESPOND 70 Emergency preparedness 70Emergency response operations 75Linking public health and security authorities 80Medical countermeasures and personnel deployment 85Risk communication 88

IHR RELATED HAZARDS AND POINTS OF ENTRY 95 Points of entry 95Chemical events 99Radiation emergencies 104

Appendix 1: Glossary 109Appendix 2: Summary of changes between JEE tool first and second editions 114


6 - Joint External Evaluation Tool - Second edition

AMR Antimicrobial resistanceBTWC Biological and Toxin Weapons ConventionCLSI Clinical and Laboratory Standards InstituteCPE Continuing Professional EducationEBS Event-based surveillanceEMT Emergency Medical TeamEOC Emergency Operations CentreEQA External Quality AssessmentEUCAST European Committee on Antimicrobial Susceptibility TestingFAO Food and Agriculture OrganizationFETP Field Epidemiology Training ProgrammeGAP Global Action PlanGHSA Global Health Security AgendaGLASS Global Antimicrobial Resistance Surveillance SystemGOARN Global Outbreak Alert and Response NetworkHAI Healthcare-associated infectionsHIV Human Immunodeficiency VirusIAEA International Atomic Energy Agency IBS Indicator-based surveillanceIHR International Health RegulationsINFOSAN International Food Safety Authorities NetworkINTERPOL International Criminal Police OrganizationISO International Organization for StandardizationIT Information TechnologyJEE Joint External EvaluationMCV Measles-containing vaccineMoU Memorandum of understandingNAPHS National Action Plan for Health Security NCC National Coordinating CentreNGO Non-governmental OrganizationNSHSP National Strategic Health Sector PlanOIE World Organisation for Animal HealthOPCW Organisation for the Prohibition of Chemical WeaponsPCR Polymerase Chain ReactionPHEIC Public Health Emergency of International ConcernPoE Points of EntryPVS Performance of Veterinary ServicesQMS Quality Management SystemSAICM Strategic Approach to International Chemicals Management SOP Standard Operating ProcedureVPDs Vaccine-preventable diseasesWAHIS World Animal Health Information SystemWASH water, sanitation and hygieneWHA World Health AssemblyWHO World Health Organization

ABBREVIATIONS



BACKGROUNDwas further echoed by the Review Committee on the Role of the IHR in the Ebola Outbreak and Res-ponse in its fifth recommendation to “introduce and promote external assessment of core capacities”.

TECHNICAL FRAMEWORK FOR IHR MONITORING AND EVALUATION POST 2016 Based on IHR Review committee recommen-dations, WHO developed a concept note for monitoring and evaluation framework comprising of the existing one mandatory component (States Parties Annual Reporting) and three new voluntary components (after action review, simulation exercises and external evaluation) in 2015. A second technical consultation in Lyon in October 2015, led to the development of the joint external evaluation (JEE) tool based on existing WHO tools and various regional strategies and other initiatives, such as the Global Health Security Agenda (GHSA), World Organisation for Animal Health Performance of Veterinary Services (OIE PVS) Pathway. The JEE was published in February 2016. In addition to evaluating the capacities required under the IHR, the JEE and NAPHS also contributes to the implementation of the Sendai Framework for Disaster Risk Reduction that recognises the importance of implementation of the International Health Regulations (2005) and the building of resilient health systems.

VOLUNTARY JOINT EXTERNAL EVALUATION (JEE)The technical areas covered in this voluntary com-ponent of the technical framework are, grouped into four core areas: – prevent, detect, respond, and IHR related hazards and points of entry. The JEE in this respect considers:• preventing and reducing the likelihood of out-

breaks and other public health hazards and events defined by IHR is essential;

• detecting threats early can save lives;• rapid and effective response requires multisec-

toral, national and international coordination and communication; and

• IHR capacities are required at points of entry, and during chemical events and radiation emergencies.

THE INTERNATIONAL HEALTH REGULATIONS (2005) In May 2005, the Fifty-eighth World Health As-sembly (WHA) adopted the International Health Regulations (IHR (2005); hereinafter “IHR” or “the Regulations”), which subsequently entered into force on 15 June 2007. All States Parties are re-quired by the IHR to develop certain minimum core public health capacities. IHR capacity requi-rements are defined as “the capacity to detect, assess, notify and report events” in Article 5; and “the capacity to respond to promptly and effectively to public health risks and public health emergen-cies of international concern” in Article 13.IHR (2005) (Article 54 and Resolution WHA61.2) requires State Parties and the WHO Director-General to report annually to the World Health Assembly on the implementation of the Regulations as decided by the Health Assembly. The IHR Core Capacity Monitoring Framework was developed by the Secretariat, with a checklist and indicators to monitor progress in the development of the core capacities. Between 2010 and 2016, 195 State Parties have reported to WHO at least once using IHR monitoring questionnaires; averaging 73% of MS reporting annually.

THE IHR REVIEW COMMITTEE ON SECOND EXTENSIONSThe IHR Review Committee on Second Extensions for establishing national public health capacities and on IHR implementation (WHA68/22 Add.1) in 2014 recommended that with a longer term vision the Secretariat “should develop options to move from exclusive self-evaluation to approaches that combine self-evaluation, peer review and volunta-ry external evaluations involving a combination of domestic and independent experts. These additio-nal approaches should consider, amongst other things, strategic and operational aspects of the IHR, such as the need for high-level political com-mitment, and whole of government/multisectoral engagement. Any new monitoring and evaluation scheme should be developed with the active invol-vement of WHO regional offices and subsequently proposed to all States Parties through the WHO governing bodies’ process”. This recommendation

1 - Checklist and indicators for monitoring progress in the development of IHR core capacities in States Parties. WHO/HSE/GCR/2013.2. Geneva: World Health Organization; 2013 (http://apps.who.int/iris/bitstream/10665/84933/1/WHO_HSE_GCR_2013.2_eng.pdf?ua=1, accessed 19 December 2017).



REVISION OF THE JEE TOOLThe first edition of the tool was made available in February 2016, and by the end of December 2017 67 countries had requested a JEE to WHO and completed the voluntary evaluation using this tool. In late 2016, the JEE Secretariat began the process of systematically collecting sug-gestions and comments on improving the first edition of the JEE tool from WHO Regional Of-fices, technical area leads in WHO headquarters and external experts who had participated in one or more JEE missions and Member States who had conducted a JEE or were preparing for a JEE. The suggested improvements and com-ments were collated into an annotated version of the JEE tool and in April 2017, WHO convened a global meeting with over 90 global technical experts and all WHO ROs to discuss the sug-gested improvements and recommend changes. These changes were incorporated into a revised version of the JEE tool and finalized in mid-2017. This is the second edition of the JEE tool2.

SUMMARY OF CHANGES INCORPORATED INTO THE SECOND ETIDION OF THE JEE TOOLThe main changes within the second edition of the JEE tool is the inclusion of two financing indicators, the merging of two indicators under legislation into a single one and the renaming of three technical areas (Real time surveillance is now Surveillance, Workforce development is now Human resources and Preparedness is now Emergency preparedness). The tool now has 49 indicators (increase of one indicator from the previous 48), within the 19 technical areas. The second edition of the tool helps clarify issues in the interpretation of various indicators, attri-butes and questionnaires, with more footnotes. It also clarifies the discrepancy found in national capacities between the human and animal sec-tors and recommends animal and human health scores for the indicators are given; the lower score of the two is to be considered, rather than the average. The technical areas of IHR coordination, commu-nication and advocacy, Biosafety and biosecu-rity, Immunization, National laboratory system, Reporting, Emergency preparedness, Medical countermeasures and personnel deployment,

Linking public health and security authorities, Risk communication, Points of entry, Chemical events and Radiation emergencies, have minor changes for the purpose of clarity and interpre-tation.

CHANGES IN INDICATORSTwo indicators of National legislation, policy and finance are combined and two additional indicators for finance added. Two indicators on Antimicrobial resistance (AMR) are combined and a new indicator on effective coordination added to align with the global action plan for AMR. For Zoonotic disease, an indicator on workforce is incorporated in the Human resources technical area and the rest of the indicators are updated to better reflect output and outcome. The food safety technical area is split into two to reflect detection and response capacities, respectively. The surveillance technical area now has three indicators where the indicators for event-based, indicator-based and syndromic surveillance are combined as “surveillance systems”. The rest of the indicators of Surveillance remain the same with a few changes that reflect output and outcome of the system. The human resources tech-nical area presently consists of four indicators with the addition of a new indicator on in-ser-vice training capacities, which incorporates veterinary workforce from Zoonotic disease and is linked to the multisectoral workforce as required for IHR implementation. The Emer-gency response operations technical area now has three indicators as one of the indicators on case management was moved to Medical coun-termeasures and personnel deployment. Two indicators on “capacity to activate” and “opera-tional procedures for emergency operations” are combined as “emergency operations centre” and an additional indicator on “emergency response coordination” is added.Details of the changes incorporated into the second edition of the JEE tool are available in Appendix 2.

PURPOSE OF THE JEE The JEE is one of the three voluntary process available for MS to request as needed to evaluate country capacity to prevent, detect and rapidly respond to public health threats independently

2 - Countries that have already started self-evaluation using the first edition of the JEE tool will be evaluated using the same tool. However, countries that are starting self-evaluation from January 2018 onwards will use the second edition of the JEE tool for self-evaluation and external evaluation.



3 - Operational readiness” concept was derived from the ‘readiness’ definition of United Nations General Assembly, 2017 (see definitions) and enables countries to fast track the development of certain capacities in order to be ready to respond to emergencies, including imminent high risks, while system-wide capacity development is ongoing.4 - International Health Regulations (IHR): joint external evaluation. Country implementation guide. WHO/WHE/CPI/2017.62. Geneva: World Health Organization; 2017 (http://apps.who.int/iris/bitstream/10665/259605/1/WHO-WHE-CPI-2017.62-eng.pdf, accessed 17 December 2017). 5 - International Health Regulations (IHR): joint external evaluation. Roster of experts process and overview. WHO/WHE/CPI/2017.63. Geneva: World Health Organization; 2017 (http://apps.who.int/iris/bitstream/10665/259604/1/WHO-WHE-CPI-2017.63-eng.pdf, accessed 17 December 2017).6 - International Health Regulations (IHR): joint external evaluation: Mission reports. [website] http://www.who.int/ihr/procedures/mission-reports/en/, accessed on 30 December 2017) 7 - In the WHO African Region, IHR implementation is within the context of Integrated Disease Surveillance and Response Strategy and in the Asia Pacific (South-East Asia Region and Western Pacific Region), IHR implementation is in the context of the Asia-Pacific Strategy for Emerging Diseases.

of whether they are naturally occurring, delibe-rate or accidental. The purpose of the external evaluation is to measure country-specific sta-tus and progress in achieving the targets. This will require a sustainable and flexible process to allow for additional countries to participate and for regular evaluation visits. The first external evaluation will establish a baseline measure-ment of the country’s capacity and capabilities, and subsequent evaluations will identify the progress made and ensure that improvements in capacity are sustainable.JEEs have a number of important features inclu-ding: voluntary country participation; a multisec-toral approach by both the external teams and the host countries; transparency and openness of data and information sharing; and the public release of reports. In the joint process during an external evaluation (envisioned to take place ap-proximately once every four to five years), a team of national experts first completes a self-eva-luation using the JEE tool that is submitted to the external team prior to the country visit. The external team uses the same tool for their inde-pendent evaluation, working together with the national team in interactive sessions.The external evaluation creates a common plat-form for country information and data. This al-lows countries to identify the most urgent needs within their health security system, to prioritize opportunities for enhanced preparedness, res-ponse and action, and to engage with current and prospective donors as well as partners to target resources effectively. Transparency is an important element for attracting and directing resources to where they are needed the most. In addition, JEE priorities and the development of a multiyear national action plan can help ensure operational readiness in countries with urgent needs (such as highly vulnerable, low resource settings).The JEE tool was developed to provide an exter-nal mechanism to evaluate a country’s IHR ca-pacity for ensuring health security and use the

expertise of global experts to provide recommen-dations across the 19 technical areas assessed. The JEE tool draws on the original IHR core ca-pacities and incorporates valuable content and lessons learned from tested external assess-ment tools and processes of several other mul-tilateral and multisectoral initiatives that sup-ported the building of capacity to prevent, detect and respond to infectious disease threats.

PROCESS FOR VOLONTARY JEEThe first stage of the process is a self-evaluation using the JEE tool and country implementation guide,4 completed by the country with multisec-toral engagement. This information is then given to the JEE team consisting of international sub-ject matter experts5. Review of this self-evalua-tion data provides the team members with an understanding of the country’s baseline health security capabilities. The JEE team consisting of international subject matter experts then vi-sit the country for facilitated in-depth discus-sions of the self-reported data and participate in structured site visits and meetings organized by the host country. The evaluation team uses fin-dings from various relevant evaluations and as-sessments, such as the OIE PVS Pathway, moni-toring and evaluation of disaster risk reduction and others.After conducting the evaluation, the JEE team drafts a report to identify status levels for each indicator and presents an analysis of the country’s capabilities, gaps, opportunities and challenges. The draft report is shared with the host country. After the host country concurs with the findings, the final report is published on the WHO website6. This approach facilitates international support of country implementation efforts, encourages sharing of best practices and lessons learned, promotes international ac-countability, engages stakeholders, and informs and guides IHR implementation both in the host country and internationally.7



THE JEE FORMATEach indicator in the JEE tool has attributes that reflect various levels of capacity. These are identified with scores ranging from “1” (indicating that implementation has not occurred) to “5” (indicating that implementation has occurred, is tested, reviewed and exercised, and that the country has a sustainable level of capability for the indicator). For each indicator, a country receives a single score based on their current capacity. The “technical area questions” help the evaluators determine the appropriate score. Most of the measures are descriptive and qualitative. Countries are asked to provide documentation for relevant items in addition to the responses. The documentation and responses are reviewed by the evaluators and discussed with host country experts using a peer-to-peer, consensus based approach. The final report includes scores as well as a narrative that document existing capacities, gaps and challenges. The key findings are presented as three to five priority actions for each of the 19 technical areas.

COLOUR SCORING SYSTEMWhile there is overlap among the capacity sections of the tool, each capacity is considered separately in the evaluation exercise. The implementation status of each core capacity is indicated by a score, which reflects the country’s level of advancement, its capacity to institutionalize technical area competencies, and ensure that they are sustainable. The following describes the level of advancement or scoring with colour coding. 1. No capacity: Attributes of a capacity are not

in place.Colour code: Red

2. Limited capacity: Attributes of a capacity are in development stage (implementation has started with some attributes achieved and others commenced).

Colour code: Yellow

3. Developed capacity: Attributes of a capacity are in place; however, sustainability has not been ensured (such as through inclusion in the operational plan of the national health sector plan with a secure funding source).

Colour code: Yellow

CONTEXTUAL QUESTIONSThese are questions on or relating to circumstances that form the backdrop for the given technical areas.

TECHNICAL QUESTIONSThese are questions directly related to technical area indicators and attributes, which enable the country and external team to evaluate achievements against specific attributes.

DOCUMENTATION OR EVIDENCE FOR LEVEL OF CAPABILITYSome responses to contextual and technical questions require documentation, which provides evidence to evaluate the level of achievement in specific indicators and technical areas. Note: In some technical areas indicator specific documentation is requested.

4. Demonstrated capacity: Attributes are in place and sustainable for a few years, and can be measured by the inclusion of attributes or IHR core capacities in the national health sector plan and a secure funding source.

Colour code: Green

5. Sustainable capacity: All attributes are functional and sustainable, and the country is supporting one or more other countries in their implementation. This is the highest level of the achievement of implementation of IHR core capacities.

Colour code: Green

1. A country can advance to the next adjacent level only when it has achieved ALL the attributes of its current capacity levels. For example, in order to reach “demonstrated” capacity, it has to meet all the attributes of “developed” and “demonstrated” capacity.2. All responses must be supported by documentable evidence.



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bu

dget

lin

e or

bu

dget

ary

allo

catio

n9 ava

ilabl

e to

fina

nce

the

impl

emen

tatio

n of

IHR

capa

citie

s, a

nd fi

nanc

ing

for i

mpl

emen

tatio

n of

IH

R ca

paci

ties

is

hand

led

thro

ugh

extr

a-bu

dget

ary

mea

ns10

Fina

ncin

g fo

r re

spon

ding

to

pu

blic

he

alth

em

erge

ncie

s is

no

t id

entifi

ed

and

fund

s ar

e al

loca

ted

and

dist

ribut

ed i

n an

ad

hoc

man

ner

durin

g a

publ

ic h

ealth

em

erge

ncy

Lim

ited

ca

paci

ty -

2

Asse

ssm

ent

of r

elev

ant

legi

slat

ion,

reg

ulat

ions

, ad

min

istr

ativ

e re

quire

men

ts a

nd o

ther

gov

ernm

ent

inst

rum

ents

fo

r IH

R im

plem

enta

tion

has

been

ca

rrie

d ou

t an

d re

quire

d ad

just

men

ts h

ave

been

id

entifi

ed

A bu

dget

ary

allo

catio

n or

su

bsta

ntia

l ex

tern

al

finan

cing

11

is

mad

e fo

r so

me

of

the

rele

vant

se

ctor

s12 a

nd th

eir r

espe

ctiv

e m

inis

trie

s to

sup

port

th

e im

plem

enta

tion

of IH

R ca

paci

ties

for b

iolo

gica

l ha

zard

s14 a

t the

nat

iona

l lev

el

An e

mer

genc

y pu

blic

fina

ncin

g m

echa

nism

exi

sts15

th

at a

llow

s fo

r st

ruct

ured

rec

eptio

n an

d ra

pid

dist

ribut

ion

of fu

nds

for r

espo

ndin

g to

pub

lic h

ealth

em

erge

ncie

s

Deve

lope

d ca

paci

ty -

3

The

coun

try

can

dem

onst

rate

the

exi

sten

ce a

nd

use

of r

elev

ant

legi

slat

ion

in a

ll re

leva

nt s

ecto

rs

invo

lved

in th

e im

plem

enta

tion

of th

e IH

R16

A bu

dget

ary

allo

catio

n or

su

bsta

ntia

l ex

tern

al

finan

cing

is

mad

e fo

r hu

man

hea

lth,

vete

rinar

y pu

blic

hea

lth,

agric

ultu

re,

and

all

othe

r re

leva

nt

min

istr

ies

or s

ecto

rs, t

o su

ppor

t the

impl

emen

tatio

n of

all17

IHR

capa

citie

s at

the

natio

nal l

evel

Fina

ncin

g fo

r res

pons

e is

iden

tified

18 fo

r im

med

iate

m

obili

zatio

n w

hen

need

ed, a

t th

e na

tiona

l, st

ate,

pr

ovin

ce a

nd r

egio

nal

leve

ls f

or a

ll th

e re

leva

nt

sect

ors19

in a

dvan

ce o

f a p

ublic

hea

lth e

mer

genc

y

Dem

onst

rate

d ca

paci

ty -

4

The

coun

try

has

legi

slat

ion

refe

renc

es

and/

or

adm

inis

trat

ive

requ

irem

ents

fo

r sp

ecifi

c ar

eas

(suc

h as

cu

rren

t le

gisl

atio

n th

at

spec

ifica

lly

addr

esse

s N

atio

nal

IHR

Foca

l Po

int

desi

gnat

ion

and

oper

atio

ns)

A su

ffici

ent

budg

et20

is

al

loca

ted

with

tim

ely

dist

ribut

ion21

at

th

e na

tiona

l an

d su

bnat

iona

l le

vel(s

) in

all

rele

vant

min

istr

ies

or s

ecto

rs fo

r th

e im

plem

enta

tion

of a

ll IH

R ca

paci

ties

The

emer

genc

y pu

blic

fina

ncin

g m

echa

nism

in

plac

e al

low

s fo

r th

e tim

ely

exec

utio

n22 o

f fu

nds23

by

all

rele

vant

sec

tors

, du

ring

a pu

blic

hea

lth

emer

genc

y

Sust

aina

ble

capa

city

– 5

The

coun

try

has

legi

slat

ion

refe

renc

es

and/

or

adm

inis

trat

ive

requ

irem

ents

for a

ll ar

eas

rela

ted

to

IHR

impl

emen

tatio

n

A su

ffici

ent

budg

et t

hat

is d

istr

ibut

ed in

a t

imel

y m

anne

r at

the

nat

iona

l and

sub

natio

nal l

evel

(s) i

n al

l rel

evan

t min

istr

ies

or s

ecto

rs is

wel

l coo

rdin

ated

in

its

exec

utio

n24, f

or th

e im

plem

enta

tion

of a

ll IH

R ca

paci

ties

Fina

ncin

g ca

n be

exe

cute

d an

d m

onito

red25

in

a tim

ely

and

coor

dina

ted

man

ner a

t all

leve

ls a

nd fo

r al

l rel

evan

t sec

tors

, with

an

emer

genc

y co

ntin

genc

y fu

nd26

in

plac

e, f

or r

espo

nse

to a

n ac

ute

publ

ic

heal

th e

mer

genc

y

PR

EV

EN

T

4 -

Food

saf

ety

legi

slat

ion

shou

ld id

eally

incl

ude

all r

oles

and

resp

onsi

bilit

ies

nece

ssar

y to

mee

t the

obj

ectiv

es a

nd e

nfor

ce th

e va

rious

ele

men

ts o

f foo

d co

ntro

l to

prev

ent f

oodb

orne

dis

ease

s an

d fo

od c

onta

min

atio

n.5

-Tw

o cr

itica

l com

pete

ncie

s on

legi

slat

ion

in th

e PV

S to

ol a

re: C

ritic

al C

ompe

tenc

y (C

C) IV

-1: P

repa

ratio

n of

legi

slat

ion

and

regu

latio

ns; a

nd C

C IV

-2: I

mpl

emen

tatio

n of

legi

slat

ion,

regu

latio

ns a

nd c

ompl

ianc

e. T

he P

VS P

athw

ay

mis

sion

repo

rts

are

a go

od s

ourc

e of

info

rmat

ion

on th

e st

ate

of v

eter

inar

y le

gisl

atio

n in

the

coun

try.

6

- Fi

nanc

ing

refe

rs to

fund

s an

d re

sour

ces

iden

tified

, allo

cate

d, d

istr

ibut

ed a

nd e

xecu

ted

on a

ctiv

ities

and

inte

rven

tions

. It d

oes

not t

ake

into

acc

ount

cos

ting

or id

entif

ying

how

man

y re

sour

ces

or fu

nds

are

nece

ssar

y fo

r th

e im

plem

enta

tion

of a

ctiv

ities

or i

nter

vent

ions

.7

-Fun

ding

and

a fi

nanc

ing

mec

hani

sm fo

r res

pond

ing

to p

ublic

hea

lth e

mer

genc

ies,

that

focu

ses

on p

rovi

ding

reso

urce

s to

faci

litat

e th

e su

rge

capa

city

of t

he h

ealth

sys

tem

and

the

depl

oym

ent o

f int

erve

ntio

ns th

at g

o be

yond

the

rout

ine

stru

ctur

e of

the

heal

th s

yste

m. T

his

coul

d in

clud

e le

gisl

atio

n in

pla

ce, s

uch

as a

pub

lic h

ealth

act

and

sta

te e

mer

genc

y ac

t.8

-As

defin

ed b

y th

e co

untr

y th

roug

h a

set o

f trig

gers

that

dec

lare

a s

ituat

ion

as a

pub

lic h

ealth

em

erge

ncy.

9 -A

bud

get l

ine

exis

ts a

nd a

bud

get i

s al

loca

ted

(the

bud

get l

ine

is fu

nded

).10

-Ac

coun

ts h

eld

by g

over

nmen

t bo

dies

, but

not

incl

uded

in t

he g

over

nmen

t bu

dget

. 11

-Fin

anci

ng f

rom

non

-dom

estic

sou

rces

tow

ards

the

impl

emen

tatio

n of

IHR

capa

citie

s th

at u

ses

the

maj

ority

of

natio

nal fi

nanc

ing

for

emer

genc

y pr

epar

edne

ss, d

etec

tion

and

resp

onse

.



12 -

Agric

ultu

re, a

nim

al h

ealth

and

hum

an h

ealth

sec

tors

, as

wel

l as

othe

r sec

tors

, who

se a

ctiv

ities

con

trib

ute

to th

e im

plem

enta

tion

of IH

R ca

paci

ties.

The

re is

a c

ruci

al c

ompe

tenc

y on

ope

ratio

nal f

undi

ng in

the

PVS

tool

CC

I-8.

13

-A

gove

rnm

ent b

ody,

mai

nly

min

istr

ies

at th

e na

tiona

l lev

el, b

ut c

ould

incl

ude

othe

r spe

ndin

g ag

enci

es th

at h

ave

spec

ific

year

ly p

ublic

app

ropr

iatio

ns o

r bud

gets

, whi

ch in

clud

e lin

e ite

m e

xpen

ses.

14 -

Com

pris

e in

fect

ious

dis

ease

eve

nts,

incl

udin

g zo

onot

ic d

isea

ses

and

food

saf

ety

even

ts.

15 -

Ther

e is

a s

peci

al s

et o

f pro

cess

es o

r cha

nnel

s in

pla

ce th

at: a

ctiv

ates

a s

peci

al e

mer

genc

y pu

blic

fina

ncin

g m

echa

nism

, allo

ws

for r

apid

rece

ptio

n an

d di

strib

utio

n of

fund

s, a

nd c

ircum

vent

s th

e va

rious

che

cks

and

bala

nces

of

the

norm

al p

ublic

fina

ncin

g m

echa

nism

. 16

- Em

erge

ncy

resp

onse

fina

ncin

g fr

om n

atio

nal/

regi

onal

con

tinge

ncy

fund

s, th

e W

orld

Ban

ks’s

Pan

dem

ic E

mer

genc

y Fi

nanc

ing

Faci

lity,

othe

r mul

tilat

eral

em

erge

ncy

resp

onse

fund

s,

or o

ther

ext

erna

l sou

rces

, are

iden

tified

and

list

ed b

y N

atio

nal I

HR

Foca

l Poi

nts,

and

con

tact

with

foca

l poi

nts

in c

harg

e of

thes

e fu

nds

or e

xter

nal s

ourc

es a

re m

ade

to p

ut in

pla

ce a

ll th

e ne

cess

ary

form

aliti

es in

adv

ance

of p

ublic

he

alth

em

erge

ncie

s.17

- F

or th

e an

imal

hea

lth s

ecto

r, th

is in

form

atio

n ca

n be

foun

d in

the

coun

try

PVS

eval

uatio

n re

port

, CC

IV-1

: Pre

para

tion

of le

gisl

atio

n an

d re

gula

tions

; and

CC

IV-2

: Im

plem

enta

tion

of le

gisl

atio

n an

d re

gula

tions

and

com

plia

nce

ther

eof.

18 -

IHR

capa

citie

s fo

r all

IHR

rela

ted

haza

rds

(che

mic

al, r

adia

tion

and

biol

ogic

al h

azar

ds).

19 -

Diff

eren

t haz

ards

or p

ublic

em

erge

ncie

s in

volv

e di

ffere

nt s

ecto

rs (e

.g. a

vian

influ

enza

invo

lves

min

istr

ies

of a

gric

ultu

re, h

ealth

and

hom

e). T

hose

sec

tors

iden

tified

as

rele

vant

in th

e em

erge

ncy

resp

onse

pla

ns fo

r eac

h ty

pe o

f ha

zard

hav

e bu

dget

line

s in

pla

ce to

rece

ive

and

exec

ute

emer

genc

y fu

ndin

g. T

here

is c

ritic

al c

ompe

tenc

y on

em

erge

ncy

fund

ing

in th

e PV

S to

ol C

C I-

9.20

- T

his

refe

rs to

acc

ess

to fu

nds

by re

leva

nt m

inis

trie

s or

gov

ernm

ent b

odie

s fo

r the

impl

emen

tatio

n of

all

IHR

capa

citie

s. S

uffic

ienc

y is

mea

sure

d, w

here

pos

sibl

e, b

y co

mpa

ring

budg

et a

lloca

tions

am

ount

s to

reso

urce

nee

ds

iden

tified

in n

atio

nal p

lans

rela

ted

to IH

R an

d/or

hea

lth s

ecur

ity.

21 -

A re

leas

e of

ann

ual a

ppro

pria

tion

of fi

nanc

ing,

usu

ally

on

a qu

arte

rly o

r mon

thly

bas

is, f

or th

e m

eetin

g of

fina

ncia

l obl

igat

ions

.22

- T

he re

spon

se to

pub

lic h

ealth

em

erge

ncie

s in

clud

es a

ser

ies

of in

terv

entio

ns, s

uch

as s

uppl

y an

d eq

uipm

ent p

rocu

rem

ent,

hum

an re

sour

ce c

ontr

actin

g an

d de

ploy

men

t, an

d lo

gist

ical

arr

ange

men

ts, a

nd in

volv

e ac

tors

not

us

ually

invo

lved

with

pub

lic s

ecto

r se

rvic

es, s

uch

as N

GO

s an

d th

e pr

ivat

e se

ctor

, 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, a

nd m

ay n

ot e

ven

be p

ossi

ble.

Mec

hani

sms,

incl

udin

g fa

st-t

rack

ex

ecut

ion

proc

edur

es a

nd le

tter

s of

und

erst

andi

ng w

ith n

on-s

tate

act

ors,

nee

d to

be

in p

lace

bef

ore

an e

mer

genc

y oc

curs

, to

allo

w fo

r exp

edite

d sp

endi

ng o

f fun

ds in

suc

h as

pect

s th

at a

re c

ruci

al to

em

erge

ncy

resp

onse

.23

- In

clud

e do

mes

tic fu

ndin

g an

d fu

ndin

g fr

om e

xter

nal s

ourc

es, a

s ap

plic

able

.24

- A

nat

iona

l aut

horit

y ha

s co

ordi

nate

d th

e al

loca

tion

and

exec

utio

n of

fina

ncin

g fo

r act

iviti

es a

nd in

terv

entio

ns to

impl

emen

t IH

R ca

paci

ties.

25 -

To

assu

re a

ccou

ntab

ility

and

gua

rant

ee th

e di

strib

utio

n of

reso

urce

s to

whe

re th

ey a

re m

ost n

eede

d, a

feed

back

mec

hani

sm is

in p

lace

to c

aptu

re a

nd re

port

cha

ngin

g ne

eds

and

prio

ritie

s.26

- A

n em

erge

ncy

cont

inge

ncy

fund

exi

sts

at th

e na

tiona

l, re

gion

al o

r int

erna

tiona

l lev

el, w

ith w

hich

a n

atio

nal a

utho

rity

can

coor

dina

te th

e re

cept

ion

and

dist

ribut

ion

of fu

nds.

PR

EV

EN

T

Cont

extu

al q

uest

ions

:

1.

How

are

the

legi

slat

ion

and

regu

latio

ns d

evel

oped

, rev

iew

ed a

nd o

pera

tiona

lized

in th

e co

untr

y?2.

D

oes

the

vete

rinar

y se

ctor

hav

e le

gisl

atio

n in

pla

ce t

hat

give

s th

em a

utho

rity

to im

pose

qua

rant

ine,

sto

p an

imal

mov

emen

t, eu

than

ize

and

reim

burs

e ow

ners

for t

he v

alue

of a

nim

als/

poul

try

that

are

sac

rifice

d in

ord

er to

con

trol

/era

dica

te a

dis

ease

?3.

W

hat p

roce

sses

and

mec

hani

sms

are

in p

lace

to g

athe

r and

cha

nnel

fina

ncin

g in

resp

onse

to p

ublic

hea

lth e

mer

genc

ies?

4.

Doe

s th

e co

untr

y de

pend

on

outs

ide

sour

ces

of fi

nanc

ing

and

othe

r res

ourc

es fo

r res

pond

ing

to p

ublic

hea

lth e

mer

genc

ies?

5.

Is th

ere

dom

estic

fina

ncin

g in

the

natio

nal b

udge

t for

recu

rren

t or p

redi

ctab

le p

ublic

hea

lth e

mer

genc

ies?

6.

Wha

t is

the

pro

port

ion

of t

he n

atio

nal h

ealth

bud

get

allo

cate

d fo

r pu

blic

hea

lth, f

or IH

R fu

nctio

ns o

r he

alth

sec

urity

rel

ated

act

iviti

es (

i.e. p

reve

ntio

n,

dete

ctio

n an

d re

spon

se)?

7.

Is th

ere

an e

xist

ing

natio

nal p

lan

to s

tren

gthe

n IH

R ca

paci

ties

(nat

iona

l hea

lth s

ecur

ity p

lan,

oth

er),

and

has

this

pla

n be

en fi

nanc

ed?

8.

Is th

ere

a pl

an to

coo

rdin

ate

the

func

tions

and

ope

ratio

ns o

f the

nat

iona

l IH

R w

ith th

e co

untr

y’s

rele

vant

env

ironm

ent a

nd a

gric

ultu

re re

spon

ders

?9.

Is

ther

e co

nsis

tent

and

tim

ely

dist

ribut

ion

of fu

nds

for r

ecur

rent

act

iviti

es th

at a

re p

art o

f an

exis

ting

natio

nal p

lan?

10

. H

ow a

re s

ubna

tiona

l lev

el a

ctiv

ities

fund

ed?

11.

Is th

ere

a fin

anci

al im

plem

enta

tion

mon

itorin

g m

echa

nism

in p

lace

?12

. W

hat m

echa

nism

s ex

ist t

o en

gage

fund

ing

from

the

priv

ate

sect

or?



27 -

The

se q

uest

ions

sho

uld

be a

nsw

ered

by

lega

l or l

egis

lativ

e ad

vise

rs, o

r exp

erts

at t

he h

ealth

min

istr

y or

oth

er re

leva

nt g

over

nmen

t offi

ces/

Nat

iona

l IH

R Fo

cal P

oint

s. P

leas

e as

k to

see

the

rele

vant

doc

umen

ts.

28 -

Leg

isla

tion:

sta

te c

onst

itutio

ns, l

aws,

dec

rees

, ord

inan

ces

or s

imila

r leg

al in

stru

men

ts.

PR

EV

EN

T

Tech

nica

l que

stio

ns:

P.1.

1 T

he S

tate

can

dem

onst

rate

that

it h

as a

sses

sed,

adj

uste

d an

d al

igne

d its

dom

estic

legi

slat

ion27

, pol

icie

s an

d ad

min

istr

ativ

e ar

rang

emen

ts in

all

rele

vant

sec

tors

to e

nabl

e co

mpl

ianc

e w

ith th

e IH

R

1.

Is th

ere

legi

slat

ion

or a

re th

ere

regu

latio

ns o

r adm

inis

trat

ive

requ

irem

ents

, or o

ther

gov

ernm

enta

l ins

trum

ents

28 g

over

ning

pub

lic h

ealth

sur

veill

ance

and

re

spon

se?

2.

Do

polic

ies

or re

gula

tions

exi

st fo

r the

use

of d

rugs

and

che

mic

als

that

can

be

part

of p

ublic

hea

lth im

port

ance

, suc

h as

AM

R, in

sect

icid

es?

3.

Has

an

asse

ssm

ent o

f rel

evan

t leg

isla

tions

, reg

ulat

ions

or a

dmin

istr

ativ

e re

quire

men

ts, a

nd o

ther

gov

ernm

enta

l ins

trum

ents

bee

n ca

rrie

d ou

t (to

det

erm

ine

if th

ey fa

cilit

ate

full

impl

emen

tatio

n of

the

IHR)

?4.

D

oes

the

asse

ssm

ent a

lso

iden

tify

area

s fo

r adj

ustm

ent f

or re

leva

nt le

gisl

atio

n, re

gula

tions

, adm

inis

trat

ive

requ

irem

ents

and

oth

er g

over

nmen

t ins

trum

ents

fo

r IH

R im

plem

enta

tion?

5 Is

ther

e ev

iden

ce o

f usi

ng re

leva

nt le

gisl

atio

n an

d po

licie

s in

var

ious

sec

tors

invo

lved

in th

e im

plem

enta

tion

of IH

R? G

ive

exam

ples

of h

ow ri

ghts

cre

ated

by

the

IHR

are

exer

cise

d an

d ho

w IH

R ob

ligat

ions

are

com

plie

d w

ith.

6.

Doe

s th

e co

untr

y’s

legi

slat

ion

or a

ny re

fere

nces

add

ress

add

ition

al s

peci

fic a

reas

oth

er th

an th

e N

atio

nal I

HR

Foca

l Poi

nt fu

nctio

n (d

esig

natio

n an

d its

op

erat

ion)

; if y

es, w

hat a

re th

ose

area

s?7.

W

hat a

re th

e ad

min

istr

ativ

e re

quire

men

ts th

e co

untr

y ha

s id

entifi

ed to

impl

emen

t the

se le

gisl

atio

n an

d/or

regu

latio

ns?

8.

How

doe

s th

e co

untr

y en

sure

the

coor

dina

tion

of le

gal a

nd re

gula

tory

fram

ewor

ks b

etw

een

sect

ors?

(Sho

w e

vide

nce.

)

P.1.

2 Fi

nanc

ing29

is a

vaila

ble

for t

he im

plem

enta

tion

of IH

R ca

paci

ties

1.

Who

is re

spon

sibl

e fo

r fina

ncia

l pla

nnin

g of

ess

entia

l pub

lic h

ealth

func

tions

for h

ealth

sec

urity

incl

udin

g di

seas

e co

ntro

l?2.

Is

ther

e a

budg

et li

ne w

ithin

a m

inis

try

(suc

h as

hea

lth, a

gric

ultu

re, d

efen

ce) a

t the

nat

iona

l lev

el fo

r act

iviti

es re

late

d to

str

engt

heni

ng IH

R co

re c

apac

ities

? If

not,

how

is IH

R im

plem

enta

tion

fund

ed?

3.

Doe

s th

e N

atio

nal S

trat

egic

Hea

lth S

ecto

r Pla

n (N

SHSP

) or o

ther

spe

cific

pla

ns (s

uch

as th

e N

atio

nal A

ctio

n Pl

an fo

r Hea

lth S

ecur

ity, (

NAP

HS)

, or H

ealth

Em

erge

ncy

Prep

ared

ness

Pla

n) in

clud

e th

e pu

blic

hea

lth fu

nctio

ns n

eede

d to

app

ly a

nd c

ompl

y w

ith th

e IH

R?

4.

Are

ther

e an

y m

emor

anda

of u

nder

stan

ding

(MoU

s) o

r oth

er a

gree

men

t(s)

with

par

tner

s to

fina

nce

IHR

core

cap

aciti

es?

If ye

s, w

hat i

s th

e pr

opor

tion

of

finan

cing

from

par

tner

s fo

r IH

R re

late

d fu

nctio

ns?

5.

Is th

ere

a bu

dget

ava

ilabl

e fo

r all

rele

vant

min

istr

ies

for a

ctiv

ities

rela

ted

to s

tren

gthe

ning

and

mai

ntai

ning

IHR

capa

citie

s fo

r all

IHR-

rele

vant

haz

ards

?6.

If

yes,

whi

ch o

f the

min

istr

ies

have

fully

allo

cate

d bu

dget

s, a

nd w

hat a

re th

e po

ssib

le fu

ndin

g lim

itatio

ns?



7.

Is e

xter

nal fi

nanc

ing

for t

he im

plem

enta

tion

of IH

R ca

paci

ties

larg

er th

an th

e su

m o

f dom

estic

fina

ncin

g fo

r the

se?

8.

Is th

ere

timel

y di

strib

utio

n of

fund

s fo

r the

exe

cutio

n of

nat

iona

l act

iviti

es to

str

engt

hen

and

mai

ntai

n IH

R ca

paci

ties?

Are

ther

e de

lays

in re

ceiv

ing

fund

s fo

r act

iviti

es to

str

engt

hen

IHR

capa

citie

s?9.

Is

ther

e tim

ely

dist

ribut

ion

of fu

nds

for a

ll m

inis

trie

s or

sec

tors

at a

ll le

vels

of t

he s

yste

m (n

atio

nal a

nd s

ubna

tiona

l)?10

. D

o th

ese

fund

s en

sure

full

impl

emen

tatio

n of

IHR

capa

citie

s?

11.

How

doe

s th

e co

untr

y en

sure

coo

rdin

atio

n of

bud

get p

lann

ing

and

deve

lopm

ent,

amon

g di

ffere

nt m

inis

trie

s an

d re

leva

nt d

epar

tmen

ts?

Doe

s a

natio

nal

auth

ority

coo

rdin

ate

diffe

rent

sec

tors

in th

e im

plem

enta

tion

of IH

R-re

late

d ac

tiviti

es, a

nd th

e di

strib

utio

n an

d ex

ecut

ion

of th

eir fi

nanc

es?

P.1.

3 Fi

nanc

ing

mec

hani

sm a

nd fu

nds

are

avai

labl

e fo

r tim

ely

resp

onse

30 to

pub

lic h

ealth

em

erge

ncie

s

1.

How

are

reso

urce

s m

anag

ed b

y th

e pu

blic

sec

tor

whe

n a

publ

ic h

ealth

em

erge

ncy

occu

rs?

How

are

reso

urce

s co

ntrib

uted

by

exte

rnal

or

priv

ate

acto

rs

gath

ered

and

dis

sem

inat

ed?

2.

Doe

s a

mec

hani

sm w

hich

allo

ws

for

reso

urce

s to

be

dist

ribut

ed fo

r re

spon

ding

to a

pub

lic h

ealth

em

erge

ncy

in a

rap

id m

anne

r, su

pers

edin

g th

e pu

blic

fin

anci

ng m

echa

nism

s, a

nd h

andl

es th

e al

loca

tion

and

dist

ribut

ion

of p

ublic

fund

s fo

r all

non-

emer

genc

y ca

ses,

exi

st?

3.

Whe

n a

publ

ic h

ealth

em

erge

ncy

occu

rs, d

oes

the

coun

try

know

whe

re it

can

imm

edia

tely

acc

ess

mos

t of t

he fi

nanc

ing

need

ed to

resp

ond

to th

e em

erge

ncy?

4.

D

oes

the

coun

try

have

an

agre

emen

t set

up

with

the

Wor

ld B

ank

Pand

emic

Fin

anci

ng F

acili

ty o

r oth

er m

ultil

ater

al e

mer

genc

y fu

ndin

g m

echa

nism

s?5.

Is

the

re a

pub

lic e

ntity

with

res

ourc

e-ra

isin

g re

spon

sibi

litie

s fo

r w

hen

a pu

blic

hea

lth e

mer

genc

y oc

curs

? H

ow d

oes

this

ent

ity r

aise

and

coo

rdin

ate

exte

rnal

ly d

onat

ed fi

nanc

es a

nd re

sour

ces?

Des

crib

e th

e la

st ti

me

this

hap

pene

d.6.

D

oes

each

rele

vant

min

istr

y or

pub

lic e

ntity

hav

e a

budg

et li

ne in

pla

ce fo

r act

iviti

es re

late

d to

resp

ondi

ng to

pub

lic h

ealth

em

erge

ncie

s?

7.

Are

ther

e sp

ecia

l mec

hani

sms

in p

lace

that

allo

w fo

r the

rapi

d ex

ecut

ion

of fu

nds

allo

cate

d fo

r pub

lic h

ealth

em

erge

ncie

s, m

akin

g it

poss

ible

to q

uick

ly

cont

ract

hum

an re

sour

ces,

pro

cure

equ

ipm

ent,

supp

lies

and

com

mod

ities

, mob

ilize

the

dist

ribut

ion

of b

oth

hum

an re

sour

ces

and

com

mod

ities

, am

ong

othe

r nec

essa

ry e

mer

genc

y re

spon

se in

terv

entio

ns, w

ithou

t hav

ing

to g

o th

roug

h th

e st

anda

rd, t

ime-

cons

umin

g pr

oced

ures

that

thes

e no

rmal

ly re

quire

? 8.

Ar

e th

ere

spec

ial m

echa

nism

s in

pla

ce th

at a

llow

for e

xecu

tion

of fu

nds

to g

o to

priv

ate

sect

or o

r non

gove

rnm

enta

l act

ors,

whe

re th

ese

norm

ally

requ

ire

spec

ial p

roce

dure

s or

are

exc

lude

d fr

om th

e pu

blic

pro

visi

on o

f ser

vice

s?9.

H

ow d

oes

the

coun

try

ensu

re c

oord

inat

ion

of fu

ndin

g re

late

d to

resp

onse

to p

ublic

hea

lth e

mer

genc

ies?

Is th

ere

a na

tiona

l aut

horit

y th

at p

rovi

des

over

sigh

t re

gard

ing

the

allo

catio

n an

d ex

ecut

ion

of fi

nanc

ing

in r

espo

nse

to a

pub

lic h

ealth

em

erge

ncy,

coor

dina

tes

the

inte

rven

tions

of

sect

ors

invo

lved

in t

he

resp

onse

, and

exe

cute

s fu

nds

rela

ted

to th

ese?

29 -

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 on

act

iviti

es a

nd in

terv

entio

ns. I

t doe

s no

t tak

e in

to a

ccou

nt 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

impl

emen

tatio

n of

act

iviti

es o

r int

erve

ntio

ns

PR

EV

EN

T



10.

Is re

al-t

ime

mon

itorin

g ca

rrie

d ou

t dur

ing

the

resp

onse

to a

pub

lic h

ealth

em

erge

ncy

that

com

mun

icat

es th

e ch

angi

ng re

sour

ce n

eeds

for t

he re

spon

se to

th

e en

titie

s th

at c

oord

inat

e th

e di

strib

utio

n of

fina

nces

bet

wee

n se

ctor

s, le

vels

and

geo

grap

hica

l are

as o

f the

cou

ntry

?11

. Ar

e pr

oced

ures

in p

lace

that

allo

w fo

r rap

id re

-dis

trib

utio

n of

fund

s an

d re

sour

ces

betw

een

sect

ors,

leve

ls o

r geo

grap

hica

l are

as o

f the

cou

ntry

, with

cha

nge

in re

quire

men

ts fo

r res

pond

ing

to a

pub

lic h

ealth

em

erge

ncy

over

tim

e?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Leg

isla

tion,

regu

latio

ns, p

olic

ies

and

finan

cial

pla

ns re

late

d to

dis

ease

con

trol

, IH

R, e

tc.

l

Asse

ssm

ent o

r eva

luat

ion

repo

rts

of le

gisl

atio

n, re

gula

tions

pol

icie

s or

pla

nsl

Any

othe

r leg

isla

tion,

regu

latio

ns a

nd/o

r pol

icie

s pe

rtin

ent t

o bi

olog

ical

, che

mic

al a

nd ra

diol

ogic

al h

azar

ds fr

om re

leva

nt s

ecto

rs

30 -

Fun

ding

and

a fi

nanc

ing

mec

hani

sm fo

r res

pond

ing

to p

ublic

hea

lth e

mer

genc

ies,

whi

ch fo

cuse

s on

pro

vidi

ng re

sour

ces

to fa

cilit

ate

the

surg

e ca

paci

ty o

f the

hea

lth s

yste

m a

nd th

e de

ploy

men

t of i

nter

vent

ions

that

go

beyo

nd

the

rout

ine

stru

ctur

e of

the

heal

th s

yste

m. T

his

coul

d in

clud

e le

gisl

atio

n in

pla

ce, s

uch

as a

pub

lic h

ealth

act

and

sta

te e

mer

genc

y ac

t.

PR

EV

EN

T



IHR

COO

RDIN

ATIO

N, C

OM

MU

NIC

ATIO

N A

ND

ADV

OCA

CYTa

rget

s: M

ultis

ecto

ral/

mul

tidis

cipl

inar

y ap

proa

ches

thro

ugh

natio

nal p

artn

ersh

ips

that

allo

w e

ffici

ent,

aler

t and

resp

onse

sys

tem

s fo

r effe

ctiv

e im

plem

enta

tion

of th

e IH

R. C

oord

inat

e na

tionw

ide

reso

urce

s, in

clud

ing

sust

aina

ble

func

tioni

ng o

f a N

atio

nal I

HR

Foca

l Poi

nt –

a n

atio

nal c

entr

e fo

r IH

R co

mm

unic

atio

ns w

hich

is

a k

ey o

blig

atio

n of

the

IHR

– th

at is

acc

essi

ble

at a

ll tim

es. S

tate

s Pa

rtie

s pr

ovid

e W

HO

with

con

tact

det

ails

of N

atio

nal I

HR

Foca

l Poi

nts,

con

tinuo

usly

upd

ate

and

annu

ally

con

firm

them

.

As m

easu

red

by: (

1) E

stab

lishm

ent o

f a fu

nctio

nal m

ultis

ecto

ral a

nd m

ultid

isci

plin

ary

mec

hani

sm fo

r the

coo

rdin

atio

n an

d in

tegr

atio

n of

rele

vant

sec

tors

in th

e im

plem

enta

tion

of IH

R an

d to

res

pond

to

any

publ

ic h

ealth

eve

nts.

(2)

Reg

ular

tes

ting

of t

he m

echa

nism

thr

ough

exe

rcis

es a

nd s

ubse

quen

t im

prov

emen

t of

ar

rang

emen

ts a

nd p

roce

dure

s.

Desi

red

impa

ct: A

mec

hani

sm f

or m

ultis

ecto

ral/

mul

tidis

cipl

inar

y co

ordi

natio

n, c

omm

unic

atio

n an

d pa

rtne

rshi

ps t

o de

tect

, ass

ess

and

resp

ond

to a

ny p

ublic

he

alth

eve

nt o

r ris

k. A

Nat

iona

l IH

R Fo

cal P

oint

that

is a

cces

sibl

e at

all

times

to c

omm

unic

ate

with

the

WH

O IH

R Re

gion

al C

onta

ct P

oint

s an

d w

ith a

ll re

leva

nt

sect

ors

and

othe

r sta

keho

lder

s in

the

coun

try.

1 -

Refe

r to

the

Nat

iona

l IH

R Fo

cal P

oint

Gui

de (h

ttp:

//w

ww

.who

.int/

ihr/

publ

icat

ions

/nfp

/en/

, acc

esse

d 20

Nov

embe

r 201

7).

PR

EV

EN

T



Scor

eIn

dica

tors

: IH

R co

ordi

natio

n, c

omm

unic

atio

n an

d ad

voca

cy2

P.2.

1 A

func

tiona

l mec

hani

sm e

stab

lishe

d fo

r the

coo

rdin

atio

n an

d in

tegr

atio

n of

rele

vant

sec

tors

in th

e im

plem

enta

tion

of IH

RN

o ca

paci

ty -

1Co

ordi

natio

n m

echa

nism

with

in a

nd b

etw

een

rele

vant

min

istr

ies,

incl

udin

g go

vern

men

t age

ncie

s, is

not

in p

lace

Lim

ited

ca

paci

ty -

2Co

ordi

natio

n m

echa

nism

with

in a

nd b

etw

een

rele

vant

min

istr

ies

is in

pla

ceN

atio

nal s

tand

ard

oper

atin

g pr

oced

ures

(SO

Ps) o

r equ

ival

ent e

xist

s fo

r coo

rdin

atio

n be

twee

n th

e N

atio

nal I

HR

Foca

l Poi

nt a

nd re

leva

nt s

ecto

rsDe

velo

ped

capa

city

- 3

A m

ultis

ecto

ral,

mul

tidis

cipl

inar

y bo

dy, c

omm

ittee

or

task

forc

e ad

dres

sing

IH

R re

quire

men

ts f

or p

ublic

hea

lth e

mer

genc

ies

of n

atio

nal a

nd in

tern

atio

nal

conc

ern

is in

pla

ce a

nd h

as p

artic

ipat

ed in

the

late

st e

vent

or s

imul

atio

n ex

erci

se

Dem

onst

rate

d ca

paci

ty -

4

Mul

tisec

tora

l and

mul

tidis

cipl

inar

y co

ordi

natio

n an

d co

mm

unic

atio

n m

echa

nism

s3 are

in p

lace

, tes

ted

and

upda

ted

regu

larly

thro

ugh

exer

cise

s or

aft

er-a

ctio

n re

view

s ba

sed

on th

e oc

curr

ence

of a

n ac

tual

eve

ntAc

tion

plan

dev

elop

ed to

inco

rpor

ate

less

ons

lear

nt fr

om m

ultis

ecto

ral a

nd m

ultid

isci

plin

ary

coor

dina

tion

and

com

mun

icat

ion

mec

hani

sms

Sust

aina

ble

capa

city

– 5

An

nual

upd

ates

on

the

stat

us o

f IH

R im

plem

enta

tion

to s

take

hold

ers

(incl

udin

g W

HO

and

oth

er IH

R St

ates

Par

ties

acro

ss a

ll re

leva

nt s

ecto

rs) a

re c

ondu

cted

an

d co

nfirm

the

effic

ienc

y an

d ef

fect

iven

ess

of th

e co

ordi

natio

n, c

omm

unic

atio

n an

d ad

voca

cy a

rran

gem

ents

acr

oss

all r

elev

ant s

ecto

rs

Cont

extu

al q

uest

ions

:

1.

How

doe

s th

e co

untr

y co

ordi

nate

with

diff

eren

t min

istr

ies,

incl

udin

g go

vern

men

t age

ncie

s an

d ot

her r

elev

ant s

ecto

rs fo

r hea

lth e

mer

genc

ies

(bef

ore,

dur

ing

and

afte

r an

emer

genc

y)?

Tech

nica

l que

stio

ns:

P.2.

1. A

func

tiona

l mec

hani

sm e

stab

lishe

d fo

r the

coo

rdin

atio

n an

d in

tegr

atio

n of

rele

vant

sec

tors

in th

e im

plem

enta

tion

of IH

R

1.

Are

key

mem

bers

of t

he N

atio

nal I

HR

Foca

l Poi

nt a

ble

to c

omm

unic

ate

effe

ctiv

ely,

in w

ritin

g an

d ve

rbal

ly, w

ith W

HO

and

oth

er in

tern

atio

nal e

xper

ts fo

r re

port

ing

purp

oses

? 2.

Is

ther

e an

upd

ated

con

tact

dire

ctor

y in

clud

ing

all m

embe

rs o

f the

Nat

iona

l IH

R Fo

cal P

oint

?3.

Is

this

mec

hani

sm p

lace

d at

a h

igh

enou

gh le

vel w

ithin

the

gove

rnm

ent s

o th

at a

who

le-o

f-go

vern

men

t app

roac

h ca

n be

take

n?4.

Ar

e th

ere

exam

ples

of

effe

ctiv

e co

ordi

natio

n w

ithin

the

rel

evan

t m

inis

trie

s on

eve

nts

that

may

con

stitu

te a

pub

lic h

ealth

eve

nt o

r ris

k of

nat

iona

l or

inte

rnat

iona

l con

cern

?

2 -

Addi

tiona

l inf

orm

atio

n ca

n be

use

d fr

om th

e fo

llow

ing

indi

cato

rs:

• D.3

.1 S

yste

m fo

r effi

cien

t rep

ortin

g to

Foo

d an

d Ag

ricul

ture

Org

aniz

atio

n (F

AO),

OIE

and

WH

O• D

.3.2

Rep

ortin

g ne

twor

k an

d pr

otoc

ols

with

in th

e co

untr

y• R

.3.1

Pub

lic h

ealth

and

sec

urity

aut

horit

ies

(suc

h as

law

enf

orce

men

t, bo

rder

con

trol

and

cus

tom

s ar

e lin

ked

durin

g a

susp

ect o

r con

firm

ed b

iolo

gica

l eve

nt)

• Rel

evan

t sec

tors

incl

ude

priv

ate

and

publ

ic s

ecto

rs, s

uch

as: a

ll le

vels

of t

he h

ealth

car

e sy

stem

(nat

iona

l, su

bnat

iona

l and

com

mun

ity/p

rimar

y pu

blic

hea

lth);

NG

Os;

div

isio

ns/a

ctiv

ities

of o

ther

sec

tors

whi

ch a

ffect

pub

lic

heal

th, s

uch

as m

inis

trie

s of

agr

icul

ture

(qua

rant

ine

and

mov

emen

t con

trol

aut

horit

y, im

port

/exp

ort r

egul

atio

ns, d

isea

se d

iagn

osis

and

con

trol

fina

ncin

g, z

oono

sis,

vet

erin

ary

labo

rato

ry e

tc.),

tran

spor

t (tr

ansp

ort p

olic

y, ci

vil

avia

tion,

por

ts a

nd m

ariti

me

tran

spor

t), t

rade

and

/or i

ndus

try

(food

saf

ety

and

qual

ity c

ontr

ol),

fore

ign

trad

e (c

onsu

mer

pro

tect

ion,

con

trol

of c

ompu

lsor

y st

anda

rd e

nfor

cem

ent)

, com

mun

icat

ion,

def

ence

, tre

asur

y or

fina

nce

(cus

tom

s), e

nviro

nmen

t, in

terio

r, he

alth

, tou

rism

; hea

lth, t

ouris

m; t

he h

ome

offic

e; m

edia

; and

regu

lato

ry b

odie

s.3

- Th

ere

is c

ritic

al c

ompe

tenc

y on

com

mun

icat

ion

in th

e PV

S to

ol C

C III

-1.

PR

EV

EN

T



5.

Are

SOPs

or g

uide

lines

ava

ilabl

e fo

r coo

rdin

atio

n be

twee

n th

e N

atio

nal I

HR

Foca

l Poi

nt a

nd o

ther

rele

vant

act

ors?

6.

Hav

e fu

nctio

nal m

echa

nism

s fo

r m

ultis

ecto

ral c

olla

bora

tion

that

incl

ude

clin

ical

ser

vice

s, a

nim

al a

nd h

uman

hea

lth s

urve

illan

ce u

nits

, com

mun

icat

ion

units

and

labo

rato

ries

been

est

ablis

hed?

7.

Is t

here

tim

ely

and

syst

emat

ic in

form

atio

n ex

chan

ge b

etw

een

Dis

tric

t/Pr

ovin

cial

Hea

lth O

ffice

s, a

nim

al s

urve

illan

ce u

nits

, lab

orat

orie

s, h

uman

hea

lth

surv

eilla

nce

units

and

oth

er re

leva

nt s

ecto

rs re

gard

ing

pote

ntia

l zoo

notic

risk

s an

d ur

gent

/em

ergi

ng z

oono

tic e

vent

s?8.

Is

ther

e a

func

tiona

l mec

hani

sm fo

r mul

tisec

tora

l col

labo

ratio

n w

ith o

ther

rele

vant

sec

tors

for o

ther

IHR

rela

ted

haza

rds,

suc

h as

che

mic

al a

nd ra

diat

ion

sect

ors?

9.

Is th

ere

a co

ordi

natio

n m

echa

nism

for d

etec

ting

and

resp

ondi

ng to

del

iber

ate

and/

or a

ccid

enta

l eve

nts

occu

rrin

g fo

r exa

mpl

e in

mas

s ga

ther

ings

?10

. Is

a m

ultis

ecto

ral,

mul

tidis

cipl

inar

y co

ordi

natio

n an

d co

mm

unic

atio

n m

echa

nism

upd

ated

and

test

ed re

gula

rly?

11.

Are

actio

n pl

ans

deve

lope

d to

inco

rpor

ate

less

ons

lear

nt fr

om m

ultis

ecto

ral/

mul

tidis

cipl

inar

y co

ordi

natio

n an

d co

mm

unic

atio

n m

echa

nism

s?12

. Ar

e th

e up

date

s of

IHR

impl

emen

tatio

n sh

ared

with

oth

er re

leva

nt s

ecto

rs?

13.

Hav

e th

e fu

nctio

ns o

f the

Nat

iona

l IH

R Fo

cal P

oint

bee

n ev

alua

ted

for e

ffect

iven

ess?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

OIE

PVS

Pat

hway

repo

rts

l

Rep

orts

to W

HO

gov

erni

ng b

odie

s on

IHR

impl

emen

tatio

n (s

uch

as E

xecu

tive

Boar

d an

d W

orld

Hea

lth A

ssem

bly)

l

Leg

isla

tion,

pro

toco

ls o

r oth

er p

olic

ies

rela

ted

to re

port

ing

to W

HO

l

Any

pla

ns th

at h

ave

been

dra

fted

or o

ther

evi

denc

e th

at c

over

s re

spon

se to

pos

sibl

e bi

olog

ical

, che

mic

al a

nd ra

diol

ogic

al e

vent

s

PR

EV

EN

T



ANTI

MIC

ROBI

AL R

ESIS

TAN

CETa

rget

: A fu

nctio

nal s

yste

m in

pla

ce fo

r the

nat

iona

l res

pons

e to

com

bat a

ntim

icro

bial

resi

stan

ce (A

MR)

with

a O

ne-H

ealth

app

roac

h, in

clud

ing:

a)

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. T

his

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 G

loba

l Act

ion

Plan

(GAP

) on

AMR.

b)

Sur

veill

ance

cap

acity

for A

MR

and

antim

icro

bial

use

at t

he n

atio

nal l

evel

, fol

low

ing

and

usin

g in

tern

atio

nally

agr

eed

syst

ems

such

as

the

WH

O G

loba

l An

timic

robi

al R

esis

tanc

e Su

rvei

llanc

e Sy

stem

(GLA

SS) a

nd th

e O

IE g

loba

l dat

abas

e on

use

of a

ntim

icro

bial

age

nts

in a

nim

als.

c)

Pre

vent

ion

of A

MR

in h

ealth

car

e 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.

d) E

nsur

ing

appr

opria

te u

se o

f an

timic

robi

als,

inc

ludi

ng a

ssur

ing

qual

ity o

f av

aila

ble

med

icin

es, c

onse

rvat

ion

of e

xist

ing

trea

tmen

ts a

nd a

cces

s to

ap

prop

riate

ant

imic

robi

als

whe

n ne

eded

, whi

le re

duci

ng in

appr

opria

te u

se.

The

JEE

tool

sho

uld

also

revi

ew a

nd v

alid

ate

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.

As m

easu

red

by: (

1) M

ultis

ecto

ral n

atio

nal a

ctio

n pl

an to

com

bat A

MR

has

been

pro

duce

d an

d m

ade

publ

ic. (

2) Im

plem

enta

tion

of th

e na

tiona

l act

ion

plan

/sec

tor

plan

s on

AM

R, w

ith m

onito

ring

and

year

ly re

port

ing

on p

rogr

ess

(incl

udin

g re

port

ing

to th

e in

tern

atio

nal l

evel

).

Desi

red

impa

ct: D

ecis

ive

and

com

preh

ensi

ve a

ctio

n to

pre

vent

the

em

erge

nce

and

spre

ad o

f AM

R, w

hich

pos

es a

sub

stan

tial a

nd e

volv

ing

thre

at t

o di

seas

e co

ntro

l and

hea

lth s

ecur

ity. C

ount

ries

will

(in

line

with

the

GAP

) in

crea

se a

war

enes

s of

AM

R ris

ks a

nd h

ow t

o re

spon

d to

the

m; s

tren

gthe

n su

rvei

llanc

e an

d la

bora

tory

cap

acity

; enh

ance

infe

ctio

n pr

even

tion

and

cont

rol a

ctiv

ities

; ens

ure

unin

terr

upte

d ac

cess

to e

ssen

tial a

ntim

icro

bial

s of

ass

ured

qua

lity;

regu

late

and

pr

omot

e th

e ap

prop

riate

use

of a

ntim

icro

bial

s in

hum

an m

edic

ine,

vet

erin

ary

med

icin

e, fo

od p

rodu

ctio

n an

d ot

her fi

elds

as

appr

opria

te; a

nd s

uppo

rt in

itiat

ives

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.

PR

EV

EN

T



Scor

e1

Indi

cato

rs: A

ntim

icro

bial

resi

stan

ce (A

MR)

2 P.

3.1

Effe

ctiv

e

mul

tisec

tora

l3 coo

rdin

atio

n on

AM

RP.

3.2

Surv

eilla

nce

of A

MR4

P.3.

3 In

fect

ion

prev

entio

n an

d co

ntro

l5,6

P.3.

4 O

ptim

ize

use

of a

ntim

icro

bial

m

edic

ines

in h

uman

and

ani

mal

he

alth

and

agr

icul

ture

No

capa

city

- 1

No

natio

nal a

ctio

n pl

an fo

r AM

RN

o la

bora

torie

s tha

t con

duct

antib

iotic

su

scep

tibili

ty t

estin

g ar

e ge

nera

ting

data

(an

tibio

tic s

usce

ptib

ility

tes

ting

and

acco

mpa

nyin

g cl

inic

al

and

epid

emio

logi

cal

data

) an

d re

port

ing

on A

MR

No

syst

emat

ic

effo

rts,

na

tiona

l pr

ogra

mm

e, o

r re

spon

sibl

e pe

rson

s fo

r in

fect

ion

prev

entio

n an

d co

ntro

l in

hu

man

he

alth

ca

re

faci

litie

s/to

pr

omot

e in

fect

ion

prev

entio

n an

d pr

even

t tr

ansm

issi

on

of

resi

stan

t ba

cter

ia in

the

anim

al fo

od p

rodu

ctio

n se

ctor

No

or w

eak

polic

y an

d re

gula

tions

on

app

ropr

iate

use

, av

aila

bilit

y an

d qu

ality

of a

ntim

icro

bial

s

Lim

ited

ca

paci

ty -

2

Nat

iona

l AM

R ac

tion

plan

un

der

deve

lopm

ent

or p

lan

invo

lves

onl

y on

e se

ctor

or m

inis

try

Mul

tisec

tora

l co

ordi

natio

n m

echa

-ni

sm h

as b

een

esta

blis

hed,

with

go-

vern

men

t lea

ders

hip

Som

e clin

ical

or r

efer

ence

labo

rato

ries

can

prod

uce

AMR

data

loc

ally

but

na

tiona

l co

ordi

natio

n an

d/or

qua

lity

man

agem

ent d

o no

t yet

exi

st

Nat

iona

l w

ater

, sa

nita

tion

and

hygi

ene

(WAS

H)

and

envi

ronm

enta

l he

alth

sta

ndar

ds e

xist

but

are

not

fu

lly im

plem

ente

dN

atio

nal p

olic

y an

d pl

an a

re a

vaila

ble

for

infe

ctio

n pr

even

tion

and

cont

rol

(IPC)

in

anim

al h

ealth

car

e th

roug

h im

prov

ing

bios

ecur

ity7 ,

anim

al

vacc

inat

ion

and

anim

al h

usba

ndry

Nat

iona

l po

licy

for

anti-

mic

robi

al

gove

rnan

ce a

nd re

gula

tion

deve

lope

d,

that

add

ress

es u

se,

avai

labi

lity

and

qual

ity o

f ant

imic

robi

als

Deve

lope

d ca

paci

ty -

3

Nat

iona

l AM

R ac

tion

plan

dev

elop

ed

that

add

ress

es a

t lea

st h

uman

hea

lth

and

anim

al fo

od p

rodu

ctio

n se

ctor

sM

ultis

ecto

ral c

oord

inat

ion

is fu

nctio

-na

l with

regu

lar m

eetin

gs

Nat

iona

l AM

R su

rvei

llanc

e ac

tiviti

es

are

perf

orm

ed a

ccor

ding

to

natio

nal

stan

dard

s, w

ith a

fun

ctio

nal n

atio

nal

AMR

refe

renc

e la

bora

tory

th

at

part

icip

ates

in

ex

tern

al

qual

ity

assu

ranc

e an

d co

nduc

ts c

onfir

mat

ory

or a

dditi

onal

test

ing

Coun

try

prio

rity

path

ogen

s ha

ve b

een

iden

tified

for s

urve

illan

ce8

Nat

iona

l gu

idel

ines

fo

r IP

C in

an

imal

pro

duct

ion

are

avai

labl

e an

d di

ssem

inat

edSe

lect

ed h

ealth

car

e fa

cilit

ies/

farm

s ar

e im

plem

entin

g th

e gu

idel

ines

, with

m

onito

ring

and

feed

back

in p

lace

All

refe

rral

ho

spita

ls

have

W

ASH

fa

cilit

ies

that

are

fun

ctio

nal,

in l

ine

with

nat

iona

l sta

ndar

ds

Prac

tices

to

assu

re a

ppro

pria

te u

se

are

impl

emen

ted

in s

ome

heal

th c

are

faci

litie

s6,9

Legi

slat

ion

and

regu

latio

ns a

ppro

ved

on i

mpo

rt,

mar

ketin

g au

thor

izat

ion,

pr

oduc

tion

and

use

of a

ntim

icro

bial

sG

uide

lines

fo

r ap

prop

riate

us

e of

an

timic

robi

als

are

avai

labl

e

PR

EV

EN

T

1 -

Sinc

e AM

R ne

eds

to b

e ad

dres

sed

as a

mul

tisec

tora

l iss

ue, t

he fi

rst a

ttrib

ute

(3.1

) ask

s ab

out p

rogr

ess

with

mul

tisec

tora

l coo

rdin

atio

n, in

clud

ing

deve

lopi

ng a

nd im

plem

entin

g a

natio

nal A

MR

actio

n pl

an. I

n or

der

to m

ake

the

asse

ssm

ent a

nd ra

ting

man

agea

ble,

the

attr

ibut

es fo

r sco

ring

are

focu

sing

on

sele

cted

asp

ects

of t

he re

spon

se to

AM

R: s

urve

illan

ce o

f res

ista

nce

(P3.

2), i

nfec

tion

prev

entio

n in

hea

lth c

are

faci

litie

s an

d on

farm

s (P

3.3)

, and

op

timiz

ing

the

use

of a

ntim

icro

bial

s (P

3.4)

, foc

usin

g on

hum

an a

nd a

nim

al h

ealth

sec

tors

onl

y. T

he a

sses

smen

t of c

apac

ities

for A

MR

cont

rol s

houl

d be

com

plet

ed tw

ice

for a

ttrib

utes

3.2

to 3

.4, a

s ca

paci

ties

shou

ld b

e se

para

tely

ev

alua

ted

in th

e hu

man

hea

lth s

ecto

r and

for a

nim

al fo

od p

rodu

ctio

n se

ctor

(ter

rest

rial a

nd a

quat

ic).

Prog

ress

on

addr

essi

ng o

ther

asp

ects

of t

he re

spon

se to

AM

R (in

clud

ing

othe

r sec

tors

) may

als

o be

con

side

red

durin

g th

e JE

E,

but t

hese

asp

ects

are

not

exp

licitl

y ra

ted.

Whe

re th

ere

are

seve

ral c

riter

ia fo

r a s

core

, the

cou

ntry

is e

xpec

ted

to m

eet a

ll th

ese

crite

ria, a

s w

ell a

s th

e cr

iteria

for l

ower

sco

res.

The

fina

l sco

re s

houl

d be

bas

ed o

n th

e lo

wer

of t

he

scor

es fo

r the

hum

an a

nd a

nim

al h

ealth

sec

tors

.2

- In

the

hum

an h

ealth

sec

tor,

the

asse

ssm

ent

shou

ld r

evie

w b

acte

rial r

esis

tanc

e to

ant

ibio

tics.

Vira

l, ot

her

non-

bact

eria

l pat

hoge

n an

d ve

ctor

res

ista

nce

are

out

of s

cope

, unl

ess

inte

grat

ed in

nat

iona

l pol

icie

s, s

tand

ards

or

guid

elin

es. S

yste

ms

for t

rack

ing

hum

an tu

berc

ulos

is re

sist

ance

are

man

aged

thro

ugh

tube

rcul

osis

pro

gram

mes

. For

food

pro

duct

ion

aspe

cts,

all

antim

icro

bial

s ar

e in

clud

ed.



Dem

onst

rate

d ca

paci

ty -

4

Mul

tisec

tora

l AM

R ac

tion

plan

ap

prov

ed a

nd re

flect

s G

AP o

bjec

tives

, w

ith

an

oper

atio

nal

plan

an

d m

onito

ring

arra

ngem

ents

Cent

rally

coo

rdin

ated

nat

iona

l AM

R se

ntin

el

surv

eilla

nce

syst

em

that

pr

oduc

es

regu

lar

repo

rts

on

AMR

resi

stan

ce le

vels

Sent

inel

labo

rato

ries

supp

ortin

g AM

R su

rvei

llanc

e th

at f

ollo

w q

ualit

y as

-su

ranc

e pr

oces

ses

and

dem

onst

rate

go

od p

erfo

rman

ce-t

estin

g

Nat

ionw

ide

impl

emen

tatio

n of

IP

C pl

ans

and

guid

elin

es i

n pu

blic

and

pr

ivat

e se

ctor

sAl

l hea

lth ca

re fa

cilit

ies h

ave a

suita

ble

func

tiona

l en

viro

nmen

t (in

clud

ing

wat

er a

nd s

anita

tion

faci

litie

s),

and

nece

ssar

y m

ater

ials

and

equ

ipm

ent

to p

erfo

rm IP

C pe

r nat

iona

l sta

ndar

ds

Prac

tices

to

enab

le a

ppro

pria

te u

se

are

impl

emen

ted

in h

ealth

fac

ilitie

s na

tionw

ide,

for a

ll an

tibio

tics10

Pr

actic

es

on

appr

opria

te

use

in

anim

als

and

crop

s in

line

with

Cod

ex

and

OIE

sta

ndar

ds a

re a

vaila

ble

and

impl

emen

ted

natio

nwid

eRe

leva

nt

legi

slat

ion

has

been

re

view

ed

for

cohe

renc

e;

gaps

/ov

erla

ps/

inco

nsis

tenc

ies

have

bee

n id

entifi

edU

se

of

antim

icro

bial

s fo

r an

imal

gr

owth

pro

mot

ion

has

been

pha

sed

out

Sust

aina

ble

capa

city

– 5

Mul

tisec

tora

l AM

R ac

tion

plan

has

id

entifi

ed f

undi

ng s

ourc

es,

is b

eing

im

plem

ente

d an

d ha

s m

onito

ring

in

plac

e

The

natio

nal

AMR

surv

eilla

nce

sys-

tem

inte

grat

es s

urve

illan

ce o

f AM

R in

pa

thog

ens

of c

once

rn t

o hu

man

and

an

imal

hea

lth a

nd a

gric

ultu

re,

and

gene

rate

s re

gula

r rep

orts

Repo

rts

prov

ide

data

tha

t is

rep

re-

sent

ativ

e of

the

gene

ral p

opul

atio

n

PC is

in p

lace

and

func

tioni

ng a

t na-

tiona

l and

hea

lth fa

cilit

y le

vels

In

fect

ion

prev

entio

n ef

fect

iven

ess

is

regu

larly

eva

luat

ed, w

ith r

esul

ts p

u-bl

ishe

d Pl

ans

and

guid

ance

are

upd

ated

in

resp

onse

to m

onito

ring

Rele

vant

legi

slat

ion

has

been

revi

sed

and

a co

here

nt fr

amew

ork

is in

pla

ce

and

fully

fun

ctio

nal,

so t

hat

only

li-

cens

ed a

nd p

rove

n qu

ality

dru

gs a

re

in u

se

PR

EV

EN

T

3 -

Mul

tisec

tora

l ind

icat

es a

One

Hea

lth (r

efer

to g

loss

ary)

app

roac

h re

pres

enta

tive

of, a

t lea

st, h

uman

, ani

mal

, cro

ps a

nd fo

od s

afet

y as

pect

s.4

- Th

is a

sses

smen

t foc

uses

on

surv

eilla

nce

of A

MR

leve

ls in

hum

an h

ealth

and

ani

mal

food

pro

duct

ion

sect

ors.

Sur

veill

ance

/mon

itorin

g of

ant

imic

robi

al u

se in

hum

ans

and

anim

als

is a

noth

er im

port

ant e

lem

ent o

f nat

iona

l AM

R ac

tion

plan

s, a

nd th

e pl

ans

may

als

o in

clud

e ot

her t

ypes

of s

urve

illan

ce; h

owev

er, w

hile

thes

e m

ay b

e di

scus

sed

durin

g th

e JE

E, th

ey a

re n

ot p

art o

f the

ratin

g.5

- Fo

r th

e hu

man

hea

lth s

ecto

r, at

trib

ute

P3.3

foc

uses

on

infe

ctio

n pr

even

tion

and

cont

rol (

IPC)

in h

ealth

car

e fa

cilit

ies,

whi

le r

ecog

nizi

ng t

hat

prev

entio

n of

infe

ctio

n in

the

com

mun

ity is

als

o cr

itica

l, th

roug

h pu

blic

hea

lth

mec

hani

sms

incl

udin

g im

prov

ing

wat

er a

nd s

anita

tion,

and

incr

easi

ng v

acci

natio

n co

vera

ge. I

PC p

rogr

amm

es in

the

heal

th s

ecto

r ar

e re

com

men

ded

to in

clud

e: d

evel

opm

ent a

nd im

plem

enta

tion

of e

vide

nce-

base

d gu

idel

ines

; ed

ucat

ion

and

trai

ning

of h

ealth

car

e w

orke

rs; s

urve

illan

ce o

f hea

lth c

are

asso

ciat

ed in

fect

ions

; mul

timod

al im

plem

enta

tion

stra

tegi

es; r

egul

ar m

onito

ring,

aud

it an

d fe

edba

ck o

f pra

ctic

es a

t the

faci

lity

leve

l and

nat

iona

l mon

itorin

g w

ith h

and

hygi

ene

as a

key

per

form

ance

indi

cato

r; an

ena

blin

g en

viro

nmen

t inc

ludi

ng b

ed o

ccup

ancy

not

exc

eedi

ng th

e ca

paci

ty o

f the

faci

lity;

hea

lth w

orke

r sta

ffing

acc

ordi

ng to

pat

ient

wor

kloa

d; a

hyg

ieni

c en

viro

nmen

t inc

ludi

ng

wat

er, s

anita

tion

and

hygi

ene

(WAS

H) i

nfra

stru

ctur

e; a

nd a

vaila

bilit

y of

IPC

mat

eria

ls a

nd e

quip

men

t. (S

ee IP

C Co

re C

ompo

nent

s, 2

016

(htt

p://

ww

w.w

ho.in

t/gp

sc/c

ore-

com

pone

nts.

pdf,

acce

ssed

23

Nov

embe

r 201

7).

6 -

For t

he a

nim

al fo

od p

rodu

ctio

n se

ctor

s, th

e fo

cus

of a

ttrib

ute

P3.3

is o

n in

fect

ion

prev

entio

n th

at p

rom

otes

goo

d an

imal

hus

band

ry a

nd a

ims

to re

duce

the

use

of a

ntim

icro

bial

s in

farm

ed a

nim

als

and

food

pro

duct

ion.

Infe

ctio

n pr

even

tion/

good

ani

mal

hus

band

ry p

lans

in th

e an

imal

food

pro

duct

ion

sect

ors

tend

to in

clud

e pr

omot

ion

of fa

rm h

ygie

ne, a

vac

cina

tion

prog

ram

me,

bio

secu

rity

mea

sure

s, a

ppro

pria

te fe

edin

g an

d cl

ean

wat

er, a

nd h

andl

ing

of

sick

ani

mal

s, to

pre

vent

the

tran

smis

sion

of r

esis

tant

bac

teria

to h

uman

s an

d ot

her a

nim

als.

7 -

Bio

secu

rity

in th

e co

ntex

t of A

MR

rela

tes

to th

e pr

even

tion

of d

isea

se tr

ansm

issi

on in

ani

mal

s. It

refe

rs to

a s

et o

f man

agem

ent a

nd

phys

ical

mea

sure

s de

sign

ed to

redu

ce th

e ris

k of

intr

oduc

tion,

est

ablis

hmen

t and

spr

ead

of a

nim

al in

fect

ions

to, f

rom

and

with

in a

n an

imal

pop

ulat

ion

(OIE

Ter

rest

rial A

nim

al H

ealth

Cod

e).

8 - P

riorit

y pa

thog

ens

for s

urve

illan

ce in

hum

an h

ealth

may

incl

ude

som

e, a

ll or

mor

e th

an th

e ei

ght p

atho

gens

(and

bug

-dru

g co

mbi

natio

ns) s

elec

ted

by th

e W

orld

Hea

lth O

rgan

izat

ion

for g

loba

l rep

ortin

g at

the

early

impl

emen

tatio

n st

age

of G

LASS

(Aci

neto

bact

er b

aum

anni

i, Es

cher

ichi

a co

li, K

lebs

iella

pne

umon

ia, S

taph

yloc

occu

s au

reus

, Str

epto

cocc

us p

neum

onia

e, S

alm

onel

la s

pp.,

Shig

ella

spp

, Nei

sser

ia g

onor

rhea

e). P

riorit

y pa

thog

ens

for a

nim

al h

ealth

and

fo

od s

afet

y w

ill b

e de

fined

at t

he g

loba

l lev

el in

201

7. S

urve

illan

ce is

exp

ecte

d to

incl

ude

Salm

onel

la s

pp. O

ther

prio

rity

path

ogen

s m

ay b

e ad

ded

by n

atio

nal a

utho

ritie

s ba

sed

on c

ount

ry n

eeds

.9

- Pr

actic

es m

ay in

clud

e: u

nint

erru

pted

acc

ess

to h

igh-

qual

ity m

edic

ines

to tr

eat b

acte

rial i

nfec

tions

; mea

sure

men

ts o

f ant

imic

robi

al u

se; a

vaila

bilit

y of

cul

ture

s an

d an

tibio

gram

s fo

r clin

ical

dec

isio

n m

akin

g; re

gula

r upd

ates

to

loca

l ant

ibio

gram

s an

d ge

netic

ana

lyse

s to

info

rm tr

eatm

ent d

ecis

ions

; and

aud

it w

ith fe

edba

ck to

pre

scrib

ers

of a

ntib

iotic

s to

enc

oura

ge a

ppro

pria

te u

se. I

n he

alth

car

e, th

ese

are

ofte

n re

ferr

ed to

as

antim

icro

bial

ste

war

dshi

p pr

ogra

mm

es.

10 -

For

the

ani

mal

sec

tor,

avai

labl

e O

IE P

VS P

athw

ay r

epor

ts s

houl

d be

tak

en in

to a

ccou

nt. C

ount

ries

shou

ld a

lso

give

con

side

ratio

n to

the

mos

t re

cent

res

pons

e to

the

trip

artit

e gl

obal

AM

R m

onito

ring

ques

tionn

aire

whe

n un

dert

akin

g th

is a

sses

smen

t. Th

ere

is a

rele

vant

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C II-

9: V

eter

inar

y m

edic

ines

and

bio

logi

cals

.



Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

P3.1

Effe

ctiv

e m

ultis

ecto

ral c

oord

inat

ion

on A

MR

and

the

natio

nal a

ctio

n pl

an

1.

How

is m

ultis

ecto

ral w

ork

on A

MR

orga

nize

d? Is

the

re a

n in

ters

ecto

ral c

oord

inat

ion

com

mitt

ee o

r w

orki

ng g

roup

with

defi

ned

term

s of

ref

eren

ce a

nd

repo

rtin

g/ac

coun

tabi

lity

mec

hani

sms?

How

oft

en h

as it

met

and

who

att

ends

the

mee

tings

? 2.

W

hat i

s th

e st

atus

of t

he n

atio

nal a

ctio

n pl

an o

n AM

R? H

as it

bee

n ap

prov

ed fo

rmal

ly?

Are

ther

e se

vera

l pla

ns o

r one

inte

grat

ed p

lan?

Are

food

, agr

icul

ture

an

d en

viro

nmen

t rep

rese

nted

in a

dditi

on to

hum

an a

nd a

nim

al h

ealth

?3.

D

oes

the

natio

nal a

ctio

n pl

an c

onsi

der

the

mai

n ar

eas

iden

tified

in t

he g

loba

l act

ion

plan

on

AMR

– p

artic

ular

ly r

aisi

ng a

war

enes

s, t

rain

ing/

educ

atio

n on

AM

R, s

urve

illan

ce o

f res

ista

nce

and

use,

pre

vent

ion

of in

fect

ions

and

opt

imiz

ing

the

use

of a

ntim

icro

bial

s in

bot

h hu

man

and

vet

erin

ary/

agric

ultu

re

sect

ors?

4.

Is

ther

e an

ope

ratio

nal p

lan

and

budg

et fo

r im

plem

enta

tion

of th

e na

tiona

l act

ion

plan

? H

ow is

fund

ing

for p

lann

ed a

ctiv

ities

org

aniz

ed?

Is th

ere

adeq

uate

in

vest

men

t/fu

ndin

g av

aila

ble

to s

uppo

rt im

plem

enta

tion?

5.

H

as p

rogr

ess

tow

ards

the

obje

ctiv

es/g

oals

laid

out

in th

e pl

an b

een

mon

itore

d ye

t? H

as th

ere

been

pro

gres

s to

war

ds im

plem

enta

tion?

Hav

e an

y ba

rrie

rs

and/

or c

halle

nges

to im

plem

entin

g th

e na

tiona

l act

ion

plan

bee

n id

entifi

ed?

6.

How

doe

s th

e pl

an re

cogn

ize

the

role

s an

d re

spon

sibi

litie

s of

mul

tiple

juris

dict

ions

and

leve

ls o

f gov

ernm

ent?

P.3.

2 An

timic

robi

al re

sist

ance

(AM

R) s

urve

illan

ce

1.

Wha

t is

the

labo

rato

ry c

apac

ity to

det

ect,

isol

ate

and

iden

tify

antim

icro

bial

-res

ista

nt o

rgan

ism

s fr

om h

uman

s, a

nim

als,

food

and

the

envi

ronm

ent?

2.

Is th

ere

a na

tiona

l pla

n/sy

stem

for s

urve

illan

ce o

f inf

ectio

ns c

ause

d by

ant

imic

robi

al-r

esis

tant

pat

hoge

ns?

Is th

ere

mon

itorin

g of

the

surv

eilla

nce

syst

em

to in

form

regu

lar p

lan

revi

ews

and

upda

tes?

3.

H

ow m

any

hosp

itals

(per

cent

age

of to

tal n

umbe

r of h

ospi

tals

) are

(will

be)

site

s fo

r sur

veill

ance

of i

nfec

tions

cau

sed

by a

ntim

icro

bial

-res

ista

nt p

atho

gens

am

ong

hum

ans?

Whi

ch s

peci

men

s, p

atho

gens

and

ant

imic

robi

als

do/w

ill th

ey c

over

? H

ow d

oes

this

com

pare

with

the

plan

for e

nhan

cing

sur

veill

ance

in

hosp

itals

? Ar

e de

nom

inat

or d

ata

(suc

h as

num

ber o

f pat

ient

s w

ith a

spe

cific

dis

ease

or s

yndr

ome,

num

ber o

f pat

ient

s w

ith s

ampl

es ta

ken)

col

lect

ed?

4.

How

will

sur

veill

ance

be

esta

blis

hed/

wha

t is

in p

lace

in th

e co

mm

unity

and

in o

utpa

tient

set

tings

? 5.

H

ow m

any

farm

s (p

erce

ntag

e of

tota

l num

ber

of fa

rms)

with

live

stoc

k ar

e (w

ill b

e) s

entin

el s

ites

for

surv

eilla

nce

of in

fect

ions

cau

sed

by a

ntim

icro

bial

-re

sist

ant p

atho

gens

in li

vest

ock?

a.

Wha

t ani

mal

spe

cies

are

cov

ered

by

AMR

surv

eilla

nce?

b. W

hat z

oono

tic b

acte

rial s

peci

es a

re c

over

ed b

y AM

R su

rvei

llanc

e?c.

Wha

t vet

erin

ary

path

ogen

s ar

e co

vere

d by

AM

R su

rvei

llanc

e?

PR

EV

EN

T



d. W

here

is A

MR

surv

eilla

nce

cond

ucte

d in

the

food

cha

in?

On-

farm

, sla

ught

ered

ani

mal

s, re

tail

mea

t?e.

Des

crib

e th

e sa

mpl

ing

sche

me.

i.

Num

ber o

f sam

pled

site

s an

d ho

w th

ey a

re c

hose

n, s

uch

as n

umbe

r of f

arm

s (r

ando

mly

sel

ecte

d, p

urpo

sive

ly s

elec

ted,

con

veni

ence

sam

ple,

cen

sus)

; nu

mbe

r of a

batt

oirs

(how

are

thes

e se

lect

ed?)

; num

ber o

f ret

ail e

stab

lishm

ents

; num

ber/

type

of p

artic

ipat

ing

clin

ical

labo

rato

ries.

ii. H

ow w

ere

the

num

ber a

nd ty

pes

of is

olat

es d

eter

min

ed?

6.

Is t

here

at

leas

t on

e na

tiona

l ref

eren

ce la

bora

tory

11 f

or A

MR?

How

wel

l is

it (a

re t

hey)

fun

ctio

ning

and

sup

port

ing

surv

eilla

nce

site

s? D

oes

it ro

utin

ely

cond

uct c

onfir

mat

ory

or a

dditi

onal

test

ing

on re

ferr

ed is

olat

es?

7.

Does

the

nat

iona

l ref

eren

ce la

bora

tory

rec

eive

sam

ples

from

clin

ics,

hos

pita

ls, v

eter

inar

y di

agno

stic

labo

rato

ries

and

envi

ronm

enta

l sou

rces

(i.e

. wat

er, s

oil,

efflu

ents

)?8.

W

hat

repo

rts

are

avai

labl

e on

leve

ls o

f res

ista

nce

in p

atho

gens

rel

evan

t to

ani

mal

food

pro

duct

ion

and

hum

ans?

Are

the

re n

atio

nal r

epor

ts o

n im

pact

/bu

rden

of A

MR

avai

labl

e? If

rout

ine

repo

rts

are

not a

vaila

ble,

wha

t stu

dies

hav

e be

en d

one

or a

re u

nder

way

? 9.

Is

ther

e a

natio

nal c

oord

inat

ing

cent

re11

est

ablis

hed

that

is p

rodu

cing

repo

rts

on re

sist

ance

leve

ls?

10.

Wha

t typ

es o

f rep

orts

are

gen

erat

ed?

Who

rece

ives

thes

e re

port

s? A

re re

port

s se

nt to

GLA

SS?

Are

repo

rts

acce

ssib

le to

oth

er s

take

hold

ers

(suc

h as

FAO

, OIE

)?11

. D

oes

surv

eilla

nce

of A

MR

inte

grat

e da

ta fr

om b

oth

hum

an a

nd a

nim

al h

ealth

sou

rces

? 12

. H

ow re

pres

enta

tive

is th

e re

port

ed A

MR

data

of t

he c

omm

unity

and

acr

oss

geog

raph

ic a

reas

and

set

tings

? 13

. H

ow h

as th

e da

ta fr

om A

MR

surv

eilla

nce

been

use

d? H

as it

bee

n co

nsid

ered

by

natio

nal p

olic

y m

aker

s? H

ave

loca

l or n

atio

nal t

reat

men

t gui

delin

es b

een

adap

ted?

Hav

e an

y vo

lunt

ary

or le

gisl

ativ

e po

licie

s be

en p

ut in

to p

lace

bas

ed o

n th

e su

rvei

llanc

e da

ta?

14.

Is a

ntim

icro

bial

use

and

/or c

onsu

mpt

ion

mon

itore

d fo

r hum

ans,

ani

mal

s, a

nd fo

od c

rops

? If

yes,

how

?15

. D

oes

the

coun

try

prov

ide

data

to th

e O

IE’s

glo

bal d

atab

ase

on a

ntim

icro

bial

age

nts

used

in a

nim

als?

16.

Is t

here

sur

veill

ance

of

resi

stan

t pa

thog

ens

cont

amin

atio

n oc

curr

ing

via

efflu

ent

disc

harg

es?

At w

hat

leve

ls (

phar

mac

eutic

al in

dust

ry s

ourc

es, h

ealth

cl

inic

s, in

tens

ive

anim

al fe

edin

g or

live

stoc

k si

tes)

are

effl

uent

s m

onito

red?

17

. Is

the

phar

mac

eutic

als

prod

uctio

n in

dust

ry a

ddre

ssed

in th

e na

tiona

l act

ion

plan

? If

yes,

how

?

11 -

Nat

iona

l Ref

eren

ce L

abor

ator

y: th

e pr

imar

y fu

nctio

n w

ithin

the

AMR

surv

eilla

nce

syst

em is

to p

rom

ote

good

mic

robi

olog

ical

labo

rato

ry p

ract

ices

, inc

ludi

ng a

dapt

ing

and

diss

emin

atin

g m

icro

biol

ogic

al m

etho

ds, s

tand

ards

and

pr

otoc

ols

and

to fa

cilit

ate

colla

bora

tion

on a

ll la

bora

tory

mat

ters

rela

ting

to A

MR.

For

sam

ple

term

s of

refe

renc

e se

e G

LASS

gui

de (G

loba

l Ant

imic

robi

al R

esis

tanc

e Su

rvei

llanc

e Sy

stem

(GLA

SS):

guid

e to

upl

oadi

ng a

ggre

gate

d an

timic

robi

al re

sist

ance

dat

a. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

6 ht

tp:/

/app

s.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/2

5174

0/1/

WH

O-D

GO

-AM

R-20

16.7

-eng

.pdf

, acc

esse

d 19

Dec

embe

r 201

7).

12 -

Nat

iona

l Coo

rdin

atin

g Ce

ntre

(NCC

) for

AM

R: a

n in

stitu

tion

that

has

bee

n de

sign

ated

by

the

natio

nal a

utho

ritie

s to

ove

rsee

the

dev

elop

men

t an

d fu

nctio

ning

of t

he n

atio

nal A

MR

surv

eilla

nce

syst

em. T

he N

CC w

ill n

eed

a st

ruct

ure

for s

urve

illan

ce c

oord

inat

ion

and

data

man

agem

ent,

and

colla

bora

te c

lose

ly w

ith b

oth

the

Nat

iona

l Ref

eren

ce L

abor

ator

y an

d su

rvei

llanc

e si

tes.

See

GLA

SS g

uide

(Glo

bal A

ntim

icro

bial

Res

ista

nce

Surv

eilla

nce

Syst

em

(GLA

SS):

guid

e to

upl

oadi

ng a

ggre

gate

d an

timic

robi

al re

sist

ance

dat

a. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

6 ht

tp:/

/app

s.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/2

5174

0/1/

WH

O-D

GO

-AM

R-20

16.7

-eng

.pdf

, acc

esse

d 19

Dec

embe

r 201

7).

PR

EV

EN

T



P.3.

3 In

fect

ion

prev

entio

n an

d co

ntro

l

Hum

an h

ealth

1.

Is th

ere

a na

tiona

l IPC

pro

gram

me

for h

uman

hea

lth, i

nclu

ding

a re

spon

sibl

e pe

rson

and

defi

ned

goal

s an

d st

rate

gies

at t

he n

atio

nal l

evel

?2.

Is

ther

e a

natio

nal p

lan

for I

PC in

hea

lth c

are

sett

ings

? H

ow o

ften

is th

e pl

an u

pdat

ed a

nd re

view

ed?

3.

How

man

y he

alth

car

e fa

cilit

ies

have

dev

elop

ed lo

cal I

PC p

lans

? 4.

W

hich

cor

e co

mpo

nent

s of

IPC

prog

ram

mes

are

par

t of n

atio

nal a

nd h

ealth

car

e fa

cilit

y le

vel I

PC p

lans

? a.

Do

IPC

plan

s in

clud

e gu

idel

ines

and

pro

cedu

res

for a

irbor

ne tr

ansm

issi

on b

ased

pre

caut

ions

? If

not,

whe

re a

re th

ey a

ddre

ssed

? 5.

D

o al

l hos

pita

ls h

ave

IPC

guid

elin

es in

pla

ce in

clud

ing

rout

ine

mon

itorin

g an

d pr

ovis

ion

of fe

edba

ck o

n he

alth

car

e pr

actic

es a

ccor

ding

to IP

C st

anda

rds?

Ar

e th

ere

func

tioni

ng IP

C co

mm

ittee

s at

faci

lity

leve

l?

6.

Are

ther

e de

sign

ated

trai

ned

IPC

prof

essi

onal

s in

eac

h ac

ute

care

faci

lity?

7.

Is

ther

e a

natio

nal o

r sub

natio

nal p

rogr

amm

e on

con

tinui

ng p

rofe

ssio

nal t

rain

ing

for h

ealth

wor

kers

that

incl

udes

key

gui

ding

prin

cipl

es o

f IPC

and

WAS

H?

8.

Is h

and

hygi

ene

com

plia

nce

mea

sure

d an

d fe

edba

ck p

rovi

ded

rout

inel

y at

the

natio

nal l

evel

? Is

ther

e m

onito

ring

to e

nsur

e su

pplie

s of

pre

vent

ive

equi

pmen

t an

d al

coho

l bas

ed h

and

rub?

9.

How

muc

h pr

ogre

ss h

as b

een

mad

e on

ens

urin

g sa

fe w

ater

, san

itatio

n an

d hy

gien

e fa

cilit

ies

in h

ealth

car

e fa

cilit

ies

and

com

mun

ities

? 10

. Is

the

asse

ssm

ent o

f WAS

H in

clud

ed in

ass

essm

ents

of t

he s

afet

y an

d fu

nctio

nalit

y of

hea

lth fa

cilit

ies

for e

mer

genc

ies?

11.

Wha

t sys

tem

s ar

e in

pla

ce a

t nat

iona

l or s

ubna

tiona

l lev

els

to re

gula

rly m

onito

r hea

lth c

are

prac

tices

acc

ordi

ng to

IPC

stan

dard

mea

sure

s, a

nd to

pub

lish

the

resu

lts?

12.

Is th

ere

a na

tiona

l sur

veill

ance

pro

gram

me

for h

ealth

care

-ass

ocia

ted

infe

ctio

ns (H

AI) i

n pl

ace?

How

doe

s H

AI d

ata

info

rm p

olic

y fo

r AM

R pr

even

tion?

Anim

al h

ealth

12.

Is t

here

a n

atio

nal p

lan

for

prev

entin

g in

fect

ious

dis

ease

s in

ani

mal

s? W

hat

mea

sure

s ar

e in

clud

ed (

such

as

bios

ecur

ity, v

acci

ne u

se a

nd c

over

age,

po

stva

ccin

atio

n m

onito

ring,

mar

ket

hygi

ene

SOPs

, far

m id

entifi

catio

n an

d re

gist

ries,

far

m lo

gs, n

atio

nal s

erol

ogic

al s

urve

illan

ce p

lans

, out

brea

k/ev

ent

repo

rtin

g to

nat

iona

l aut

horit

ies/

OIE

)?13

. W

hat s

yste

ms

are

in p

lace

to s

uppo

rt th

e im

plem

enta

tion

of g

ood

anim

al h

usba

ndry

pra

ctic

es, b

iose

curit

y an

d va

ccin

e st

rate

gies

in a

nim

al p

rodu

ctio

n sy

stem

s? A

re t

here

nat

iona

l pla

ns fo

r va

ccin

atio

n in

ani

mal

s (t

erre

stria

l or

aqua

tic)?

Is t

here

a s

yste

m in

pla

ce t

o re

port

ani

mal

dis

ease

s to

vet

erin

ary

serv

ices

? 14

. W

hat i

s th

e ex

tent

of e

xten

sion

ser

vice

s to

farm

ers,

fish

erm

en, l

ives

tock

ow

ners

and

coo

pera

tives

?15

. W

hat s

yste

ms

are

in p

lace

to re

gula

rly e

valu

ate

the

effe

ctiv

enes

s of

infe

ctio

n co

ntro

l mea

sure

s an

d pu

blis

h re

sults

in a

nim

al h

ealth

(suc

h as

use

of t

he O

IE

PVS

tool

)?

PR

EV

EN

T



16.

Wha

t alte

rnat

ive

stra

tegi

es a

nd te

chno

logi

es a

re p

ropo

sed

to s

uppo

rt th

e re

duct

ion

of a

ntim

icro

bial

use

in a

nim

al p

rodu

ctio

n sy

stem

s (s

uch

as n

utrit

iona

l st

rate

gies

)?17

. Ar

e th

ere

food

hyg

iene

pra

ctic

es fo

r har

vest

ing

and

proc

essi

ng o

f foo

ds in

pla

ce a

nd fu

nctio

nal?

18.

Is th

ere

a w

aste

wat

er m

anag

emen

t pla

n in

pla

ce a

nd b

eing

impl

emen

ted?

P.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

1.

Wha

t are

the

natio

nal p

olic

ies

and

regu

latio

ns re

latin

g to

app

ropr

iate

use

, ava

ilabi

lity

and

qual

ity o

f ant

imic

robi

als

for h

uman

and

ani

mal

use

? 2.

Is

ther

e na

tiona

l gui

danc

e on

app

ropr

iate

use

of a

ntib

iotic

s in

hum

ans?

a.

Has

the

appr

opria

tene

ss o

f ant

ibio

tic u

se b

een

stud

ied?

Are

stu

dies

pla

nned

, suc

h as

on

qual

ity o

f pre

scrib

ing?

b. I

s th

ere

a na

tiona

l sel

ectio

n m

echa

nism

or c

omm

ittee

for r

ecom

men

ded

antib

iotic

s?

c. A

re th

ere

antib

iotic

gui

delin

es b

ased

on

natio

nal/

loca

l ant

ibio

gram

s? G

ive

exam

ples

. d.

How

man

y ce

ntre

s m

onito

r or a

udit

adhe

renc

e to

nat

iona

l gui

danc

e on

app

ropr

iate

ant

ibio

tic u

se?

e. A

re th

e la

test

gui

delin

es in

tegr

ated

in p

re-s

ervi

ce tr

aini

ng a

nd in

con

tinui

ng e

duca

tion

cour

ses?

3.

Is

a p

resc

riptio

n re

quire

d fo

r ant

ibio

tic u

se in

hum

ans?

Wha

t evi

denc

e is

ther

e th

at th

is a

pplie

s in

pra

ctic

e in

pub

lic a

nd p

rivat

e se

ctor

s?

4.

Doe

s a

natio

nal p

lan

for a

ntim

icro

bial

ste

war

dshi

p ex

ist i

n th

e ho

spita

l sec

tor?

How

far h

as it

bee

n im

plem

ente

d?5.

W

hat m

easu

res

(e.g

. act

ion

on s

tock

-out

s) a

re in

pla

ce to

ass

ure

acce

ss to

ant

imic

robi

als

for t

hose

hum

ans/

anim

als

who

nee

d th

em?

6.

Is a

pre

scrip

tion

requ

ired

for

antim

icro

bial

use

in a

nim

als

(ter

rest

rial,

aqua

tic, f

eed

indu

stry

)? W

hen

is a

pre

scrip

tion

not

requ

ired?

Wha

t ha

ppen

s in

pr

actic

e? D

o fa

rmer

s ha

ve a

cces

s to

vet

erin

aria

ns a

nd o

ther

pro

fess

iona

ls w

ho c

an a

dvis

e/au

thor

ize

an a

ntim

icro

bial

?7.

Is

ther

e a

plan

to s

tren

gthe

n pr

uden

t use

or s

tew

ards

hip

in a

nim

als?

If y

es, w

ho p

artic

ipat

es a

nd h

ow is

it m

onito

red?

Is it

con

sist

ent w

ith C

odex

and

OIE

gu

idel

ines

? H

ave

guid

elin

es o

n pr

uden

t use

bee

n de

velo

ped?

8.

Wha

t is

the

natio

nal p

olic

y on

use

of a

ntim

icro

bial

s fo

r ani

mal

gro

wth

pro

mot

ion?

Wha

t are

the

next

ste

ps p

lann

ed o

n th

ose?

9.

Is

tes

ting

of a

ntim

icro

bial

qua

lity

in p

lace

? Is

the

re a

mec

hani

sm o

r ar

e th

ere

activ

ities

to

iden

tify

subs

tand

ard,

spu

rious

, fal

sely

labe

lled,

fal

sifie

d an

d co

unte

rfei

t ant

imic

robi

als?

Are

ther

e pe

nalti

es fo

r cou

nter

feit/

subs

tand

ard

prod

ucts

and

are

thes

e en

forc

ed?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Nat

iona

l ac

tion

plan

for

AM

R an

d/or

pla

ns f

or A

MR

dete

ctio

n/re

port

ing,

sur

veill

ance

of

AMR,

mon

itorin

g an

timic

robi

al c

onsu

mpt

ion

and

use,

IPC

pr

ogra

mm

es in

hum

an h

ealth

faci

litie

s, in

fect

ion

prev

entio

n an

d im

prov

ed h

usba

ndry

in li

vest

ock/

food

pro

duct

ion,

and

pla

ns to

impr

ove

use

and

qual

ity o

f an

timic

robi

als

(suc

h as

ant

imic

robi

al s

tew

ards

hip

prog

ram

mes

).

PR

EV

EN

T



l

Mon

itorin

g re

view

s of

pro

gres

s w

ith im

plem

enta

tion

of n

atio

nal a

ctio

n pl

an(s

) and

rela

ted

plan

s.l

Cou

ntry

resp

onse

to th

e gl

obal

mon

itorin

g su

rvey

on

AMR.

l

Ava

ilabl

e O

IE P

VS P

athw

ay re

port

s.l

Min

utes

from

mee

tings

or o

utpu

ts o

f the

mul

tisec

tora

l coo

rdin

atio

n co

mm

ittee

or g

roup

.l

Cop

y of

repo

rts

mea

surin

g:

• pro

port

ion

of A

MR

path

ogen

s am

ong

spec

imen

s or

isol

ates

;

• res

ults

from

par

ticip

atio

n in

inte

rnat

iona

l ext

erna

l qua

lity

asse

ssm

ent (

EQA)

roun

ds o

f the

nat

iona

l ref

eren

ce la

bora

tory

;

• inc

iden

ce o

f inf

ectio

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)

;

• ant

imic

robi

al c

onsu

mpt

ion

leve

ls o

r sur

veys

of u

se (h

uman

and

ani

mal

incl

udin

g m

edic

ated

ani

mal

feed

– te

rres

tria

l and

aqu

atic

);

• pro

port

ion

of fa

cilit

ies

adhe

ring

to b

est p

ract

ices

for I

PC in

clud

ing

hand

hyg

iene

(if k

now

n);

• m

anda

tory

farm

qua

lity

assu

ranc

e pr

ogra

mm

es th

at in

clud

e an

timic

robi

al u

se s

urve

illan

ce a

nd s

tew

ards

hip

info

rmat

ion;

• a

vaila

bilit

y of

ant

imic

robi

als

(or s

tock

-out

s), h

ygie

ne s

uppl

ies

and

WAS

H in

hea

lth fa

cilit

ies;

and

• p

erce

ntag

e of

ant

ibio

tics

adm

inis

tere

d ap

prop

riate

ly (i

f sur

veye

d).

l

Doc

umen

tatio

n of

the

revi

ew p

roce

ss, i

nclu

ding

par

ticip

atin

g ag

enci

es o

r sec

tors

.

Refe

renc

es:

l

Shar

ing

FAO

too

ls f

or v

eter

inar

y la

bora

tory

ass

essm

ent.

Food

and

Agr

icul

ture

Org

aniz

atio

n [w

ebsi

te] h

ttp:

//w

ww

.fao.

org/

ag/a

gain

fo/p

rogr

amm

es/e

n/em

pres

/new

s_23

1216

b.ht

ml,

acce

ssed

28

Dec

embe

r 201

7)l

Nat

iona

l ant

imic

robi

al re

sist

ance

sur

veill

ance

sys

tem

s an

d pa

rtic

ipat

ion

in th

e G

loba

l Ant

imic

robi

al R

esis

tanc

e Su

rvei

llanc

e Sy

stem

(GLA

SS):

A gu

ide

to

plan

ning

, im

plem

enta

tion

and

mon

itorin

g an

d ev

alua

tion.

Wor

ld H

ealth

Org

aniz

atio

n; 2

016

(htt

p://

apps

.who

.int/

iris/

bits

trea

m/1

0665

/251

554/

1/W

HO

-D

GO

-AM

R-20

16.4

-eng

.pdf

, acc

esse

d 23

Nov

embe

r 201

7).

l

OIE

dat

a co

llect

ion

tem

plat

e. P

aris

: Wor

ld O

rgan

isat

ion

for

Anim

al H

ealth

; 201

7 (h

ttp:

//w

ww

.oie

.int/

filea

dmin

/Hom

e/en

g/O

ur_s

cien

tific_

expe

rtis

e/do

cs/

pdf/

AMR/

A_AM

Use

_Tem

plat

e_Fi

nal_

2017

.xls

, acc

esse

d 25

Dec

embe

r 201

7).

l

OIE

sta

ndar

ds a

nd r

ecom

men

datio

ns [

fact

shee

t]. P

aris

: W

orld

Org

anis

atio

n fo

r An

imal

Hea

lth;

2016

(ht

tp:/

/ww

w.o

ie.in

t/fil

eadm

in/h

ome/

eng/

Med

ia_

Cent

er/d

ocs/

pdf/

Fact

_she

ets/

EN_N

orm

es.p

df, a

cces

sed

19 D

ecem

ber 2

017)

.l

WH

O

Glo

bal

actio

n pl

an

on

antim

icro

bial

re

sist

ance

. G

enev

a:

Wor

ld

Hea

lth

Org

aniz

atio

n;

2015

(h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/1

9373

6/1/

9789

2415

0976

3_en

g.pd

f, ac

cess

ed 1

7 D

ecem

ber 2

017)

.l

Gui

delin

es o

n co

re c

ompo

nent

s of

infe

ctio

n pr

even

tion

and

cont

rol p

rogr

amm

es a

t th

e na

tiona

l and

acu

te h

ealth

car

e fa

cilit

y. G

enev

a: W

orld

Hea

lth

Org

aniz

atio

n; 2

016

(htt

p://

ww

w.w

ho.in

t/gp

sc/c

ore-

com

pone

nts.

pdf,

acce

ssed

23

Nov

embe

r 201

7).

PR

EV

EN

T



ZOO

NO

TIC

DIS

EASE

Targ

et: F

unct

iona

l mul

tisec

tora

l, m

ultid

isci

plin

ary

mec

hani

sms,

pol

icie

s, s

yste

ms

and

prac

tices

are

in p

lace

to m

inim

ize

the

tran

smis

sion

of z

oono

tic d

isea

ses

from

ani

mal

s to

hum

an p

opul

atio

ns.

As m

easu

red

by: (

1) A

gree

men

t by

the

anim

al h

ealth

and

pub

lic h

ealth

sec

tors

on

a co

mm

on li

st o

f zoo

notic

dis

ease

s/pa

thog

ens

of g

reat

est n

atio

nal p

ublic

hea

lth

conc

ern.

(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.

Desi

red

impa

ct:

Func

tiona

l an

imal

hea

lth a

nd p

ublic

hea

lth s

yste

ms

wor

k in

divi

dual

ly a

nd c

olla

bora

tivel

y to

geth

er t

hrou

gh d

ocum

ente

d m

echa

nism

s an

d op

erat

iona

l fra

mew

orks

, usi

ng a

One

Hea

lth a

ppro

ach

and

base

d on

inte

rnat

iona

l sta

ndar

ds, g

uida

nce

and

best

pra

ctic

es, t

o m

inim

ize

the

tran

smis

sion

of

zoon

otic

dis

ease

s to

hum

an p

opul

atio

ns.

PR

EV

EN

T



Scor

e1

Zoon

otic

dis

ease

2,3

P.4.

1 Co

ordi

nate

d su

rvei

llanc

e4 sy

stem

s in

pla

ce i

n th

e an

imal

hea

lth a

nd

publ

ic h

ealth

sec

tors

for

zoo

notic

dis

ease

s/pa

thog

ens

iden

tified

as

join

t pr

iorit

ies5

P.4.

2 M

echa

nism

s fo

r re

spon

ding

to

infe

ctio

us a

nd p

oten

tial

zoon

otic

di

seas

es e

stab

lishe

d an

d fu

nctio

nal

No

capa

city

- 1

Som

e ca

paci

ties

for

surv

eilla

nce

of z

oono

tic d

isea

ses

exis

t bu

t ar

e no

t or

gani

zed

betw

een

the

anim

al h

ealth

or p

ublic

hea

lth s

yste

mD

espi

te s

ome

mec

hani

sms

for s

peci

fic d

isea

ses/

path

ogen

s, n

o co

ordi

nate

d re

spon

se m

echa

nism

for z

oono

tic d

isea

ses

is in

pla

ce

Lim

ited

ca

paci

ty -

2

Coun

try

has

a lis

t of fi

ve p

riorit

y zo

onot

ic d

isea

ses/

path

ogen

s ag

reed

am

ong

sect

ors

to b

e of

gre

ates

t nat

iona

l pub

lic h

ealth

con

cern

but

doe

s no

t hav

e a

spec

ific

syst

em fo

r the

ir su

rvei

llanc

e in

pla

ce

Doc

umen

ted

mul

tisec

tora

l nat

iona

l pol

icy,

stra

tegy

and

/or p

lan

for r

espo

nse

to z

oono

tic e

vent

s ha

ve b

een

elab

orat

ed

Deve

lope

d ca

paci

ty -

3

Zoon

otic

sur

veill

ance

sys

tem

s in

pla

ce f

or o

ne t

o fo

ur z

oono

tic d

isea

ses/

path

ogen

s of

gre

ates

t pub

lic h

ealth

con

cern

An e

stab

lishe

d m

ultis

ecto

ral

oper

atio

nal

mec

hani

sm f

or c

oord

inat

ed r

es-

pons

e to

out

brea

ks o

f zoo

notic

dis

ease

s by

hum

an, a

nim

al a

nd w

ildlif

e se

c-to

rs is

in p

lace

Dem

onst

rate

d ca

paci

ty -

4

Zoon

otic

sur

veill

ance

sys

tem

s in

pla

ce f

or fi

ve o

r m

ore

prio

rity

zoon

otic

di

seas

es/p

atho

gens

of g

reat

est p

ublic

hea

lth c

once

rnSe

vera

l exp

erie

nces

of r

espo

nse

to z

oono

tic e

vent

s co

nfirm

“tim

elin

ess”

6 an

d ef

ficie

ncy

of t

he m

ultis

ecto

ral

oper

atio

nal

mec

hani

sm, i

nclu

ding

sys

tem

a-tic

info

rmat

ion

exch

ange

bet

wee

n an

imal

/wild

life

surv

eilla

nce

units

, hum

an

heal

th s

urve

illan

ce u

nits

and

oth

er re

leva

nt s

ecto

rs7,

8

Sust

aina

ble

capa

city

- 5

Rout

ine

shar

ing

of i

nfor

mat

ion

betw

een

the

sect

ors

ensu

res

a co

nfirm

ed

surv

eilla

nce

syst

em fo

r zoo

notic

dis

ease

s of

prio

rity

and/

or o

ther

sTh

e m

ultis

ecto

ral o

pera

tiona

l mec

hani

sm fo

r the

resp

onse

to z

oono

tic e

vent

s an

d em

ergi

ng d

isea

ses

is re

gula

rly te

sted

for c

ontin

uous

impr

ovem

ent

1 -

For f

ull s

core

s, c

apab

ilitie

s sh

ould

be

sepa

rate

ly e

valu

ated

bot

h in

the

hum

an a

nd a

nim

al (l

ives

tock

, com

pani

on a

nim

al a

nd w

ildlif

e) h

ealth

sec

tors

and

mec

hani

sms

for r

egul

ar jo

int p

lann

ing,

sha

ring

of in

form

atio

n, c

olla

bora

tion,

co

mm

unic

atio

n an

d jo

int p

olic

y-de

velo

pmen

t in

a O

ne H

ealth

app

roac

h sh

ould

be

in p

lace

. The

fina

l sco

re s

houl

d be

bas

ed o

n th

e lo

wer

of t

he s

core

s fo

r the

hum

an a

nd a

nim

al h

ealth

sec

tors

.2

- Zo

onot

ic d

isea

ses

is a

n in

fect

ion

or d

isea

ses

that

is tr

ansm

issi

ble

betw

een

anim

als

and

hum

ans.

3 -

Also

see

sec

tion

on F

ood

safe

ty in

dica

tors

for f

urth

er in

form

atio

n.4

- Su

rvei

llanc

e re

fers

to d

isea

ses

on th

e ag

reed

list

of p

riorit

y zo

onos

es. I

f the

re is

no

list,

it re

fers

to s

urve

illan

ce fo

r dis

ease

s on

the

list o

f prio

rity

zoon

oses

of t

he p

ublic

hea

lth s

ecto

r.5

- Th

e in

dica

tor r

efer

s to

the

natio

nal c

apac

ity to

det

ect,

asse

ss a

nd re

spon

d to

zoo

notic

dis

ease

s, a

nd in

clud

es c

onsi

dera

tion

of th

e an

imal

hea

lth a

nd h

uman

hea

lth s

ecto

r cap

acity

, as

wel

l as

the

colla

bora

tive

mec

hani

sm b

etw

een

them

.6

- Ti

mel

ines

s is

judg

ed a

nd d

eter

min

ed b

y ea

ch c

ount

ry a

nd is

refe

rred

to h

ere

as th

e tim

e be

twee

n de

tect

ion

and

resp

onse

.7

- Re

leva

nt s

ecto

rs: A

t min

imum

, the

min

istr

ies

or a

genc

ies

that

are

key

to th

e te

chni

cal a

rea

and

may

incl

ude

hum

an h

ealth

, ani

mal

hea

lth, e

nviro

nmen

t, fo

od s

afet

y, fin

ance

, tra

de/p

orts

of e

ntry

, che

mic

al s

afet

y, ra

diat

ion

safe

ty,

secu

rity,

defe

nce,

priv

ate

sect

or, r

egul

ator

y bo

dies

, med

ia a

mon

g ot

hers

. Civ

il as

soci

atio

ns, s

uch

as p

rivat

e st

akeh

olde

rs (f

rom

indu

stry

, med

ical

ass

ocia

tions

, far

mer

s as

soci

atio

ns) a

nd a

cade

mia

resp

onsi

ble

for a

spec

ts o

f the

te

chni

cal a

rea

(but

not

key

) may

be

incl

uded

as

need

ed.

8 -

Link

ages

bet

wee

n m

inis

trie

s of

hea

lth a

nd a

gric

ultu

re, a

nd w

ildlif

e sp

ecia

lists

to p

rom

ote

the

shar

ing

of in

form

atio

n an

d da

ta s

houl

d be

effi

cien

t and

als

o ex

ist a

t the

regi

onal

and

loca

l lev

els.

Cont

extu

al q

uest

ions

:1.

Fo

r whi

ch o

f the

zoo

notic

dis

ease

s of

gre

ates

t pub

lic h

ealth

con

cern

with

in th

e co

untr

y is

it a

ssum

ed th

at th

e pr

iorit

ized

list

of z

oono

tic d

isea

ses

for t

he

coun

try

is b

ased

on

an in

ters

ecto

ral d

ecis

ion

mak

ing

proc

ess?

a. W

hat p

roce

ss w

as u

sed

to d

evel

op th

e lis

t of z

oono

tic d

isea

ses

of g

reat

est p

ublic

hea

lth c

once

rn?

Did

the

proc

ess

incl

ude

anim

al h

ealth

, as

wel

l as

envi

ronm

enta

l and

oth

er re

leva

nt s

ecto

rs?

2.

Is th

ere

a fo

rmal

mul

tisec

tora

l pol

icy

for c

olla

bora

tion

on z

oono

tic d

isea

ses

in th

e co

untr

y? If

so,

how

is it

org

aniz

ed/l

ed/g

over

ned?

PR

EV

EN

T



9 -

In th

is in

dica

tor,

agric

ultu

re m

inis

try

refe

rs to

that

min

istr

y or

age

ncy

resp

onsi

ble

for a

nim

al h

ealth

and

pro

duct

ion.

The

agr

icul

ture

min

istr

y (o

r oth

er re

leva

nt a

genc

y) c

an p

rovi

de a

n ac

cura

te d

escr

iptio

n of

ani

mal

dem

ogra

phic

s w

ithin

the

coun

try

and

with

in e

ach

adm

inis

trat

ive

unit.

3.

Is th

ere

a na

tiona

l mul

tisec

tora

l coo

rdin

atio

n co

mm

ittee

for

one

or m

ore

zoon

otic

dis

ease

s ho

ldin

g re

gula

r m

eetin

gs c

urre

ntly

? If

so, w

hich

is th

e le

ad

agen

cy?

4.

Is th

ere

a m

echa

nism

for j

oint

risk

ass

essm

ent f

or z

oono

tic d

isea

se e

vent

s?5.

W

ithin

the

past

two

year

s, h

as a

n ex

erci

se b

een

cond

ucte

d or

a re

al e

vent

occ

urre

d in

volv

ing

the

min

istr

ies

of h

ealth

and

agr

icul

ture

to p

ract

ice

and

test

th

e sk

ills

of p

ublic

hea

lth w

orke

rs in

bot

h hu

man

and

ani

mal

sec

tors

to in

vest

igat

e an

d re

spon

d to

a z

oono

tic e

vent

? a.

Des

crib

e th

e ex

erci

se o

r rea

l eve

nt th

at o

ccur

red.

b. W

hat w

ere

the

mos

t sig

nific

ant l

esso

ns le

arne

d fr

om th

e ex

erci

se/r

eal e

vent

? 6.

Li

st th

e zo

onot

ic d

isea

ses

for w

hich

con

trol

pol

icie

s ex

ist w

ith th

e pu

rpos

e of

redu

cing

thei

r spr

ead

into

hum

an p

opul

atio

ns?

a. D

escr

ibe

the

prog

ress

in im

plem

entin

g th

ese

polic

ies.

b. I

s th

ere

a pl

an in

pla

ce to

enc

oura

ge re

port

ing

of a

nim

al d

isea

se (m

ay in

clud

e in

dem

nitie

s pa

id)?

c. I

s th

ere

a pl

an in

pla

ce to

add

ress

fact

ors

that

may

pre

vent

farm

ers/

owne

rs fr

om re

port

ing

anim

al d

isea

se (m

ay in

clud

e la

ck o

f fam

iliar

ity w

ith re

port

ing

proc

ess,

lack

of i

ndem

nity

, soc

ial s

tigm

a)?

7.

Has

ther

e be

en a

n O

IE P

VS e

valu

atio

n m

issi

on o

r PVS

Gap

Ana

lysi

s? If

so,

wha

t yea

r(s)

was

it h

eld?

8.

H

as th

ere

been

an

IHR-

PVS

Nat

iona

l Brid

ging

Wor

ksho

p or

oth

er “O

ne H

ealth

” rel

ated

wor

ksho

ps fo

r rel

evan

t min

istr

ies?

If s

o, m

entio

n w

hich

one

(s).

Tech

nica

l que

stio

ns:

P.4.

1 Su

rvei

llanc

e sy

stem

s in

pla

ce fo

r prio

rity

zoon

otic

dis

ease

s/pa

thog

ens

1.

Des

crib

e th

e sy

stem

/mec

hani

sm b

y w

hich

sur

veill

ance

act

iviti

es a

re p

lann

ed a

nd im

plem

ente

d co

ncur

rent

ly b

y th

e an

imal

hea

lth a

nd h

uman

hea

lth s

ecto

rs.

2.

Doe

s th

e co

untr

y ha

ve a

n ag

reed

list

of p

riorit

y zo

onot

ic d

isea

ses?

3.

Doe

s th

e co

untr

y ha

ve a

sur

veill

ance

sys

tem

in p

lace

on

rele

vant

ani

mal

pop

ulat

ions

for t

hese

prio

rity

zoon

otic

dis

ease

s?

4.

Doe

s th

e co

untr

y ha

ve a

hum

an s

urve

illan

ce s

yste

m in

pla

ce fo

r the

se d

isea

ses?

5.

Des

crib

e pa

rtne

rshi

ps b

etw

een

the

min

istr

ies

of h

ealth

and

agr

icul

ture

9 an

d ot

her

rele

vant

age

ncie

s in

clud

ing

biol

ogic

al s

peci

alis

ts, a

cade

mia

, wild

life

spec

ialis

ts a

nd e

nviro

nmen

tal g

roup

s as

they

rela

te to

zoo

notic

dis

ease

det

ectio

n an

d re

spon

se.

a. A

re s

ituat

iona

l aw

aren

ess

repo

rts

or re

port

s of

pot

entia

l dis

ease

out

brea

ks s

hare

d be

twee

n th

e ag

enci

es?

6.

Do

publ

ic h

ealth

labo

rato

ries

and

anim

al h

ealth

labo

rato

ries

com

mun

icat

e w

ith e

ach

othe

r?

a. I

s th

ere

a pr

oces

s fo

r sha

ring

uniq

ue o

r ser

ious

isol

ates

bet

wee

n pu

blic

hea

lth a

nd a

nim

al h

ealth

labo

rato

ries?

b. I

s th

ere

a pr

oces

s fo

r sha

ring

biol

ogic

al s

peci

men

s be

twee

n pu

blic

hea

lth a

nd a

nim

al h

ealth

labo

rato

ries?

c. I

s th

ere

a pr

oces

s fo

r sha

ring

labo

rato

ry re

port

s or

ale

rts

betw

een

publ

ic h

ealth

and

ani

mal

hea

lth la

bora

torie

s?d.

Are

thes

e re

port

s sh

ared

on

a re

gula

r bas

is, o

r onl

y w

hen

zoon

otic

dis

ease

s ar

e di

scov

ered

or s

uspe

cted

?

PR

EV

EN

T



7. D

escr

ibe

the

exch

ange

of e

pide

mio

logi

cal r

epor

ts.

a. H

ow o

rgan

ized

is th

e ex

chan

ge o

f epi

dem

iolo

gica

l rep

orts

on

zoon

otic

dis

ease

s?b.

How

are

ani

mal

sur

veill

ance

sys

tem

s lin

ked

to s

urve

illan

ce s

yste

ms

used

for h

uman

pat

hoge

ns?

c. I

s th

ere

a pr

oces

s fo

r sha

ring

surv

eilla

nce

repo

rts

betw

een

publ

ic h

ealth

and

ani

mal

hea

lth la

bora

torie

s?

P.4.

2 M

echa

nism

s fo

r res

pond

ing

to in

fect

ious

and

pot

entia

l zoo

notic

dis

ease

s es

tabl

ishe

d an

d fu

nctio

nal

1. D

escr

ibe

the

polic

y, st

rate

gy o

r pla

n fo

r res

pond

ing

to z

oono

tic e

vent

s in

the

coun

try

in th

e an

imal

hea

lth a

nd p

ublic

hea

lth s

ecto

rs.

a. I

s th

ere

a jo

int p

lan

or s

trat

egy

that

exi

sts

betw

een

hum

an h

ealth

and

ani

mal

hea

lth (i

nclu

ding

wild

life)

sec

tors

?b.

Is

ther

e an

y M

oU b

etw

een

the

sect

ors

for t

he m

anag

emen

t of z

oono

tic e

vent

s?2.

D

escr

ibe

how

the

late

st z

oono

tic e

vent

s w

ere

man

aged

, for

exa

mpl

e:a.

How

was

the

info

rmat

ion

shar

ed b

etw

een

sect

ors?

b. H

ow o

ften

did

the

sect

ors

mee

t at t

he te

chni

cal l

evel

? c.

Are

ther

e ou

tbre

ak in

vest

igat

ion

and

resp

onse

repo

rts

on th

e la

test

zoo

notic

eve

nts?

3.

Are

ther

e an

y m

echa

nism

s fo

r est

ablis

hing

inte

rage

ncy

resp

onse

team

s in

the

even

t of a

sus

pect

ed z

oono

tic o

utbr

eak?

4.

Des

crib

e th

e ro

les

and

resp

onsi

bilit

ies

of h

uman

hea

lth a

nd a

nim

al h

ealth

(inc

ludi

ng w

ildlif

e) s

ecto

rs o

n th

ese

rece

nt z

oono

tic e

vent

s.5.

D

oes

the

coun

try

have

cap

acity

to re

spon

d to

mor

e th

an 8

0% o

f zoo

notic

eve

nts

on ti

me?

Wha

t is

the

timel

ines

s at

pre

sent

?6.

D

oes

the

coun

try

have

a p

repa

redn

ess

plan

for h

andl

ing

emer

ging

or r

e-em

ergi

ng z

oono

tic d

isea

ses

with

ver

ifica

tion?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Agr

eed

list o

f zoo

notic

prio

rity

path

ogen

s in

pub

lic h

ealth

l

Des

crip

tions

of e

xist

ing

zoon

otic

sur

veill

ance

sys

tem

sl

OIE

cou

ntry

PVS

Pat

hway

mis

sion

repo

rt

Refe

renc

es:

l

OIE

PVS

Pat

hway

mis

sion

repo

rts.

Wor

ld O

rgan

isat

ion

for A

nim

al H

ealth

[web

site

] (ht

tp:/

/ww

w.o

ie.in

t/su

ppor

t-to

-oie

-mem

bers

/pvs

-pat

hway

/, ac

cess

ed

23 N

ovem

ber 2

017)

.l

Han

dboo

k fo

r th

e as

sess

men

t of

cap

aciti

es a

t th

e hu

man

–an

imal

inte

rfac

e. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

7 (h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/2

5455

2/1/

9789

2415

1188

9-en

g.pd

f?ua

=1, a

cces

sed

27 D

ecem

ber 2

017)

.l

Pub

licat

ions

on

food

saf

ety

and

rela

ted

area

s. W

orld

Hea

lth O

rgan

izat

ion

[web

site

] (ht

tp:/

/ww

w.w

ho.in

t/fo

odsa

fety

/pub

licat

ions

/all/

en/,

acce

ssed

23

Nov

embe

r 201

7).

PR

EV

EN

T



FOO

D S

AFET

YTa

rget

: Fun

ctio

naf 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.

As m

easu

red

by: (

1) E

xist

ence

of i

ndic

ator

-bas

ed d

isea

se s

urve

illan

ce (I

BS)

or e

vent

-bas

ed d

isea

se s

urve

illan

ce (E

BS)

and

supp

ortin

g la

bora

tory

ana

lysi

s to

de

tect

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)

Exis

tenc

e of

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) E

mer

genc

y Co

ntac

t Po

int,

and

the

OIE

Foc

al P

oint

on

Anim

al P

rodu

ctio

n Fo

od S

afet

y w

ith a

cen

tral

coo

rdin

atio

n m

echa

nism

in p

lace

.

Desi

red

impa

ct: T

imel

y de

tect

ion

and

effe

ctiv

e re

spon

se o

f pot

entia

l foo

d-re

late

d ev

ents

in c

olla

bora

tion

with

oth

er s

ecto

rs re

spon

sibl

e fo

r foo

d sa

fety

.

PR

EV

EN

T



Scor

eIn

dica

tors

: Foo

d sa

fety

1 P.

5.1

Surv

eilla

nce

syst

ems

in p

lace

for

the

det

ectio

n an

d m

onito

ring

of

food

born

e di

seas

es a

nd fo

od c

onta

min

atio

nP.

5.2

Mec

hani

sms

are

esta

blis

hed

and

func

tioni

ng f

or t

he r

espo

nse

and

man

agem

ent o

f foo

d sa

fety

em

erge

ncie

s

No

capa

city

- 1

No

or v

ery

limite

d su

rvei

llanc

e sy

stem

in p

lace

for f

oodb

orne

dis

ease

s or

for

food

con

tam

inat

ion

(che

mic

al a

nd m

icro

biol

ogic

al) m

onito

ring

No

or v

ery

limite

d m

echa

nism

in p

lace

Lim

ited

ca

paci

ty -

2Co

untr

y ha

s IB

S or

EBS

and

mon

itorin

g sy

stem

s in

pla

ce t

o m

onito

r tr

ends

an

d de

tect

food

born

e ev

ents

(out

brea

k or

con

tam

inat

ion)

Coun

try

has

a na

tiona

l fo

od

safe

ty

emer

genc

y pl

an

with

fo

od

safe

ty

emer

genc

ies

defin

ed to

ser

ve a

s a

trig

ger f

or e

scal

atin

g ap

prop

riate

resp

onse

Deve

lope

d ca

paci

ty -

3

IBS

or E

BS s

yste

m i

nclu

des

labo

rato

ry a

naly

sis

to a

ssig

n ae

tiolo

gy f

or

food

born

e di

seas

es o

r orig

in o

f con

tam

inat

ion

even

t, an

d in

vest

igat

e ha

zard

s in

food

s lin

ked

to c

ases

, out

brea

ks o

r eve

nts

Coun

try

has

a na

tiona

l foo

d sa

fety

em

erge

ncy

plan

and

a d

esig

nate

d IN

FOSA

N

Emer

genc

y Co

ntac

t Po

int,

with

a c

entr

al c

oord

inat

ion

mec

hani

sm in

pla

ce

that

incl

udes

all

rele

vant

sec

tors

with

fun

ctio

nal a

rran

gem

ents

in p

lace

for

im

plem

enta

tion

of re

spon

se in

the

even

t of a

food

saf

ety

emer

genc

yDe

mon

stra

ted

capa

city

– 4

Coun

try

has

capa

city

to u

nder

take

rapi

d ris

k as

sess

men

ts o

f acu

te fo

odbo

rne

even

ts a

t the

nat

iona

l and

sub

natio

nal l

evel

sSt

rate

gies

and

gui

danc

e fo

r co

mm

unic

atin

g w

ith p

artn

ers,

sta

keho

lder

s,

gene

ral p

ublic

and

inte

rnat

iona

l org

aniz

atio

ns a

re in

pla

ce

Sust

aina

ble

capa

city

– 5

Coun

try

has

a su

rvei

llanc

e sy

stem

in p

lace

that

inte

grat

es in

form

atio

n fr

om

the

entir

e fo

od c

hain

incl

udin

g tim

ely

and

syst

emat

ic in

form

atio

n ex

chan

ge,

to e

nabl

e a

bett

er u

nder

stan

ding

of r

isk

and

miti

gatio

n po

ssib

ilitie

s

The

food

saf

ety

emer

genc

y re

spon

se p

lan,

bas

ed o

n th

e ris

k an

alys

is

fram

ewor

k, is

pre

test

ed a

nd re

view

ed a

fter

an

emer

genc

y ha

s oc

curr

ed

Not

es:

The

PVS

tool

has

thre

e cr

itica

l com

pete

ncie

s on

food

saf

ety

of w

hich

CC

II-8

B (A

nte

and

post

mor

tem

insp

ectio

n at

aba

ttoi

rs a

nd a

ssoc

iate

d pr

emis

es) a

nd

CC II

-8 C

(Ins

pect

ion

of c

olle

ctio

n, p

roce

ssin

g an

d di

strib

utio

n of

pro

duct

s of

ani

mal

orig

in)

can

prov

ide

rele

vant

info

rmat

ion

on c

ount

ry c

apac

ity t

o co

nduc

t su

rvei

llanc

e on

food

born

e pa

thog

ens.

Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

P.5.

1 Su

rvei

llanc

e sy

stem

s in

pla

ce fo

r the

det

ectio

n an

d m

onito

ring

of fo

odbo

rne

dise

ases

and

food

con

tam

inat

ion

1.

Doe

s th

e co

untr

y ha

ve a

sur

veill

ance

and

mon

itorin

g sy

stem

in p

lace

that

incl

udes

prio

rity

food

born

e di

seas

es a

s w

ell a

s pr

iorit

y ha

zard

s (c

hem

ical

and

m

icro

biol

ogic

al)?

2.

Doe

s th

e co

untr

y ha

ve c

ase

defin

ition

s fo

r eac

h of

the

notifi

able

food

born

e di

seas

es?

3.

Are

heal

th c

are

wor

kers

and

san

itary

/foo

d in

spec

tors

trai

ned

on re

port

ing

food

born

e ev

ents

(dis

ease

out

brea

ks o

r con

tam

inat

ion

even

ts)?

4.

Is th

ere

a te

am a

t the

nat

iona

l and

sub

natio

nal l

evel

who

can

rapi

dly

asse

ss fo

odbo

rne

even

ts?

5.

Are

peop

le id

entifi

ed to

take

par

t in

the

outb

reak

or e

vent

resp

onse

team

s tr

aine

d to

und

erta

ke o

utbr

eak

inve

stig

atio

ns o

f foo

dbor

ne d

isea

ses?

1 -

Refe

r to

the

rele

vant

tech

nica

l are

a w

here

ther

e is

an

over

lap

betw

een

one

or m

ore

tech

nica

l are

as (s

uch

as F

ood

safe

ty a

nd Z

oono

tic d

isea

se).

PR

EV

EN

T



6.

Are

outb

reak

resp

onse

team

s tra

ined

to c

olle

ct a

nd tr

ansp

ort a

ppro

pria

te s

peci

men

s to

a la

bora

tory

dur

ing

food

born

e ou

tbre

aks

to id

entif

y th

e ae

tiolo

gica

l age

nt?

7.

Doe

s th

e co

untr

y ha

ve a

n up

date

d lis

t of l

abor

ator

ies

that

can

per

form

the

nece

ssar

y te

stin

g du

ring

food

born

e ou

tbre

aks

or c

onta

min

atio

n ev

ents

?8.

Ar

e re

pres

enta

tives

from

food

saf

ety

and

othe

r lab

orat

orie

s (a

nd a

nim

al h

ealth

, whe

re a

pplic

able

) rou

tinel

y pa

rt o

f the

out

brea

k re

spon

se te

am?

9.

Do

surv

eilla

nce

and

resp

onse

sta

ff kn

ow th

e fo

cal p

oint

s fo

r foo

d sa

fety

, ani

mal

hea

lth a

nd th

e ke

y la

bora

torie

s th

at w

ould

be

requ

ired

to te

st c

linic

al a

nd/o

r fo

od s

ampl

es c

olle

cted

dur

ing

an e

vent

?10

. Is

ther

e an

effe

ctiv

e (fo

rmal

or i

nfor

mal

) mec

hani

sm fo

r rap

id in

form

atio

n ex

chan

ge d

urin

g su

spec

ted

food

born

e di

seas

e ou

tbre

ak o

r eve

nt in

vest

igat

ions

be

twee

n al

l the

sta

keho

lder

s/re

leva

nt s

ecto

rs?

P.5.

2 M

echa

nism

s ar

e es

tabl

ishe

d an

d fu

nctio

ning

for t

he re

spon

se a

nd m

anag

emen

t of f

ood

safe

ty e

mer

genc

ies

1.

Doe

s th

e co

untr

y ha

ve a

pla

n th

at d

ocum

ents

resp

onse

pro

cedu

res

to a

ddre

ss fo

od s

afet

y em

erge

ncie

s?a.

Doe

s it

incl

ude

defin

ition

of t

rigge

rs?

b. D

oes

it re

fer t

o na

tiona

l (ce

ntra

l) co

ordi

natio

n?c.

Are

cle

ar ro

les

and

resp

onsi

bilit

ies

esta

blis

hed?

d. A

re p

roce

dure

s fo

r com

mun

icat

ions

est

ablis

hed?

2.

Was

the

plan

dev

elop

ed in

a p

artic

ipat

ory

way

?3.

Ar

e al

l key

par

tner

s an

d in

volv

ed s

take

hold

ers

prop

erly

aw

are

of th

eir r

oles

and

of t

he re

spon

se p

roce

dure

s re

quire

d of

them

in th

e ev

ent o

f a fo

od s

afet

y cr

isis

/em

erge

ncy?

4.

Are

all i

mpo

rtan

t sta

keho

lder

s (in

clud

ing

thei

r dec

isio

n m

aker

s, le

ader

s, a

nd w

orki

ng te

ams)

fully

brie

fed

on re

spon

se p

roce

dure

s?5.

Is

the

re a

nat

iona

l mec

hani

sm in

pla

ce e

nsur

ing

the

gath

erin

g an

d sh

arin

g of

rel

evan

t in

form

atio

n fo

r co

llect

ive

eval

uatio

n (s

uch

as n

atio

nal o

r re

gion

al

info

rmat

ion

shar

ing

netw

orks

)?6.

Is

ther

e an

act

ive

INFO

SAN

Em

erge

ncy

Cont

act P

oint

? Ar

e th

ere

activ

e IN

FOSA

N F

ocal

Poi

nts?

Are

ther

e ac

tive

OIE

Nat

iona

l Foc

al P

oint

s on

Ani

mal

Pro

duct

ion

Food

Saf

ety?

7.

Is th

ere

a co

ordi

natio

n m

echa

nism

in p

lace

(suc

h as

a m

ultia

genc

y co

ordi

natio

n te

am) w

ith c

lear

term

s of

refe

renc

e to

faci

litat

e co

mm

unic

atio

n be

twee

n ce

ntra

l and

loca

l lev

els?

a. D

oes

this

invo

lve

sect

ors

from

pub

lic h

ealth

, foo

d in

spec

tion,

vet

erin

ary,

offic

ial l

abor

ator

y, cu

stom

s an

d qu

aran

tine,

and

agr

icul

ture

?b.

Doe

s th

is in

volv

e ot

her r

elev

ant s

ecto

rs, s

uch

as to

uris

m, n

atio

nal s

ecur

ity d

epar

tmen

t, en

viro

nmen

tal s

ervi

ces?

c. A

re c

lear

role

s an

d re

spon

sibi

litie

s as

sign

ed to

all

part

ners

of t

he c

oord

inat

ion

team

?8.

Ar

e ke

y st

akeh

olde

rs a

war

e of

the

prin

cipl

es a

nd p

ract

ices

of c

omm

unic

atio

n an

d co

ntro

l sys

tem

s in

the

even

t of a

food

saf

ety

cris

is o

r em

erge

ncy?

9.

Is th

ere

a lis

t of a

ll ne

cess

ary

cont

act d

etai

ls fo

r com

mun

icat

ing

with

par

tner

s re

adily

ava

ilabl

e an

d up

date

d (lo

cal a

nd fo

reig

n go

vern

men

ts, i

nter

natio

nal

orga

niza

tions

, ind

ustr

y)?

10.

Doe

s th

e co

untr

y un

dert

ake

regu

lar a

ctiv

ities

aim

ed a

t pre

parin

g ef

fect

ive

com

mun

icat

ions

for f

ood

safe

ty e

mer

genc

y re

spon

ses?

11.

Are

ther

e pe

riodi

c si

mul

atio

n ex

erci

ses

to p

re-t

est t

he e

mer

genc

y re

spon

se p

lan?

12.

Are

ther

e re

cord

s of

feed

back

s fro

m p

ast e

mer

genc

y re

view

s, c

onsi

derin

g:a.

app

ropr

iate

ness

of r

espo

nse

activ

ities

;

PR

EV

EN

T



b. e

ffect

iven

ess

of w

ithdr

awal

or r

ecal

ls im

plem

ente

d;c.

reg

ulat

ory

proc

edur

es a

vaila

ble

to in

spec

tors

to ta

ke a

ctio

n (p

reve

nt p

rodu

ctio

n an

d di

strib

utio

n of

food

pro

duct

s);

d. c

apac

ity o

f ana

lytic

al s

ervi

ces;

e. g

loba

l cap

acity

of i

nspe

ctio

n se

rvic

es a

nd la

bora

torie

s to

repo

rt to

the

cent

ral c

oord

inat

ion

mec

hani

sm;

f. m

eans

of c

omm

unic

atio

ns; a

ndg.

suf

ficie

nt re

sour

ces

(sta

ff, a

naly

tical

, etc

.) an

d ca

paci

ties

(add

ition

al n

eeds

for t

rain

ing)

?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

tyl

List

of p

riorit

y fo

odbo

rne

dise

ases

and

prio

rity

food

born

e ha

zard

s (c

hem

ical

and

mic

robi

olog

ical

)l

Gui

danc

e on

prio

rity

food

born

e di

seas

es a

nd th

eir c

ase

defin

ition

sl

Nat

iona

l lev

el re

port

bas

ed o

n co

llate

d lo

cal r

epor

ts fo

r rap

id ri

sk a

sses

smen

tl

Trai

ning

mat

eria

l, re

port

s an

d ce

rtifi

cate

sl

Inte

rvie

ws

with

san

itary

/foo

d in

spec

tors

l

Prot

ocol

s fo

r col

lect

ing/

test

ing

clin

ical

spe

cim

ens

and

food

sam

ples

for a

ll pr

iorit

y fo

odbo

rne

dise

ases

and

food

born

e ha

zard

sl

Dat

a re

port

ing

prot

ocol

s fo

r all

prio

rity

food

born

e di

seas

es a

nd fo

odbo

rne

haza

rds

l

List

of c

onta

ct la

bora

torie

sl

Que

stio

nnai

res

for p

riorit

y fo

odbo

rne

path

ogen

s an

d fo

odbo

rne

haza

rds

l

Inte

grat

ed fo

od c

hain

sur

veill

ance

dat

abas

el

Dat

a an

alys

is re

port

sl

Copi

es o

f reg

ular

sur

veill

ance

bul

letin

sl

Doc

umen

tatio

n pr

esen

ting

the

defin

ition

of a

nat

iona

l foo

d sa

fety

em

erge

ncy

l

Inte

rvie

w o

f key

par

tner

s/st

akeh

olde

rs re

gard

ing

thei

r kno

wle

dge

of th

eir r

oles

and

of r

espo

nse

proc

edur

esl

Reco

rds

of in

form

atio

n ex

chan

ge a

nd c

omm

unic

atio

n w

ith re

leva

nt in

tern

atio

nal,

regi

onal

and

nat

iona

l net

wor

ksl

Upd

ated

list

of p

artn

ers’

con

tact

sl

Doc

umen

ted

and

upda

ted

lists

of p

ossi

ble

exte

rnal

reso

urce

s (e

xper

ts, c

ompe

tenc

ies,

or s

peci

alis

t gro

upin

gs)

l

Any

docu

men

tatio

n, re

port

or r

ecor

d on

the

esta

blis

hmen

t, im

plem

enta

tion

and

ongo

ing

wor

k of

the

coor

dina

tion

mec

hani

sms

l

List

of a

ll ne

cess

ary

cont

act d

etai

ls (l

ocal

and

fore

ign

gove

rnm

ents

, int

erna

tiona

l org

aniz

atio

ns, i

ndus

try)

l

Tem

plat

es fo

r not

ifica

tions

of i

ncid

ents

l

Mod

el p

ress

rele

ases

l

Reca

ll an

d w

ithdr

awal

not

ices

l

Prep

ared

que

stio

ns a

nd a

nsw

ers

l

Repo

rts

on s

imul

atio

n ex

erci

ses

to p

re-t

est t

he re

spon

se e

mer

genc

y pl

anl

Reco

rd o

f fee

dbac

ks fr

om p

ast e

mer

genc

y re

view

s

PR

EV

EN

T



BIO

SAFE

TY A

ND

BIO

SECU

RITY

Targ

et: F

A w

hole

-of-

gove

rnm

ent m

ultis

ecto

ral n

atio

nal b

iosa

fety

1 and

bio

secu

rity2 s

yste

m w

ith d

ange

rous

pat

hoge

ns3 i

dent

ified

, 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

es4 ;

biol

ogic

al ri

sk m

anag

emen

t tra

inin

g an

d ed

ucat

iona

l out

reac

h co

nduc

ted

to p

rom

ote

a sh

ared

cul

ture

of

resp

onsi

bilit

y5 , re

duce

dua

l-us

e ris

ks, m

itiga

te b

iolo

gica

l pro

lifer

atio

n an

d de

liber

ate

use

thre

ats,

and

ens

ure

safe

tran

sfer

of b

iolo

gica

l age

nts;

and

cou

ntry

-sp

ecifi

c bi

osaf

ety

and

bios

ecur

ity le

gisl

atio

n, la

bora

tory

lice

nsin

g an

d pa

thog

en c

ontr

ol m

easu

res

in p

lace

as

appr

opria

te.

As m

easu

red

by:

(1)

Exis

tenc

e of

a n

atio

nal

fram

ewor

k fo

r pa

thog

en b

iosa

fety

and

bio

secu

rity,

stra

in c

olle

ctio

ns, c

onta

inm

ent

labo

rato

ries,

tha

t 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 com

preh

ensi

ve o

vers

ight

and

mon

itorin

g sy

stem

s.

Desi

red

impa

ct: I

mpl

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

untr

y, an

d in

volv

ing

rese

arch

, dia

gnos

tic a

nd b

iote

chno

logy

fac

ilitie

s w

ithin

all

sect

ors6 .

A ca

dre

of b

iolo

gica

l ris

k m

anag

emen

t ex

pert

s po

sses

sing

the

ski

llset

to

trai

n ot

hers

is

esta

blis

hed

with

in t

heir

resp

ectiv

e in

stitu

tions

. Str

engt

hene

d, 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 m

ater

ials

. Rap

id a

nd c

ultu

re-f

ree

diag

nost

ics

are

prom

oted

as

a fa

cet o

f bio

logi

cal r

isk

man

agem

ent.

Safe

and

com

plia

nt tr

ansp

ort o

f inf

ectio

us s

ubst

ance

s is

al

so ta

ken

into

acc

ount

acc

ordi

ng to

nat

iona

l and

inte

rnat

iona

l reg

ulat

ions

as

appr

opria

te.

1 -

Labo

rato

ry b

iosa

fety

des

crib

es th

e co

ntai

nmen

t prin

cipl

es, t

echn

olog

ies

and

prac

tices

that

are

impl

emen

ted

to p

reve

nt u

nint

entio

nal e

xpos

ure

to p

atho

gens

and

toxi

ns, o

r the

ir ac

cide

ntal

rele

ase.

2 -

Labo

rato

ry b

iose

curit

y de

scrib

es th

e pr

otec

tion,

con

trol

and

acc

ount

abili

ty fo

r val

uabl

e bi

olog

ical

mat

eria

ls w

ithin

labo

rato

ries

as 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, i

n or

der 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.

3 -

Dan

gero

us p

atho

gens

and

toxi

ns –

The

info

rmal

Aus

tral

ia G

roup

pro

vide

s a

List

of h

uman

and

ani

mal

pat

hoge

ns a

nd to

xins

for e

xpor

t con

trol

(htt

p://

ww

w.a

ustr

alia

grou

p.ne

t/en

/hum

an_a

nim

al_p

atho

gens

.htm

l, ac

cess

ed 2

3 N

ovem

ber 2

017)

.4

- It

is s

ugge

sted

that

min

imal

/bes

t pra

ctic

e w

ould

follo

w th

e W

HO

Lab

orat

ory

bios

afet

y m

anua

l?5

- 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

(htt

p://

ww

w.w

ho.in

t/cs

r/re

sour

ces/

publ

icat

ions

/HSE

_GAR

_BD

P_20

10_2

/en

/ (a

cces

sed

21 N

ovem

ber 2

017)

.6

- W

ithin

bot

h hu

man

and

ani

mal

hea

lth s

ecto

rs.

PR

EV

EN

T



Scor

eIn

dica

tors

: Bio

safe

ty a

nd b

iose

curit

yP.

6.1

Who

le-o

f-go

vern

men

t bio

safe

ty a

nd b

iose

curit

y sy

stem

in p

lace

for a

ll se

ctor

s (in

clud

ing

hum

an, a

nim

al a

nd a

gric

ultu

re fa

cilit

ies)

P.6.

2 Bi

osaf

ety

and

bios

ecur

ity tr

aini

ng a

nd p

ract

ices

in a

ll re

leva

nt s

ecto

rs7

(incl

udin

g hu

man

, ani

mal

and

agr

icul

ture

)

No

capa

city

- 1

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

g8, a

re n

ot in

pla

ceN

o bi

olog

ical

bio

safe

ty a

nd b

iose

curit

y tr

aini

ng o

r pla

ns a

re in

pla

ce

Lim

ited

ca

paci

ty -

2

Som

e, b

ut n

ot a

ll, e

lem

ents

of

a co

mpr

ehen

sive

bio

safe

ty a

nd b

iose

curit

y sy

stem

are

in p

lace

. The

cou

ntry

is:

Star

ting

the

proc

ess

to m

onito

r and

dev

elop

an

upda

ted

reco

rd a

nd in

vent

ory

of p

atho

gens

with

in fa

cilit

ies

that

sto

re o

r pro

cess

dan

gero

us p

atho

gens

and

to

xins

and

wha

t the

y ho

use

Dev

elop

ing,

but

has

not

fina

lized

, co

mpr

ehen

sive

nat

iona

l bi

osaf

ety

and

bios

ecur

ity re

gula

tory

fram

ewor

kD

evel

opin

g la

bora

tory

lice

nsin

g

Coun

try

has

cond

ucte

d a

trai

ning

nee

ds a

sses

smen

t an

d id

entifi

ed g

aps

in

bios

afet

y an

d bi

osec

urity

trai

ning

but

has

not

yet i

mpl

emen

ted

com

preh

ensi

ve

trai

ning

Gen

eral

lack

of

awar

enes

s am

ong

the

labo

rato

ry w

orkf

orce

of

inte

rnat

iona

l bi

osaf

ety

and

bios

ecur

ity b

est

prac

tices

for

saf

e, s

ecur

e an

d re

spon

sibl

e co

nduc

tCo

untr

y do

es n

ot y

et h

ave

sust

aine

d ac

adem

ic t

rain

ing

in i

nstit

utio

ns

prop

ortio

nate

to th

e as

sess

ed ri

sks,

incl

udin

g tr

aini

ng th

ose

who

mai

ntai

n or

w

ork

with

dan

gero

us p

atho

gens

and

toxi

ns

Deve

lope

d ca

paci

ty -

3

Com

preh

ensi

ve n

atio

nal b

iosa

fety

and

bio

secu

rity

syst

em is

bei

ng d

evel

oped

. Th

e co

untr

y is

:Fi

naliz

ing

the

proc

ess

to s

uppo

rt a

ctiv

e m

onito

ring

and

mai

ntai

ning

of u

p-to

-da

te re

cord

s an

d pa

thog

en in

vent

orie

s w

ithin

faci

litie

s th

at s

tore

or p

roce

ss

dang

erou

s pa

thog

ens

and

toxi

nsFi

naliz

ing

the

deve

lopm

ent

and

impl

emen

tatio

n of

com

preh

ensi

ve n

atio

nal

bios

afet

y an

d bi

osec

urity

regu

lato

ry fr

amew

ork

incl

udin

g lic

ensi

ngFi

naliz

ing

the

deve

lopm

ent a

nd im

plem

enta

tion

of p

atho

gen

cont

rol m

easu

res,

op

erat

iona

l han

dlin

g an

d co

ntai

nmen

t fai

lure

repo

rtin

g sy

stem

sSt

artin

g th

e co

nsol

idat

ion

of d

ange

rous

pat

hoge

ns a

nd to

xins

into

a m

inim

um

num

ber o

f fac

ilitie

sSt

artin

g to

put

into

pla

ce t

ools

and

res

ourc

es t

o su

ppor

t di

agno

stic

s th

at

prec

lude

cul

turin

g da

nger

ous

path

ogen

sSt

artin

g to

put

in p

lace

inci

dent

and

em

erge

ncy

and

resp

onse

pro

gram

mes

Coun

try

has

trai

ning

pro

gram

mes

in

plac

e pr

opor

tiona

te t

o th

e as

sess

ed

risks

and

has

beg

un im

plem

enta

tion

Coun

try

has

spec

ific

trai

ning

pro

gram

mes

in p

lace

at m

ost f

acili

ties

hous

ing

or w

orki

ng w

ith d

ange

rous

pat

hoge

ns a

nd to

xins

Trai

ning

on

bios

afet

y an

d bi

osec

urity

has

bee

n pr

ovid

ed to

sta

ff at

som

e, b

ut

not a

ll, fa

cilit

ies

that

mai

ntai

n or

wor

k w

ith d

ange

rous

pat

hoge

ns a

nd to

xins

Coun

try

is d

evel

opin

g su

stai

ned

acad

emic

tra

inin

g pr

opor

tiona

te t

o th

e as

sess

ed r

isks

, in

clud

ing

the

one

for

thos

e w

ho m

aint

ain

or w

ork

with

da

nger

ous

path

ogen

s an

d to

xins

7 -

Rele

vant

sec

tors

incl

ude,

at m

inim

um, t

he m

inis

trie

s or

age

ncie

s th

at a

re k

ey to

this

tech

nica

l are

a, s

uch

as h

uman

hea

lth, a

nim

al h

ealth

, env

ironm

ent,

food

saf

ety,

defe

nce,

priv

ate

sect

or.

8 -

Such

a c

ompr

ehen

sive

bio

safe

ty a

nd b

iose

curit

y sy

stem

wou

ld c

over

legi

slat

ion,

regu

latio

ns, r

equi

rem

ents

and

fina

ncin

g.

PR

EV

EN

T



Dem

onst

rate

d ca

paci

ty –

4

Bios

afet

y an

d bi

osec

urity

sys

tem

is

deve

lope

d, b

ut n

ot s

usta

inab

le.

The

coun

try

is:

Activ

ely

mon

itorin

g an

d m

aint

aini

ng a

n up

date

d re

cord

and

inv

ento

ry o

f pa

thog

ens

with

in f

acili

ties

that

sto

re o

r pr

oces

s da

nger

ous

path

ogen

s an

d to

xins

Impl

emen

ting

enac

ted

com

preh

ensi

ve n

atio

nal

bios

afet

y an

d bi

osec

urity

re

gula

tory

fram

ewor

kIm

plem

entin

g la

bora

tory

lice

nsin

gIm

plem

entin

g pa

thog

en

cont

rol

mea

sure

s,

oper

atio

nal

hand

ling

and

cont

ainm

ent f

ailu

re re

port

ing

syst

ems

Com

plet

ing

the

cons

olid

atio

n of

dan

gero

us p

atho

gens

and

tox

ins

into

a

min

imum

num

ber o

f fac

ilitie

sEm

ploy

ing

diag

nost

ics

that

pre

clud

e cu

lturin

g da

nger

ous

path

ogen

sO

pera

ting

inci

dent

and

em

erge

ncy

and

resp

onse

pro

gram

mes

Coun

try

has

trai

ning

pro

gram

mes

in p

lace

Co

untr

y ha

s tr

aini

ng p

rogr

amm

es in

pla

ce a

t al

l fac

ilitie

s an

d st

aff

trai

ned

prop

ortio

nate

to th

e as

sess

ed ri

sks,

incl

udin

g th

ose

that

hou

se o

r wor

k w

ith

dang

erou

s pa

thog

ens

and

toxi

nsCo

untr

y ha

s in

pla

ce a

cade

mic

trai

ning

pro

port

iona

te to

the

asse

ssed

risk

s,

incl

udin

g in

stitu

tions

that

trai

n th

ose

who

mai

ntai

n or

wor

k w

ith d

ange

rous

pa

thog

ens

and

toxi

nsCo

untr

y ha

s lim

ited

abili

ty to

sel

f-su

stai

n al

l of t

he a

bove

Sust

aina

ble

capa

city

– 5

Sust

aina

ble

mul

tisec

tora

l bio

safe

ty a

nd b

iose

curit

y sy

stem

is in

pla

ceM

inis

trie

s ha

ve m

ade

avai

labl

e ad

equa

te f

undi

ng a

nd p

oliti

cal

supp

ort

for

a co

mpr

ehen

sive

nat

iona

l bi

osaf

ety

and

bios

ecur

ity s

yste

m, i

nclu

ding

m

aint

enan

ce o

f fac

ilitie

s an

d eq

uipm

ent

Coun

try

has

sust

aina

ble

trai

ning

pro

gram

mes

incl

uded

into

uni

vers

ity/c

olle

ge

curr

icul

a of

pre

-ser

vice

trai

ning

and

into

con

tinui

ng e

duca

tion

prog

ram

mes

. St

aff c

ompe

tenc

e is

ass

esse

d an

d ex

erci

ses

are

cond

ucte

d pe

riodi

cally

Coun

try

has

fund

ing

and

capa

city

to s

usta

in a

ll of

the

abov

eRe

view

of t

rain

ing

need

s as

sess

men

t is

cond

ucte

d pe

riodi

cally

and

refr

eshe

r tr

aini

ng o

n ne

eds

area

s ar

e co

nduc

ted

perio

dica

llyTr

aini

ng o

n em

erge

ncy

resp

onse

pro

cedu

res

are

prov

ided

per

iodi

cally

Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

P.6.

1 W

hole

-of-

gove

rnm

ent b

iosa

fety

and

bio

secu

rity

syst

em in

pla

ce fo

r all

sect

ors

(incl

udin

g hu

man

, ani

mal

and

agr

icul

ture

faci

litie

s)1.

Is

ther

e ac

tive

mon

itorin

g an

d de

velo

pmen

t of a

n up

date

d re

cord

and

inve

ntor

y of

pat

hoge

ns w

ithin

faci

litie

s th

at s

tore

or p

roce

ss d

ange

rous

pat

hoge

ns a

nd

toxi

ns?

a. D

oes

the

coun

try

have

in p

lace

an

upda

ted

reco

rd o

f whe

re a

nd in

whi

ch fa

cilit

ies

dang

erou

s pa

thog

ens

and

toxi

ns a

re h

ouse

d?i.

Hav

e co

llect

ions

of p

atho

gens

and

toxi

ns b

een

iden

tified

?ii.

Wha

t gui

danc

e is

to b

e pr

ovid

ed to

cou

ntrie

s w

hich

do

not h

ave

supp

ortin

g sy

stem

s an

d le

gisl

atio

n al

read

y in

pla

ce to

ena

ble

them

to re

quire

inve

ntor

y re

cord

s of

“dan

gero

us p

atho

gens

and

toxi

ns” k

ept b

y fa

cilit

ies?

PR

EV

EN

T



iii.

Is th

ere

an a

gree

d lis

t of “

dang

erou

s pa

thog

ens

and

toxi

ns” t

o w

hich

this

que

stio

n ap

plie

s?

iv.

How

oft

en a

re fa

cilit

ies

expe

cted

to u

pdat

e su

ch re

cord

s?

2.

Is th

ere

a co

mpr

ehen

sive

nat

iona

l bio

safe

ty a

nd b

iose

curit

y re

gula

tory

fram

ewor

k be

ing

enac

ted?

a. D

oes

the

coun

try

have

bio

secu

rity

legi

slat

ion

and/

or re

gula

tions

in p

lace

? Ar

e th

ey b

eing

impl

emen

ted?

b. D

oes

the

coun

try

have

bio

safe

ty le

gisl

atio

n an

d/or

regu

latio

ns in

pla

ce?

Are

they

bei

ng im

plem

ente

d?c.

Des

crib

e th

e fo

llow

ing

from

the

cou

ntry

’s n

atio

nal b

iose

curit

y le

gisl

atio

n, r

egul

atio

ns o

r fr

amew

orks

, and

cou

ntry

’s n

atio

nal b

iosa

fety

legi

slat

ion,

re

gula

tions

or f

ram

ewor

ks.

i. H

ow is

this

info

rmat

ion

shar

ed w

ith la

bora

torie

s at

sub

natio

nal l

evel

s w

ithin

the

coun

try?

ii. A

re re

gula

tions

and

/or g

uide

lines

for b

iose

curit

y fo

llow

ed b

y la

bora

torie

s w

ithin

the

coun

try?

Wha

t abo

ut fo

r bio

safe

ty?

iii. D

escr

ibe

bios

ecur

ity m

onito

ring

activ

ities

. Des

crib

e bi

osaf

ety

mon

itorin

g ac

tiviti

es.

iv. H

as a

third

par

ty a

sses

sed

bios

ecur

ity a

t nat

iona

l lab

orat

ory

faci

litie

s? W

as a

bio

safe

ty a

sses

smen

t als

o do

ne?

1.

Whe

n w

as th

e as

sess

men

t don

e?

2.

Hav

e th

e re

com

men

datio

ns fr

om th

ose

bios

ecur

ity a

nd b

iosa

fety

ass

essm

ents

bee

n pu

t int

o pl

ace?

v.

W

hat t

ype

of la

bora

tory

requ

ires

a lic

ence

in th

e co

untr

y?

vi.

Are

ther

e co

mm

on li

cenc

e co

nditi

ons/

safe

ty a

nd s

ecur

ity re

quire

men

ts fo

r all

licen

sed

labo

rato

ries?

If s

o, w

hat a

re th

ey?

vii.

How

is c

ompl

ianc

e w

ith li

cens

ing

requ

irem

ents

mon

itore

d?vi

ii. Is

ther

e ad

equa

te a

vaila

bilit

y of

fund

ing

to s

uppo

rt b

iosa

fety

and

bio

secu

rity

prog

ram

mes

/ini

tiativ

es a

nd th

eir

over

sigh

t and

enf

orce

men

t at t

he

min

istr

y le

vel?

ix

. Is th

ere

a m

echa

nism

for b

iose

curit

y ov

ersi

ght o

f dua

l-us

e re

sear

ch a

nd re

spon

sibl

e co

de o

f con

duct

for s

cien

tists

?3.

Ar

e th

e la

bora

tory

lice

nsin

g an

d pa

thog

en c

ontr

ol m

easu

res,

incl

udin

g re

quire

men

ts fo

r phy

sica

l con

tain

men

t and

ope

ratio

nal p

ract

ices

, and

con

tain

men

t an

d fa

ilure

repo

rtin

g sy

stem

s be

ing

impl

emen

ted?

a. P

hysi

cal s

ecur

ityi.

Are

appr

opria

te s

ecur

ity m

easu

res

in p

lace

to m

inim

ize

pote

ntia

l ina

ppro

pria

te re

mov

al o

r rel

ease

of b

iolo

gica

l age

nts

(suc

h as

thef

t, ea

rthq

uake

, flo

od)?

b. I

nfor

mat

ion

secu

rity

i. Is

acc

ess

to s

ensi

tive

info

rmat

ion

(suc

h as

inve

ntor

y of

age

nts

and

toxi

ns) c

ontr

olle

d by

ade

quat

e po

licie

s an

d pr

oced

ures

?c.

Tra

nspo

rtat

ion

secu

rity

i. Ar

e pr

oced

ures

for a

saf

e an

d se

cure

tran

spor

t of c

ultu

re, s

peci

men

s, s

ampl

es a

nd o

ther

con

tam

inat

ed m

ater

ials

est

ablis

hed

and

follo

wed

? ii.

Is

ther

e na

tiona

l leg

isla

tion

for t

he tr

ansp

orta

tion

of d

ange

rous

goo

ds, i

nclu

ding

pat

hoge

ns?

d. P

erso

nnel

sec

urity

i.

Is th

ere

a m

echa

nism

to d

eter

min

e w

hich

per

sonn

el a

re a

utho

rized

to a

cces

s pa

thog

ens

of s

ecur

ity c

once

rn?

ii.

Is th

ere

evid

ence

that

this

mec

hani

sm to

aut

horiz

e pe

rson

nel i

s be

ing

impl

emen

ted

corr

ectly

?

PR

EV

EN

T



e. B

iosa

fety

and

bio

secu

rity

prac

tices

at f

acili

ties

hous

ing

or w

orki

ng w

ith d

ange

rous

pat

hoge

nsi.

Are

site

-spe

cific

bio

safe

ty a

nd b

iose

curit

y m

anag

emen

t pro

gram

mes

and

sup

port

ing

docu

men

ts (m

anua

ls, S

OPs

, job

aid

es, r

ecor

ds) a

vaila

ble

to

incl

ude

bios

afet

y, bi

osec

urity

, inc

iden

t res

pons

e an

d em

erge

ncy

plan

s (s

uch

as fo

r exp

losi

on, fi

re, f

lood

, wor

ker e

xpos

ure,

acc

iden

t or i

llnes

s, m

ajor

sp

illag

e)?

ii.

Are

role

s an

d re

spon

sibi

litie

s re

late

d to

bio

safe

ty a

nd b

iose

curit

y m

anag

emen

t defi

ned

and

docu

men

ted

(bio

safe

ty o

ffice

r, se

curit

y m

anag

er)?

iii.

Hav

e th

e bi

osaf

ety

and

bios

ecur

ity ri

sks

been

ass

esse

d an

d ca

tego

rized

?iv

. Ar

e bi

osaf

ety

and

bios

ecur

ity c

ontr

ol m

easu

res

desc

ribed

in a

n ac

tion

plan

? v.

Ar

e th

ere

mec

hani

sms

to e

nsur

e th

at p

erso

nnel

: are

sui

tabl

e an

d co

mpe

tent

(e.g

. bes

t pra

ctic

es) i

n hu

man

reso

urce

s m

anag

emen

t (e.

g. v

erifi

catio

n of

prio

r edu

catio

n an

d em

ploy

men

t, pe

riodi

c pe

rfor

man

ce re

view

s), h

ave

succ

essf

ully

com

plet

ed tr

aini

ng/m

ento

rshi

p pr

ogra

mm

es, a

nd h

ave

the

abili

ty to

wor

k un

supe

rvis

ed?

f. I

s th

ere

a sy

stem

in p

lace

to c

ondu

ct a

udits

of l

abor

ator

y fa

cilit

ies?

i.

If so

, are

aud

its p

erfo

rmed

regu

larly

? ii.

W

hat o

rgan

izat

ion

cond

ucts

thes

e au

dits

? Ar

e th

ese

with

in th

e go

vern

men

t or e

xter

nal?

iii

. Ar

e au

dits

con

duct

ed b

y th

e na

tiona

l aut

horit

y (s

uch

as In

stitu

tiona

l Bio

safe

ty C

omm

ittee

) or b

y th

e lo

cal B

iolo

gica

l Saf

ety

Offi

cer?

iv.

Whi

ch ty

pes

of la

bora

torie

s ar

e su

bjec

t to

thes

e au

dits

? g.

Do

labo

rato

ries

ensu

re th

at b

est p

ract

ices

for b

iosa

fety

and

bio

secu

rity

are

in p

lace

? If

yes,

how

?h.

Do

any

of th

e na

tiona

l lab

orat

orie

s ha

ve o

ther

rele

vant

cla

ssifi

catio

ns (i

.e. F

AO/O

IE/W

HO

Col

labo

ratin

g Ce

ntre

s/Re

fere

nce

Labo

rato

ries)

?4.

Ar

e da

nger

ous

path

ogen

s an

d to

xins

con

solid

ated

into

a m

inim

um n

umbe

r of f

acili

ties?

a. H

as th

e co

untr

y co

nsid

ered

con

solid

atin

g th

e lo

catio

ns fo

r dan

gero

us p

atho

gens

and

toxi

ns?

i. If

not,

will

con

solid

atio

n be

con

side

red?

b. H

ave

colle

ctio

ns o

f dan

gero

us p

atho

gens

bee

n co

nsol

idat

ed in

to a

min

imum

num

ber o

f fac

ilitie

s?

5.

Are

they

em

ploy

ing

diag

nost

ics

that

pre

clud

e cu

lturin

g da

nger

ous

path

ogen

s?a.

Doe

s th

e co

untr

y ut

ilize

dia

gnos

tic te

sts

that

elim

inat

e th

e ne

ed fo

r cul

turin

g da

nger

ous

path

ogen

s?6.

Ar

e th

ey im

plem

entin

g ov

ersi

ght

and

enfo

rcem

ent

mec

hani

sms,

and

hav

e m

inis

trie

s m

ade

avai

labl

e ad

equa

te f

undi

ng t

o su

ppor

t th

e co

mpr

ehen

sive

na

tiona

l bio

safe

ty a

nd b

iose

curit

y sy

stem

?a.

Are

ther

e m

echa

nism

s fo

r ove

rsig

ht, e

nfor

cem

ent a

nd a

ttrib

utio

n fo

r bio

safe

ty a

nd b

iose

curit

y le

gisl

atio

n, re

gula

tions

and

/or g

uide

lines

? b.

Doe

s th

e co

untr

y ha

ve fu

ndin

g fo

r the

se a

ctiv

ities

? Is

the

fund

ing

sour

ce s

usta

inab

le?

7.

Are

the

new

faci

litie

s pl

anne

d w

ith lo

ng-t

erm

com

mitm

ent o

f res

ourc

es fo

r ope

ratio

n an

d m

aint

enan

ce a

nd fo

rmal

ly c

omm

issi

oned

bef

ore

open

ing?

8.

Can

the

bios

afet

y ca

bine

ts b

e se

rvic

ed lo

cally

?9.

Ar

e th

ere

suffi

cien

t nat

iona

l res

ourc

es (b

udge

t and

hum

an) t

o en

sure

pro

per a

nd ti

mel

y m

aint

enan

ce o

f fac

ilitie

s an

d eq

uipm

ent?

10.

Is th

ere

an a

ppro

pria

te w

aste

man

agem

ent p

olic

y at

the

natio

nal l

evel

and

is it

bei

ng im

plem

ente

d lo

cally

?

PR

EV

EN

T



11.

Doe

s ea

ch fa

cilit

y ha

ve s

uffic

ient

per

sona

l pro

tect

ive

equi

pmen

t bas

ed o

n lo

cal r

isk

asse

ssm

ent?

12.

Is th

ere

a fr

amew

ork

to d

ocum

ent,

repo

rt, i

nves

tigat

e an

d ad

dres

s an

y in

cide

nts

and

acci

dent

s at

the

faci

lity

and

natio

nal l

evel

s?13

. Ar

e na

tiona

l reg

ulat

ions

in p

lace

and

up-

to-d

ate

for t

he tr

ansp

ort o

f inf

ectio

us s

ubst

ance

s (C

ateg

orie

s A

and

B)?

a. If

yes

, do

loca

l car

riers

ens

ure

the

tran

spor

t of i

nfec

tious

sub

stan

ces

acco

rdin

g to

nat

iona

l reg

ulat

ions

? b.

Do

the

peop

le re

spon

sibl

e fo

r the

shi

pmen

t of s

peci

men

s ha

ve a

cces

s to

trai

ning

on

infe

ctio

us s

ubst

ance

tran

spor

t?i.

If ye

s, a

re th

ese

trai

ning

s in

line

with

Uni

ted

Nat

ions

regu

latio

ns o

n th

e tr

ansp

ort o

f inf

ectio

us s

ubst

ance

s?14

. D

o la

bora

tory

per

sonn

el h

ave

equa

l acc

ess

to o

ccup

atio

nal/w

orke

r hea

lth s

ervi

ces

in a

ll fa

cilit

ies?

15.

Is th

ere

a sp

ecifi

c va

ccin

atio

n po

licy

(pre

-exp

osur

e pr

ophy

laxi

s) fo

r lab

orat

ory

pers

onne

l (he

patit

is B

and

oth

er re

leva

nt d

isea

ses)

?16

. Is

pos

t-ex

posu

re p

roph

ylax

is tr

eatm

ent p

rovi

ded

to la

bora

tory

wor

kers

in a

ll fa

cilit

ies?

17

. Ar

e la

bora

tory

-acq

uire

d in

fect

ions

and

oth

er in

cide

nts

repo

rted

? a.

Who

doe

s it

get r

epor

ted

to?

b. I

s th

ere

a na

tiona

l sna

psho

t as

to w

hat i

s ha

ppen

ing

acro

ss th

e co

untr

y?

P.6.

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

and

agr

icul

ture

)1.

D

oes

the

coun

try

have

trai

ning

pro

gram

mes

in p

lace

at a

ll fa

cilit

ies,

incl

udin

g th

ose

that

hou

se o

r wor

k w

ith d

ange

rous

pat

hoge

ns a

nd to

xins

?a.

Is b

iosa

fety

and

bio

secu

rity

trai

ning

in p

lace

acr

oss

all f

acili

ties,

incl

udin

g th

ose

that

hou

se o

r w

ork

with

dan

gero

us p

atho

gens

? W

hat

abou

t bi

osaf

ety

trai

ning

? 2.

H

as tr

aini

ng o

n bi

osaf

ety

and

bios

ecur

ity b

een

prov

ided

to s

taff

at a

ll fa

cilit

ies,

incl

udin

g th

ose

that

mai

ntai

n or

wor

k w

ith d

ange

rous

pat

hoge

ns a

nd to

xins

?a.

Doe

s th

e co

untr

y co

nduc

t nee

ds a

sses

smen

ts fo

r bio

safe

ty a

nd b

iose

curit

y tr

aini

ngs?

If s

o, h

ow o

ften

?b.

How

oft

en a

re s

taff

trai

ned

on b

iosa

fety

pro

cedu

res?

Wha

t abo

ut fo

r bio

secu

rity

proc

edur

es?

c. H

ow o

ften

are

sta

ff te

sted

or e

xerc

ised

on

bios

afet

y pr

oced

ures

? W

hat a

bout

for b

iose

curit

y pr

oced

ures

? d.

How

are

thes

e ex

erci

ses

mon

itore

d an

d as

sess

ed?

e. D

o th

ese

exer

cise

s in

clud

e a

proc

ess

to d

ocum

ent s

ucce

sses

and

are

as fo

r im

prov

emen

t?f.

Are

ther

e co

rrec

tive

actio

n pl

ans

in p

lace

?3.

D

oes

the

coun

try

have

in p

lace

sus

tain

ed a

cade

mic

trai

ning

in in

stitu

tions

, inc

ludi

ng th

ose

that

trai

n th

ose

who

mai

ntai

n or

wor

k w

ith d

ange

rous

pat

hoge

ns

and

toxi

ns?

a. D

o ac

adem

ic in

stitu

tions

in th

e co

untr

y ha

ve b

iosa

fety

trai

ning

pro

gram

mes

in p

lace

, inc

ludi

ng th

ose

trai

ning

to w

ork

with

dan

gero

us p

atho

gens

?4.

D

oes

the

coun

try

have

the

fund

ing

and

capa

city

to s

usta

in b

iosa

fety

and

bio

secu

rity

trai

ning

?5.

H

ow d

oes

the

natio

nal s

yste

m e

nsur

e ac

cess

to tr

ansp

ort p

rovi

ders

for n

atio

nal a

nd in

tern

atio

nal t

rans

port

atio

n of

“inf

ectio

us s

ubst

ance

s”?

6.

Is th

ere

indu

ctio

n an

d re

fresh

er tr

aini

ng fo

r all

labo

rato

ry s

taff

on b

iosa

fety

and

bio

secu

rity?

7.

Is th

ere

a m

echa

nism

to e

nsur

e an

d m

onito

r sta

ff co

mpe

tenc

e an

d st

anda

rds

of tr

aini

ng a

t all

labo

rato

ries?

PR

EV

EN

T



Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

tyl

Doc

umen

tatio

n of

dan

gero

us p

atho

gen

colle

ctio

ns h

ouse

d in

the

coun

try

l

Esta

blis

hmen

t, en

actm

ent a

nd e

nfor

cem

ent o

f any

rele

vant

nat

iona

l leg

isla

tion

on b

iosa

fety

and

bio

secu

rity

l

Bios

afet

y of

ficer

s tr

aine

d, re

ceiv

ing

ongo

ing

trai

ning

and

sta

tione

d at

all

labo

rato

ries

that

hav

e th

e po

tent

ial t

o ha

ndle

dan

gero

us p

atho

gens

and

hig

h ris

k ex

perim

ents

l

Polic

y do

cum

ent f

or b

ioris

k or

bio

safe

ty m

anag

emen

t in

a fa

cilit

y is

a w

ritte

n po

licy

stat

emen

t tha

t is

sign

ed a

nd re

view

ed a

nnua

llyl

OIE

cou

ntry

PVS

Eva

luat

ion

mis

sion

repo

rt (a

lso

see

sect

ion

“Pre

vent

– Z

oono

tic d

isea

se”)

l

OIE

cou

ntry

PVS

Gap

Ana

lysi

s re

port

(als

o se

e se

ctio

n “P

reve

nt –

Zoo

notic

dis

ease

”)l

OIE

cou

ntry

PVS

Lab

orat

ory

mis

sion

repo

rt

PR

EV

EN

T



IMM

UN

IZAT

ION

Targ

et: A

nat

iona

l vac

cine

del

iver

y sy

stem

– w

ith n

atio

nwid

e re

ach,

effe

ctiv

e di

strib

utio

n, e

asy

acce

ss fo

r m

argi

naliz

ed p

opul

atio

ns, a

dequ

ate

cold

cha

in a

nd

ongo

ing

qual

ity c

ontr

ol –

that

is a

ble

to re

spon

d to

new

dis

ease

thre

ats.

As m

easu

red

by: 9

0–95

% c

over

age

of th

e co

untr

y’s

12-m

onth

-old

pop

ulat

ion

with

at l

east

one

dos

e of

mea

sles

-con

tain

ing

vacc

ine

(MCV

), as

dem

onst

rate

d by

co

vera

ge s

urve

ys o

r adm

inis

trat

ive

data

.

Desi

red

impa

ct: E

ffect

ive

prot

ectio

n th

roug

h ac

hiev

emen

t an

d m

aint

enan

ce o

f im

mun

izat

ion

agai

nst

mea

sles

and

oth

er e

pide

mic

-pro

ne v

acci

ne-p

reve

ntab

le

dise

ases

(VPD

s). M

easl

es im

mun

izat

ion

is e

mph

asiz

ed b

ecau

se it

is w

idel

y re

cogn

ized

as

a pr

oxy

indi

cato

r for

ove

rall

imm

uniz

atio

n ag

ains

t VPD

s. 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,

men

ingo

cocc

al d

isea

se, t

ypho

id a

nd y

ello

w fe

ver)

. Dis

ease

s th

at a

re tr

ansf

erab

le fr

om c

attle

to h

uman

s, s

uch

as a

nthr

ax a

nd ra

bies

, are

als

o in

clud

ed.

PR

EV

EN

T



Scor

eIn

dica

tors

: Im

mun

izat

ion

P.7.

1 Va

ccin

e co

vera

ge (m

easl

es) a

s pa

rt o

f nat

iona

l pro

gram

me

P.7.

2 N

atio

nal v

acci

ne a

cces

s an

d de

liver

y

No

capa

city

- 1

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

one

dose

of M

CV, a

s de

mon

stra

ted

by c

over

age

surv

eys

or a

dmin

istr

ativ

e da

taPl

an is

in p

lace

to

impr

ove

cove

rage

, inc

ludi

ng s

uppl

emen

tal i

mm

uniz

atio

n ac

tiviti

es

No

plan

is

in p

lace

for

nat

ionw

ide

vacc

ine

deliv

ery,

nor

have

pla

ns b

een

draf

ted

to p

rovi

de v

acci

nes

thro

ugho

ut th

e co

untr

y to

targ

et p

opul

atio

ns b

ut

not i

mpl

emen

ted

Inad

equa

te v

acci

ne p

rocu

rem

ent a

nd fo

reca

stin

g le

ad to

regu

lar

stoc

k-ou

ts

at th

e ce

ntra

l and

dis

tric

t lev

els

Lim

ited

ca

paci

ty -

2

50–

69%

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

dose

of M

CV, a

s de

mon

stra

ted

by c

over

age

surv

eys

or a

dmin

istr

ativ

e da

taPl

an is

in p

lace

to a

chie

ve 9

0% c

over

age

with

in th

e ne

xt fi

ve y

ears

and

incl

ude

supp

lem

enta

l im

mun

izat

ion

activ

ities

Impl

emen

tatio

n ha

s be

gun

to m

aint

ain

a co

ld c

hain

for v

acci

ne d

eliv

ery,

but

is a

vaila

ble

in fe

wer

than

40%

of d

istr

icts

in th

e co

untr

y, or

vac

cine

del

iver

y (m

aint

aini

ng c

old

chai

n) is

ava

ilabl

e to

less

than

40%

of t

he ta

rget

pop

ulat

ion

in th

e co

untr

yIn

adeq

uate

vac

cine

pro

cure

men

t an

d fo

reca

stin

g le

ad t

o oc

casi

onal

sto

ck-

outs

at c

entr

al a

nd d

istr

ict l

evel

s

Deve

lope

d ca

paci

ty -

3

70–

89%

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

dose

of M

CV, a

s de

mon

stra

ted

by c

over

age

surv

eys

or a

dmin

istr

ativ

e da

taPl

an is

in p

lace

to a

chie

ve 9

5% c

over

age

with

in th

e ne

xt th

ree

year

s

Vacc

ine

deliv

ery

(mai

ntai

ning

col

d ch

ain)

is a

vaila

ble

in 4

0–59

% o

f dis

tric

ts

with

in th

e co

untr

y, or

vac

cine

del

iver

y (m

aint

aini

ng c

old

chai

n) is

ava

ilabl

e to

40

–59

% o

f the

targ

et p

opul

atio

n in

the

coun

try

Vacc

ine

proc

urem

ent

and

fore

cast

ing

lead

to

no s

tock

-out

s of

vac

cine

s at

ce

ntra

l lev

el a

nd o

ccas

iona

l sto

ck-o

uts

at d

istr

ict l

evel

Dem

onst

rate

d ca

paci

ty -

4

90%

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

nd t

he t

raje

ctor

y of

pro

gres

s, p

lans

and

cap

aciti

es a

re in

pla

ce t

o ac

hiev

e 95

% c

over

age

by 2

0201

Mor

e th

an 9

0% o

f al

l su

bnat

iona

l (d

istr

icts

/pro

vinc

es o

r st

ates

) un

its a

re

cove

red

Vacc

ine

deliv

ery

(mai

ntai

ning

col

d ch

ain)

is a

vaila

ble

in 6

0–79

% o

f dis

tric

ts

with

in th

e co

untr

y or

vac

cine

del

iver

y (m

aint

aini

ng c

old

chai

n) is

ava

ilabl

e in

60

–79

% o

f the

targ

et p

opul

atio

n in

the

coun

try

Func

tiona

l va

ccin

e pr

ocur

emen

t an

d fo

reca

stin

g, t

ake

into

acc

ount

glo

bal

stoc

ks, l

ead

to n

o st

ock-

outs

at t

he c

entr

al le

vel a

nd r

are

stoc

k-ou

ts a

t the

di

stric

t lev

el th

at a

re w

ithin

thei

r con

trol

Sust

aina

ble

capa

city

- 5

95%

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; o

r 90%

of

the

cou

ntry

’s 1

2-m

onth

-old

pop

ulat

ion

has

rece

ived

at

leas

t on

e do

se

of M

CV a

nd t

he t

raje

ctor

y of

pro

gres

s, p

lans

and

cap

aciti

es a

re in

pla

ce t

o ac

hiev

e 95

% c

over

age

by 2

020

Vacc

ine

deliv

ery

(mai

ntai

ning

col

d ch

ain)

is a

vaila

ble

in g

reat

er th

an 8

0% o

f di

stric

ts w

ithin

the

cou

ntry

or

vacc

ine

deliv

ery

(mai

ntai

ning

col

d ch

ain)

is

avai

labl

e to

mor

e th

an 8

0% o

f the

nat

iona

l tar

get p

opul

atio

nSy

stem

s to

rea

ch m

argi

naliz

ed p

opul

atio

ns u

sing

cul

tura

lly a

ppro

pria

te

prac

tices

are

in p

lace

Vacc

ine

deliv

ery

has

been

test

ed th

roug

h a

natio

nwid

e va

ccin

e ca

mpa

ign

or

func

tiona

l exe

rcis

eFu

nctio

nal p

rocu

rem

ent a

nd v

acci

ne fo

reca

stin

g re

sults

in n

o st

ock-

outs

1 -

Glo

bal M

easl

es a

nd R

ubel

la: S

trat

egic

Pla

n 20

12–

2020

(htt

p://

apps

.who

.int/

iris/

bits

trea

m/1

0665

/448

55/1

/978

9241

5033

96_e

ng.p

df, a

cces

sed

23 N

ovem

ber 2

017)

.

PR

EV

EN

T


47 - Joint External Evaluation Tool

Cont

extu

al q

uest

ions

:

1.

Des

crib

e if

ther

e ar

e ot

her n

atio

nally

impo

rtan

t im

mun

izat

ions

out

side

the

scop

e of

the

WH

O G

loba

l Vac

cine

Act

ion

Plan

(suc

h as

cho

lera

, Jap

anes

e en

ceph

aliti

s,

men

ingo

cocc

al d

isea

se, t

ypho

id a

nd y

ello

w fe

ver)

.2.

Is

pub

lic p

erce

ptio

n on

the

topi

c of

imm

uniz

atio

n m

onito

red?

Do

vacc

inat

ion

cam

paig

ns a

ddre

ss p

erce

ptio

n is

sues

?

Tech

nica

l que

stio

ns:

P.7.

1 Va

ccin

e co

vera

ge (m

easl

es) a

s pa

rt o

f nat

iona

l pro

gram

me

1.

Doe

s th

e co

untr

y ha

ve a

nat

iona

l-le

vel i

mm

uniz

atio

n pr

ogra

mm

e or

pla

n?

a. W

hat v

acci

ne-p

reve

ntab

le d

isea

ses

are

cove

red

by th

is p

rogr

amm

e or

pla

n?b.

Lis

t the

targ

et ra

tes

for c

over

age

for e

ach

of th

ese

vacc

ines

.c.

Is

the

coun

try’

s na

tiona

l vac

cine

act

ion

plan

alig

ned

with

the

WH

O G

loba

l Vac

cine

Act

ion

Plan

?d.

Doe

s th

e co

untr

y’s

plan

take

into

acc

ount

zoo

notic

dis

ease

s of

nat

iona

l con

cern

?e.

Is

imm

uniz

atio

n m

anda

tory

or v

olun

tary

?2.

W

hat p

rogr

amm

es o

r inc

entiv

es a

re in

pla

ce to

enc

oura

ge/s

uppo

rt ro

utin

e va

ccin

atio

n?

3.

Wha

t fac

tors

dis

cour

age/

hind

er ro

utin

e va

ccin

atio

n?4.

D

escr

ibe

the

syst

ems

used

to m

onito

r vac

cine

cov

erag

e.a.

Is

the

perc

enta

ge o

f cov

erag

e w

ith m

easl

es-c

onta

inin

g an

tigen

vac

cine

and

dip

hthe

ria te

tanu

s pe

rtus

sis

trac

ked

for t

he p

opul

atio

n?b.

Whi

ch o

ffice

s or

age

ncie

s ar

e in

volv

ed in

mon

itorin

g va

ccin

e co

vera

ge fo

r the

cou

ntry

?c.

How

oft

en is

vac

cine

cov

erag

e m

easu

red?

d.

Wha

t is

the

sour

ce a

nd q

ualit

y of

the

data

use

d as

den

omin

ator

in c

over

age

estim

ates

?e.

Whi

ch s

yste

ms

are

in p

lace

to m

onito

r the

qua

lity

of c

over

age

data

? 5.

Is

ther

e sp

ecifi

c su

ppor

t (m

onet

ary

and

staf

fing)

for d

ata

gath

erin

g/re

port

ing?

P.7.

2 N

atio

nal v

acci

ne a

cces

s an

d de

liver

y1.

D

escr

ibe

how

nat

iona

l sys

tem

s en

sure

con

tinuo

us c

old

chai

ns a

s ne

cess

ary

for v

acci

ne d

eliv

ery

thro

ugho

ut th

e co

untr

y.2.

W

hat s

truc

ture

and

mec

hani

sms

are

in p

lace

to e

nsur

e a

sust

aina

ble

supp

ly to

ena

ble

a su

cces

sful

pro

gram

me?

3.

Confi

rm th

at g

loba

l vac

cine

sto

ck le

vels

are

take

n in

to a

ccou

nt w

hen

revi

ewin

g do

mes

tic s

tock

leve

ls.

4.

Des

crib

e th

e m

ost r

ecen

t nat

iona

l vac

cine

cam

paig

n(s)

or a

ny re

cent

func

tiona

l exe

rcis

es g

eare

d to

war

ds v

acci

ne d

istr

ibut

ion

and/

or a

dmin

istr

atio

n in

the

coun

try.

5.

Is th

ere

spec

ific

supp

ort (

mon

etar

y an

d st

affin

g) fo

r im

mun

izat

ion

deliv

ery?

PR

EV

EN

T


48 - Joint External Evaluation Tool

Refe

renc

es:

l

The

Expa

nded

Pro

gram

me

on Im

mun

izat

ion.

Wor

ld H

ealth

Org

aniz

atio

n [w

ebsi

te] (

http

://w

ww

.who

.int/

imm

uniz

atio

n/pr

ogra

mm

es_s

yste

ms/

supp

ly_c

hain

/be

nefit

s_of

_im

mun

izat

ion/

en/,

acce

ssed

23

Nov

embe

r 201

7).

l

WH

O m

easl

es a

nd p

olio

era

dica

tion

prog

ram

mes

.l

Glo

bal V

acci

ne A

ctio

n Pl

an 2

011–

2020

. Wor

ld H

ealth

Org

aniz

atio

n [w

ebsi

te] (

http

://w

ww

.who

.int/

imm

uniz

atio

n/gl

obal

_vac

cine

_act

ion_

plan

/en/

, acc

esse

d 23

Nov

embe

r 201

7).

l

Glo

bal M

easl

es a

nd R

ubel

la –

Str

ateg

ic P

lan

2012

–20

20.

Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

012

(http

://ap

ps.w

ho.in

t/iri

s/bi

tstre

am/1

0665

/448

55/1

/ 97

8924

1503

396_

eng.

pdf?

ua=1

, acc

esse

d 23

Nov

embe

r 201

7).

PR

EV

EN

T



DETE

CTN

ATIO

NAL

LAB

ORA

TORY

SYS

TEM

1 Ta

rget

: A S

urve

illan

ce w

ith a

nat

iona

l lab

orat

ory

syst

em, in

clud

ing

all r

elev

ant s

ecto

rs2 ,

part

icul

arly

hum

an a

nd a

nim

al h

ealth

, and

effe

ctiv

e m

oder

n3 poi

nt-o

f-ca

re

and

labo

rato

ry-b

ased

dia

gnos

tics.

As m

easu

red

by: (

1) A

nat

ionw

ide

labo

rato

ry s

yste

m a

ble

to re

liabl

y co

nduc

t at l

east

five

of t

he 1

0 co

re te

sts4 o

n ap

prop

riate

ly id

entifi

ed a

nd c

olle

cted

out

brea

k sp

ecim

ens

tran

spor

ted

safe

ly a

nd s

ecur

ely

to a

ccre

dite

d la

bora

torie

s fr

om a

t lea

st 8

0% o

f int

erm

edia

te le

vels

/dis

tric

ts in

the

coun

try.

(2) E

xist

ence

of n

atio

nal

qual

ity la

bora

tory

sta

ndar

ds a

nd s

yste

m fo

r lic

enci

ng la

bora

torie

s.

Desi

red

impa

ct: E

ffect

ive

use

of a

nat

ionw

ide

labo

rato

ry s

yste

m, i

nclu

ding

all

rele

vant

sec

tors

, cap

able

of s

afel

y an

d ac

cura

tely

det

ectin

g an

d ch

arac

teriz

ing

path

ogen

s ca

usin

g ep

idem

ic d

isea

se in

clud

ing

both

kno

wn

and

unkn

own

thre

ats

from

all

part

s of

the

coun

try.

Exp

ande

d de

ploy

men

t, ut

iliza

tion

and

sust

ainm

ent

of m

oder

n, s

afe,

sec

ure,

affo

rdab

le a

nd a

ppro

pria

te d

iagn

ostic

test

s or

dev

ices

est

ablis

hed.

1 -

The

Nat

iona

l Lab

orat

ory

Syst

em is

a c

olla

bora

tive

com

mun

ity o

f clin

ical

labo

rato

ries,

pub

lic h

ealth

labo

rato

ries,

and

man

y in

divi

dual

par

tner

s w

ho in

itiat

e te

sts

and/

or u

se te

st re

sults

(htt

ps:/

/ww

w.n

cbi.n

lm.n

ih.g

ov/p

mc/

2 -

Rele

vant

sec

tors

incl

ude

priv

ate

and

publ

ic s

ecto

rs, s

uch

as: a

ll le

vels

of t

he h

ealth

car

e sy

stem

(nat

iona

l, su

bnat

iona

l and

com

mun

ity/p

rimar

y pu

blic

hea

lth);

NG

Os;

div

isio

ns/a

ctiv

ities

of o

ther

sec

tors

whi

ch a

ffect

pub

lic h

ealth

, su

ch a

s m

inis

trie

s of

agr

icul

ture

(qu

aran

tine

and

mov

emen

t co

ntro

l aut

horit

y, im

port

/exp

ort

regu

latio

ns, d

isea

se d

iagn

osis

and

con

trol

fina

ncin

g, z

oono

sis,

vet

erin

ary

labo

rato

ry e

tc.),

tra

nspo

rt (

tran

spor

t po

licy,

civi

l avi

atio

n,

port

s an

d m

ariti

me

tran

spor

t), t

rade

and

/or

indu

stry

(foo

d sa

fety

and

qua

lity

cont

rol),

fore

ign

trad

e (c

onsu

mer

pro

tect

ion,

con

trol

of c

ompu

lsor

y st

anda

rd e

nfor

cem

ent)

, com

mun

icat

ion,

def

ence

, tre

asur

y or

fina

nce

(cus

tom

s),

envi

ronm

ent,

inte

rior,

heal

th, t

ouris

m; h

ealth

, tou

rism

; the

hom

e of

fice;

med

ia; a

nd re

gula

tory

bod

ies.

3 -

Mod

ern

mea

ns n

ovel

mol

ecul

ar a

nd c

ellu

lar m

etho

ds c

apab

le o

f pro

mpt

and

acc

urat

e id

entifi

catio

n of

pat

hoge

ns in

a ti

mes

avin

g an

d co

st-e

ffect

ive

man

ner.

4 -

10 c

ore

test

s: A

list

in e

ach

coun

try

incl

udes

six

test

ing

met

hods

sel

ecte

d ac

cord

ing

to th

e 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

-inc

ome

coun

trie

s: p

olym

eras

e ch

ain

reac

tion

test

ing

for

influ

enza

viru

s; v

irus

cultu

re fo

r po

liovi

rus;

ser

olog

y fo

r H

IV; m

icro

scop

y fo

r M

ycob

acte

rium

tube

rcul

osis

; rap

id d

iagn

ostic

test

ing

for

Plas

mod

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 on

the

basi

s of

maj

or n

atio

nal p

ublic

hea

lth c

once

rns.

DE

TE

CT



Scor

e5

Indi

cato

rs: N

atio

nal l

abor

ator

y sy

stem

6,7,

8 D.

1.1

Labo

rato

ry te

stin

g3 for

de

tect

ion

of p

riorit

y di

seas

es10

D.

1.2

Spec

imen

refe

rral

and

tr

ansp

ort s

yste

m11

D.

1.3

Effe

ctiv

e na

tiona

l dia

gnos

tic n

etw

ork12

D.

1.4

Labo

rato

ry q

ualit

y sy

stem

13

No

capa

city

- 1

Coun

try

has

not t

aken

a ri

sk-b

ased

ap

proa

ch t

o de

term

ine

at le

ast

10

prio

rity

dise

ases

for c

ore

test

ing14

No

syst

em15

in p

lace

for

tra

nspo

r-tin

g sp

ecim

ens

from

int

erm

edia

te

leve

ls/d

istr

icts

to

natio

nal

labo

ra-

torie

s; o

nly

ad h

oc tr

ansp

orta

tion16

is

ava

ilabl

e

No

evid

ence

of u

se o

f rap

id a

nd a

ccur

ate

poin

t-of

-car

e/17

farm

-bas

ed d

iagn

ostic

s18 a

nd la

bo-

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

Ther

e ar

e no

nat

iona

l la

bo-r

ator

y qu

ality

sta

ndar

ds

Lim

ited

ca

paci

ty –

2

Coun

try

has

defin

ed 1

0 co

re t

ests

an

d th

e na

tiona

l lab

orat

ory

syst

em

is c

ondu

ctin

g on

e to

two

core

test

s an

d qu

ality

ass

uran

ce p

roce

ss is

in

plac

e

Syst

em i

s in

pla

ce t

o tr

ansp

ort

spec

imen

s to

nat

iona

l lab

orat

orie

s fr

om le

ss th

an 5

0% o

f int

erm

edia

te

leve

ls/d

istr

icts

in

the

coun

try

for

adva

nced

dia

gnos

tics

Min

imal

, la

bora

tory

di

agno

stic

ca

pabi

lity

exis

ts w

ithin

the

cou

ntry

, but

no

tier-

spec

ific

diag

nost

ic te

stin

g st

rate

gies

are

doc

umen

ted.

Po

int-

of-c

are/

farm

-bas

ed

diag

nost

ics

are

bein

g us

ed fo

r cou

ntry

prio

rity

dise

ases

19

Nat

iona

l qu

ality

st

anda

rds

have

be

en d

evel

oped

but

ther

e is

no

sys-

tem

for v

erify

ing

thei

r im

plem

enta

-tio

n

Deve

lope

d ca

paci

ty –

3

Nat

iona

l la

bora

tory

sy

stem

is

co

nduc

ting

thre

e to

four

cor

e te

sts;

su

scep

tibili

ty t

estin

g an

d qu

ality

as

sura

nce

proc

ess

are

in p

lace

Syst

em i

s in

pla

ce t

o tr

ansp

ort

spec

imen

s to

nat

iona

l lab

orat

orie

s fr

om 5

0–80

% o

f in

term

edia

te l

e-ve

ls/d

istr

icts

with

in th

e co

untr

y fo

r ad

vanc

ed d

iagn

ostic

s

Tier

-spe

cific

di

agno

stic

te

stin

g st

rate

gies

ar

e do

cum

ente

d, b

ut n

ot f

ully

im

plem

ente

d.

Coun

try

is p

rofic

ient

in

clas

sica

l di

agno

stic

te

chni

ques

in

clud

ing

bact

erio

logy

, se

rolo

gy

and

PCR

in s

elec

t lab

orat

orie

s bu

t has

lim

ited

refe

rral

and

con

firm

ator

y pr

oces

ses.

Cou

ntry

is

usi

ng p

oint

-of-

care

dia

gnos

tics

for

coun

try

prio

rity

dise

ases

A sy

stem

of

licen

sing

of

labo

rato

-rie

s th

at i

nclu

des

conf

orm

ity t

o a

natio

nal q

ualit

y st

anda

rd e

xist

s bu

t it

is v

olun

tary

or

is n

ot a

req

uire

-m

ent f

or a

ll la

bora

torie

s

5 -

For f

ull s

core

s, c

apab

ilitie

s sh

ould

be

sepa

rate

ly e

valu

ated

bot

h in

the

hum

an a

nd a

nim

al (l

ives

tock

, com

pani

on a

nim

al a

nd w

ildlif

e) h

ealth

sec

tors

and

mec

hani

sms

for r

egul

ar jo

int p

lann

ing,

sha

ring

of in

form

atio

n, c

olla

bora

tion,

co

mm

unic

atio

n, a

nd jo

int p

olic

y-de

velo

pmen

t in

a O

ne H

ealth

app

roac

h sh

ould

be

in p

lace

. The

fina

l sco

re s

houl

d be

bas

ed o

n th

e lo

wer

of t

he s

core

s fo

r the

hum

an a

nd a

nim

al h

ealth

sec

tors

.6

- Th

e in

dica

tors

refe

r to

the

natio

nal l

abor

ator

y ca

paci

ty fo

r the

cou

ntry

.7

- Li

nk th

is te

chni

cal a

rea

with

oth

er te

chni

cal a

reas

that

requ

ire la

bora

tory

test

ing

capa

city

(suc

h as

sur

veill

ance

, zoo

nosi

s, fo

od s

afet

y, AM

R)8

- Th

e na

tiona

l lab

orat

ory

syst

em s

houl

d in

clud

e:

• Abi

lity

to c

ondu

ct a

t lea

st fi

ve o

f the

10

core

test

s (s

ee fo

otno

te 4

).• A

bilit

y to

tran

spor

t spe

cim

ens

safe

ly a

nd q

uick

ly fr

om 8

0% o

r mor

e of

inte

rmed

iate

leve

ls/d

istr

icts

to n

atio

nal l

abor

ator

y fa

cilit

ies

for a

dvan

ced

diag

nost

ics.

• Abi

lity

to c

ondu

ct h

igh-

leve

l dia

gnos

tic te

stin

g at

nat

iona

l lab

orat

orie

s or

hav

e ag

reem

ents

with

regi

onal

net

wor

ks to

ens

ure

test

ing

is a

vaila

ble.

• Abi

lity

to te

st fo

r ant

imic

robi

al s

usce

ptib

ility

for p

riorit

y pa

thog

ens

in h

uman

hea

lth a

nd in

ani

mal

food

pro

duct

ion.

9 -

Rapi

d di

agno

stic

test

per

form

ed a

nd re

sult

obta

ined

with

in 1

2–48

hou

rs o

r in

a tim

ely

man

ner f

or tr

igge

ring

and

guid

ing

cont

rol m

easu

res.

10 -

Prio

rity

dise

ases

– b

ased

on

the

loca

l epi

dem

iolo

gy a

nd a

s de

fined

in n

atio

nal s

urve

illan

ce g

uide

lines

for p

riorit

y di

seas

es a

nd/o

r not

ifiab

le d

isea

ses

(ref

er to

Glo

ssar

y an

d fo

otno

te 4

). 11

- T

rans

port

“sys

tem

”: Ac

cura

tely

col

lect

and

mai

ntai

n sp

ecim

en in

tegr

ity a

nd a

s w

ritte

n in

the

SOP.

12 -

The

re is

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C II-

1: V

eter

inar

y la

bora

tory

dia

gnos

is. T

he O

IE c

ondu

cts

PVS

labo

rato

ry m

issi

ons

whe

re th

e ne

twor

k as

pect

s ar

e ev

alua

ted.

13 -

The

re is

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C II-

2: L

abor

ator

y qu

ality

ass

uran

ce.

14 -

Cor

e te

sts

can

incl

ude

loca

l prio

rity

test

s de

term

ined

by

coun

try-

sele

cted

indi

cato

r pat

hoge

ns o

n th

e ba

sis

of m

ajor

nat

iona

l pub

lic h

ealth

con

cern

. For

the

anim

al h

ealth

sec

tor,

core

test

s m

ean

the

abili

ty to

test

for a

ll di

seas

es

on th

e ag

reed

list

of p

riorit

y zo

onot

ic d

isea

ses.

If th

ere

is n

o su

ch li

st, t

hen

it is

the

abili

ty to

test

for d

isea

ses

on th

e lis

t of p

riorit

y zo

onot

ic d

isea

ses

of th

e pu

blic

hea

lth s

ecto

r.15

- A

n or

gani

zed

or e

stab

lishe

d pr

oced

ure

in th

e co

untr

y or

out

side

. Som

e is

land

cou

ntrie

s m

ay n

ot re

quire

a s

yste

m in

pla

ce a

t the

cou

ntry

leve

l and

can

hav

e ac

cess

to re

gion

al o

r int

erna

tiona

l lab

orat

orie

s.

16 -

“Ad

hoc”

tran

spor

t sys

tem

: no

SOP

on h

ow to

tran

spor

t sam

ple.

17 -

Poi

nt-o

f-ca

re d

iagn

ostic

s is

med

ical

dia

gnos

tic te

stin

g pe

rfor

med

out

side

the

clin

ical

labo

rato

ry in

clo

se p

roxi

mity

to w

here

the

patie

nt is

rec

eivi

ng c

are.

Poi

nt-o

f-ca

re d

iagn

ostic

s is

usu

ally

per

form

ed b

y no

n-la

bora

tory

pe

rson

nel (

e.g.

with

rapi

d di

agno

stic

kits

) and

the

resu

lts a

re u

sed

for c

linic

al d

ecis

ion-

mak

ing.

18 -

Far

m b

ased

dia

gnos

tics:

Rap

id d

iagn

ostic

test

that

can

be

used

in a

farm

for t

estin

g sa

mpl

es.

19 -

It is

impo

rtan

t tha

t the

pro

cess

of d

efini

ng p

riorit

y di

seas

es in

volv

es v

eter

inar

y se

rvic

es a

nd a

ppro

pria

te in

tern

atio

nal c

onsu

ltatio

n (s

uch

as w

ith O

IE a

nd W

HO

).

DE

TE

CT



Dem

onst

rate

d ca

paci

ty –

4

Nat

iona

l la

bora

tory

sy

stem

is

co

nduc

ting

thre

e to

four

cor

e te

sts;

su

scep

tibili

ty t

estin

g an

d qu

ality

as

sura

nce

proc

ess

are

in p

lace

Syst

em i

s in

pla

ce t

o tr

ansp

ort

spec

imen

s to

nat

iona

l lab

orat

orie

s fr

om a

t le

ast

80%

of

inte

rmed

iate

le

vels

/dis

tric

ts w

ithin

the

cou

ntry

fo

r adv

ance

d di

agno

stic

s

Coun

try

has

docu

men

ted

and

fully

im

ple-

men

ted

tier-

spec

ific

diag

nost

ic te

stin

g st

rate

-gi

es, a

nd a

nat

iona

l sys

tem

of s

ampl

e re

ferr

al

and

confi

rmat

ory

diag

nost

ics

culm

inat

ing

in

perf

orm

ance

of m

olec

ular

or s

erol

ogic

al te

ch-

niqu

es a

t nat

iona

l and

/or r

egio

nal l

abor

ator

ies

Poin

t-of

-car

e/fa

rm-b

ased

di

agno

stic

s ar

e be

ing

used

acc

ordi

ng to

tier

-spe

cific

dia

gnos

-tic

test

ing

stra

tegi

es fo

r dia

gnos

is o

f cou

ntry

pr

iorit

y di

seas

es

Man

dato

ry li

cens

ing

of a

ll la

bora

-to

ries

is i

n pl

ace

and

conf

orm

ity

to a

nat

iona

l qu

ality

sta

ndar

d is

re

quire

d

Sust

aina

ble

capa

city

– 5

Syst

ems

for q

ualit

y as

sura

nce

are

in p

lace

and

res

ults

are

dis

sem

i-na

ted

regu

larly

Tran

spor

t of

spe

cim

ens

to/f

rom

ot

her

labo

rato

ries

in

the

regi

on

and

fund

ed f

rom

the

hos

t co

untr

y bu

dget

Coun

try

has

capa

bilit

y fo

r pe

rfor

min

g ad

-va

nced

mol

ecul

ar a

nd s

erol

ogic

al te

chni

ques

as

par

t of a

nat

iona

l sys

tem

of s

ampl

e re

ferr

al

and

confi

rmat

ory

diag

nost

ics

Coun

try

is u

sing

acc

urat

e po

int-

of-c

are/

farm

-ba

sed

diag

nost

ics

as d

efine

d by

tie

r-sp

ecifi

c di

agno

stic

test

ing

stra

tegi

esCo

untr

y is

als

o fo

rmal

ly e

ngag

ing

othe

r re

-fe

renc

e la

bora

torie

s fo

r te

stin

g ca

paci

ty n

ot

avai

labl

e in

the

coun

try,

whe

re n

eede

d, to

sup

-pl

emen

t the

nat

iona

l dia

gnos

tic te

stin

g st

rate

-gi

es f

or s

even

or

mor

e of

the

10

labo

rato

ry

test

s re

quire

d fo

r pr

iorit

y di

seas

es. C

ount

ry is

ab

le to

sus

tain

this

cap

abili

ty o

n its

ow

n

Man

dato

ry li

cens

ing

of a

ll la

bora

-to

ries

is in

pla

ce a

nd c

onfo

rmity

to

an in

tern

atio

nal q

ualit

y st

anda

rd is

re

quire

d

Cont

extu

al q

uest

ions

:

1.

Wha

t are

the

prio

rity

dise

ases

of t

he c

ount

ry a

nd w

hich

of t

hese

are

test

ed in

the

coun

try?

2.

Whi

ch o

f the

10

core

test

s is

the

coun

try

capa

ble

of c

ondu

ctin

g?3.

D

escr

ibe

the

stru

ctur

e of

the

labo

rato

ry s

yste

m, i

nclu

ding

the

num

ber o

f lab

orat

orie

s, a

t loc

al, i

nter

med

iate

leve

ls/d

istr

icts

, and

the

natio

nal l

evel

.a.

How

man

y re

fere

nce

labo

rato

ries

exis

t and

for w

hich

mic

robe

s?b.

Do

loca

l clin

icia

ns h

ave

the

cust

om o

f usi

ng th

e la

bora

tory

sys

tem

? Are

ther

e na

tiona

l gui

delin

es in

pla

ce fo

r clin

icia

ns o

n ho

w to

con

duct

mic

robi

olog

ical

te

sts

in s

peci

fic s

yndr

omes

, suc

h as

sev

ere

pneu

mon

ia, s

ever

e di

arrh

oea

or s

uspe

cted

men

ingi

tis?

c. W

hat s

yste

ms

exis

t for

get

ting

labo

rato

ry re

sults

bac

k to

pra

ctiti

oner

s? H

ow lo

ng d

oes

this

take

?d.

Wha

t per

cent

age

of th

e po

pula

tion

has

acce

ss to

labo

rato

ry s

ervi

ces

for t

he 1

0 pr

iorit

y di

seas

es?

DE

TE

CT



4.

Hav

e na

tiona

l lab

orat

orie

s be

en a

ccre

dite

d?e.

If y

es, t

o w

hat s

tand

ard?

f. Ar

e gu

idel

ines

and

pro

toco

ls fo

r qua

lity

man

agem

ent s

yste

m e

nfor

ced

and

in u

se b

y pu

blic

and

ani

mal

hea

lth la

bora

torie

s?g.

Is

ther

e a

natio

nal b

ody

that

ove

rsee

s in

tern

al q

ualit

y co

ntro

ls a

nd E

QA

sche

mes

for p

ublic

hea

lth la

bora

torie

s at

all

leve

ls?

h. A

re a

ll la

bora

torie

s en

rolle

d in

the

EQA

prog

ram

me

for t

he te

sts

they

per

form

to d

etec

t any

of t

he 1

0 pr

iorit

y di

seas

es?

5.

How

is la

bora

tory

dat

a on

zoo

notic

dis

ease

s sh

ared

bet

wee

n hu

man

and

ani

mal

hea

lth la

bora

torie

s? A

re th

e tw

o in

tero

pera

ble

data

sys

tem

s? (S

ee re

late

d qu

estio

ns in

Pre

vent

– Z

oono

tic d

isea

se.)

6.

Is p

erso

nal p

rote

ctiv

e eq

uipm

ent a

vaila

ble

for l

abor

ator

y st

aff?

i. H

ow is

ava

ilabi

lity

of p

erso

nal p

rote

ctiv

e eq

uipm

ent t

rack

ed fo

r lab

orat

orie

s?j.

Des

crib

e th

e tr

aini

ng p

roce

dure

s fo

r per

sona

l pro

tect

ive

equi

pmen

t use

in n

atio

nal l

abor

ator

ies.

7.

Wha

t bio

secu

rity/

bios

afet

y tr

aini

ng is

pro

vide

d to

labo

rato

ry w

orke

rs?

(See

rela

ted

tech

nica

l que

stio

ns in

Pre

vent

– B

iosa

fety

and

bio

secu

rity.

)

Tech

nica

l que

stio

ns:

D.1.

1 La

bora

tory

test

ing

for d

etec

tion

of p

riorit

y di

seas

es1.

Is

ther

e a

set o

f nat

iona

l dia

gnos

tic a

lgor

ithm

s fo

r per

form

ance

of c

ore

labo

rato

ry te

sts

that

has

bee

n al

igne

d w

ith in

tern

atio

nal s

tand

ards

(i.e

. Clin

ical

and

La

bora

tory

Sta

ndar

ds In

stitu

te (C

LSI),

OIE

, WH

O)?

2.

How

man

y of

the

core

test

s fo

r the

10

prio

rity

dise

ases

are

impl

emen

ted

effe

ctiv

ely

acro

ss th

e tie

red

labo

rato

ry n

etw

ork?

a. O

f the

test

s th

at c

anno

t be

cond

ucte

d, a

re th

ere

plan

s an

d tim

elin

es in

pla

ce to

gai

n th

is c

apac

ity w

ithin

the

next

yea

r?b.

Are

ther

e of

ficia

l agr

eem

ents

with

labo

rato

ries

outs

ide

the

coun

try

for s

peci

aliz

ed te

stin

g no

t ava

ilabl

e in

the

coun

try?

3.

Has

the

coun

try

iden

tified

four

cou

ntry

-spe

cific

test

s? H

as th

e co

untr

y pr

iorit

ized

impl

emen

tatio

n of

the

10 c

ore

test

s? W

hat i

s th

e an

ticip

ated

test

ing

load

for

each

(or h

ighe

st p

riorit

y) te

st?

Has

the

coun

try

sele

cted

whi

ch p

roto

cols

to u

se fo

r eac

h te

st?

Doe

s th

e co

untr

y ha

ve p

lans

in p

lace

for p

rocu

rem

ent o

f sup

plie

s?

Doe

s th

e la

bora

tory

hav

e qu

ality

ass

uran

ce/q

ualit

y co

ntro

l/Qua

lity

Man

agem

ent S

yste

m (Q

MS)

pla

ns in

pla

ce?

4.

Do

labo

rato

ries

have

the

requ

ired

equi

pmen

t (ba

sed

on te

stin

g ap

prop

riate

for t

he le

vel i

n th

e tie

red

labo

rato

ry n

etw

ork)

to s

uppo

rt c

ore

labo

rato

ry te

sts?

Are

m

aint

enan

ce c

ontr

acts

in p

lace

for k

ey e

quip

men

t and

is p

reve

ntiv

e m

aint

enan

ce im

plem

ente

d re

gula

rly?

5.

How

doe

s th

e co

untr

y en

sure

sta

ndar

diza

tion

of te

stin

g? D

o na

tiona

l lab

orat

orie

s se

nd o

ut s

ampl

es fo

r tes

ting

valid

atio

n of

mor

e lo

cal/r

egio

nal l

abor

ator

ies?

6.

Do

the

min

istr

ies

of h

ealth

, agr

icul

ture

or o

ther

rele

vant

min

istr

ies

have

in-c

ount

ry p

rodu

ctio

n an

d/or

pro

cure

men

t pro

cess

es fo

r acq

uirin

g ne

cess

ary

med

ia

and

reag

ents

for p

erfo

rman

ce o

f cor

e la

bora

tory

test

s?7.

H

ow d

oes

the

labo

rato

ry s

yste

m m

anag

e te

stin

g an

d re

port

ing

on a

ntim

icro

bial

sus

cept

ibili

ty?

a. D

oes

a na

tiona

l pla

n fo

r the

det

ectio

n an

d re

port

ing

of a

ntim

icro

bial

resi

stan

t pat

hoge

ns e

xist

? b.

How

man

y la

bora

torie

s ar

e ab

le to

con

duct

sen

sitiv

ity te

stin

g an

d re

port

ing?

c.

Whi

ch p

atho

gens

and

ant

imic

robi

al s

usce

ptib

ility

pat

tern

s ca

n be

test

ed fo

r?

d. H

ow a

re th

ese

data

val

idat

ed?

Is th

e da

ta re

port

ing

and

valid

atio

n m

echa

nism

func

tiona

l?

DE

TE

CT



e. H

ave

labo

rato

ry m

etho

ds b

een

verifi

ed a

nd t

he q

ualit

y m

onito

red,

suc

h as

thr

ough

ext

erna

l qua

lity

assu

ranc

e? D

oes

the

labo

rato

ry p

artic

ipat

e in

na

tiona

l/in

tern

atio

nal p

rofic

ienc

y te

stin

g? Is

ther

e a

QM

S fo

r lab

orat

orie

s in

the

AMR

surv

eilla

nce

syst

em?

f. H

ow a

nd to

who

m is

dat

a re

port

ed?

g. W

hat i

nter

pret

ive

crite

ria a

re u

sed

to re

port

ant

imic

robi

al s

usce

ptib

ility

test

ing

resu

lts (s

uch

as C

LSI, E

urop

ean

Com

mitt

ee o

n An

timic

robi

al S

usce

ptib

ility

Te

stin

g (E

UCA

ST))

? Ar

e cl

inic

al b

reak

poin

ts u

sed

or e

pide

mio

logi

cal c

ut-o

ffs?

D.1.

2 Sp

ecim

en re

ferr

al a

nd tr

ansp

ort s

yste

m1.

Is

the

spec

imen

refe

rral

net

wor

k do

cum

ente

d fo

r eac

h of

the

test

s ne

cess

ary

to d

etec

t and

con

firm

aet

iolo

gies

of t

he 1

0 pr

iorit

y di

seas

es?

2.

Is th

ere

proo

f of a

func

tioni

ng re

ferr

al s

yste

m a

vaila

ble?

For

exa

mpl

e, d

ata

on th

e nu

mbe

r of i

sola

tes/

sam

ples

sub

mitt

ed to

nat

iona

l ref

eren

ce la

bora

tory

for

key

dise

ase(

s) p

er 1

00 0

00 p

opul

atio

n.3.

D

escr

ibe

the

syst

em fo

r spe

cim

en tr

ansp

ort f

rom

inte

rmed

iate

leve

ls (d

istr

icts

) to

refe

renc

e la

bora

torie

s an

d na

tiona

l lab

orat

orie

s.a.

Are

sta

ndar

dize

d SO

Ps in

pla

ce fo

r spe

cim

en c

olle

ctio

n, p

acka

ging

and

tran

spor

t?b.

Is

spec

imen

tran

spor

t (su

ch a

s co

urie

r con

trac

ts) s

uppo

rted

by

the

heal

th m

inis

try

or it

s pa

rtne

rs?

c. W

ill th

e tr

ansp

ort s

yste

m in

clud

e m

otor

bike

s, p

ost o

ffice

and

spe

cial

cou

riers

, to

be u

sed

for a

ll sp

ecim

ens

(e.g

. drie

d bl

ood

spot

s an

d st

ools

)?

d. I

s th

ere

a w

ay to

“rus

h” h

igh

prio

rity

spec

imen

s (e

.g. s

uspe

ct v

iral h

aem

orrh

agic

feve

r spe

cim

ens)

? e.

Is

trac

king

in p

lace

to d

ocum

ent s

peci

men

shi

pmen

t and

rece

ipt?

f.

Is tr

aini

ng in

pla

ce fo

r lab

orat

orie

s to

use

the

syst

em?

g. A

re g

uide

lines

in p

lace

for s

ched

ule

and

tran

sit t

imes

? h.

Is

ther

e a

prot

ocol

(s) w

ritte

n an

d if

so, a

re la

bora

torie

s aw

are

of it

and

do

they

use

it?

4.

Doe

s th

e ho

st c

ount

ry p

artic

ipat

e in

a re

gion

al (i

nter

natio

nal)

labo

rato

ry n

etw

ork?

D.1.

3 Ef

fect

ive

natio

nal d

iagn

ostic

net

wor

k 1.

D

oes

the

coun

try

have

str

ateg

ies

of c

ondu

ctin

g po

int-

of-c

are/

farm

-bas

ed d

iagn

ostic

s? If

yes

,a.

Wha

t are

thos

e te

sts

and

at w

hat l

evel

s ar

e th

ose

avai

labl

e?b.

Do

thes

e te

sts

cove

r the

cou

ntry

’s p

riorit

y di

seas

es?

c. I

f not

, is

the

coun

try

deve

lopi

ng th

ese

stra

tegi

es?

2.

Has

the

coun

try

deve

lope

d st

rate

gies

for t

ier-

spec

ific

diag

nost

ics?

If n

ot, i

s th

e co

untr

y de

velo

ping

thes

e st

rate

gies

?3.

Is

ther

e a

plan

and

/or m

echa

nism

in p

lace

to im

prov

e th

e av

aila

bilit

y of

poi

nt-o

f-ca

re d

iagn

ostic

s at

clin

ical

site

s ac

ross

the

coun

try?

4.

Do

the

min

istr

ies

of h

ealth

/agr

icul

ture

, or o

ther

rele

vant

min

istr

ies,

hav

e in

-cou

ntry

pro

duct

ion

and/

or p

rocu

rem

ent p

roce

sses

for a

cqui

ring

nece

ssar

y m

edia

an

d re

agen

ts fo

r the

per

form

ance

of c

ore

labo

rato

ry te

sts?

5.

Doe

s th

e co

untr

y pe

rfor

m a

dvan

ced

mol

ecul

ar a

nd s

erol

ogic

al te

stin

g fo

r ref

erre

d sa

mpl

es a

nd fo

r con

firm

atio

n/re

-con

firm

atio

n of

dia

gnos

is?

DE

TE

CT



D.1.

4 La

bora

tory

qua

lity

syst

em1.

Is

ther

e a

natio

nal b

ody

in c

harg

e of

labo

rato

ry li

cens

ing?

2.

Is th

ere

a na

tiona

l bod

y in

cha

rge

of la

bora

tory

insp

ectio

n?a.

If y

es, d

escr

ibe

the

insp

ectio

n m

echa

nism

(fre

quen

cy, p

roce

dure

s, s

anct

ions

, etc

.)6.

Is

ther

e a

natio

nal b

ody

in c

harg

e of

labo

rato

ry c

ertifi

catio

n (e

.g. u

sing

ISO

900

1)?

a. I

f yes

, pro

vide

nam

e(s)

.7.

Is

ther

e a

natio

nal b

ody

in c

harg

e of

labo

rato

ry a

ccre

dita

tion

(e.g

. usi

ng IS

O 1

5189

)?a.

If y

es, p

rovi

de n

ame(

s).

b. I

f not

, do

labo

rato

ries

use

serv

ices

of f

orei

gn n

atio

nal/

regi

onal

acc

redi

tatio

n bo

dies

?c.

If y

es, p

rovi

de n

ame(

s).

8.

Are

som

e la

bora

torie

s ac

cred

ited

for d

isea

se-s

peci

fic te

stin

g by

WH

O (e

.g. p

olio

, mea

sles

, HIV

gen

otyp

ing)

?9.

Pr

ovid

e th

e nu

mbe

r of l

abor

ator

ies

cert

ified

or a

ccre

dite

d an

d sp

ecify

to w

hich

sta

ndar

d.10

. Is

ther

e a

spec

ific

natio

nal d

ocum

ent t

hat d

escr

ibes

the

regi

stra

tion

proc

edur

e fo

r in

vitro

dia

gnos

tic d

evic

es (i

.e. k

its a

nd re

agen

ts)?

11.

Is th

ere

a na

tiona

l reg

ulat

ory

auth

ority

resp

onsi

ble

for i

n vi

tro d

iagn

ostic

dev

ices

qua

lifica

tion

or re

gist

ratio

n?a.

If y

es, p

rovi

de a

sum

mar

y of

the

qual

ifica

tion

or re

gist

ratio

n m

echa

nism

s.12

. Be

side

s th

e in

spec

tion,

cer

tifica

tion

or a

ccre

dita

tion

deta

iled

abov

e is

any

oth

er k

ind

of s

uper

visi

on o

rgan

ized

?a.

If y

es o

r par

tial,

desc

ribe

the

supe

rvis

ion

plan

and

pro

cedu

res

(e.g

. thr

ough

spe

cific

net

wor

ks li

ke tu

berc

ulos

is c

ontr

ol o

r sur

veill

ance

pro

gram

mes

).13

. Ar

e th

ere

stan

dard

ized

sup

ervi

sion

che

cklis

ts o

r pro

cedu

res?

14.

Whe

n su

perv

ised

, do

the

labo

rato

ries

rece

ive

a re

port

afte

r eac

h su

perv

isio

n vi

sit?

15.

Are

ther

e in

dica

tors

to m

easu

re p

rogr

ess

in la

bora

tory

test

qua

lity?

If y

es, l

ist t

hese

indi

cato

rs.

16.

Doe

s th

e co

untr

y ha

ve a

nat

iona

l EQ

A pr

ogra

mm

e (p

rofic

ienc

y-te

stin

g or

rech

ecki

ng) i

n th

e fo

llow

ing

area

s:a.

bac

terio

logy

b. v

irolo

gyc.

ser

olog

yd.

par

asito

logy

e. b

ioch

emis

try

f. ha

emat

olog

yg.

ana

tom

ical

pat

holo

gyh.

cyt

ogen

etic

i. tr

ansf

usio

n m

edic

ine?

17.

Des

crib

e th

e na

tiona

l EQ

A pr

ogra

mm

e(s)

/org

aniz

atio

n by

pro

vidi

ng fo

r eac

h: th

e na

me

of th

e pr

ogra

mm

e, c

onta

ct p

erso

n(s)

, and

onl

ine

desc

riptio

n.a.

If a

pplic

able

, is

part

icip

atio

n in

nat

iona

l EQ

A pr

ogra

mm

e(s)

man

dato

ry fo

r pub

lic la

bora

torie

s?b.

If a

pplic

able

, is

part

icip

atio

n in

nat

iona

l EQ

A pr

ogra

mm

e(s)

man

dato

ry fo

r priv

ate

labo

rato

ries?

DE

TE

CT



c. P

erce

ntag

e of

pub

lic la

bora

torie

s pa

rtic

ipat

ing

in n

atio

nal E

QA

prog

ram

me(

s)?

d. P

erce

ntag

e of

priv

ate

labo

rato

ries

part

icip

atin

g in

nat

iona

l EQ

A pr

ogra

mm

e(s)

?e.

Are

cor

rect

ive

actio

ns o

rgan

ized

whe

n th

e as

sess

men

t res

ult i

s po

or?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

tyl

Nat

iona

l lab

orat

ory

stra

tegi

c pl

an d

efini

ng ti

ered

labo

rato

ry n

etw

ork

l

Nat

iona

l lab

orat

ory

polic

yl

Doc

umen

ted

list o

f top

10

prio

rity

dise

ases

and

thre

e co

re s

yndr

omes

for t

arge

ted

impr

ovem

ent o

f pre

vent

ion,

det

ectio

n an

d re

spon

sel

Cert

ifica

tes

of a

ccre

dita

tion

for n

atio

nal l

abor

ator

ies

and/

or E

QA

resu

lts w

ithin

the

past

six

mon

ths

for c

ore

test

sl

Doc

umen

ted

spec

imen

refe

rral

rout

es fo

r det

ectio

n/co

nfirm

atio

n of

top

10 p

riorit

y di

seas

esl

Plan

for t

rans

port

ing

spec

imen

s sa

fely

thro

ugho

ut th

e co

untr

yl

All O

IE re

leva

nt to

ols

and

stan

dard

s (M

anua

l) sh

ould

be

cite

d

Refe

renc

es:

l

Inte

rnat

iona

l Hea

lth R

egul

atio

ns: W

hat g

ets

mea

sure

d ge

ts d

one

(incl

udes

list

ing

of th

e 10

cor

e te

sts)

. Cen

ters

for D

isea

se C

ontr

ol a

nd P

reve

ntio

n [w

ebsi

te]

(htt

p://

ww

wnc

.cdc

.gov

/eid

/art

icle

/18/

7/12

-048

7-t2

, acc

esse

d 23

Nov

embe

r 201

7).

l

Labo

rato

ry a

sses

smen

t too

l. W

orld

Hea

lth O

rgan

izat

ion

[web

site

] (W

HO

/HSE

/GCR

/LYO

/201

2.2,

htt

p://

ww

w.w

ho.in

t/ih

r/pu

blic

atio

ns/l

abor

ator

y_to

ol/e

n/,

acce

ssed

23

Nov

embe

r 201

7).

l

All O

IE r

elev

ant

tool

s an

d st

anda

rds.

Wor

ld O

rgan

isat

ion

for

Anim

al H

ealth

[web

site

] (ht

tp:/

/ww

w.o

ie.in

t/en

/sup

port

-to-

oie-

mem

bers

/pvs

-eva

luat

ions

/oi

e-pv

s-to

ol/,

acce

ssed

23

Dec

embe

r 201

7).

DE

TE

CT



SURV

EILL

ANCE

Targ

et: (

1) S

tren

gthe

ned

indi

cato

r-ba

sed

and

even

t-ba

sed

surv

eilla

nce

syst

ems

that

are

abl

e to

det

ect e

vent

s of

sig

nific

ance

for p

ublic

hea

lth a

nd h

ealth

sec

urity

; (2

) im

prov

ed c

omm

unic

atio

n an

d co

llabo

ratio

n ac

ross

sec

tors

and

bet

wee

n su

bnat

iona

l (lo

cal a

nd in

term

edia

te),

natio

nal a

nd in

tern

atio

nal l

evel

s of

aut

horit

y re

gard

ing

surv

eilla

nce

of e

vent

s of

pub

lic h

ealth

sig

nific

ance

; and

(3) i

mpr

oved

nat

iona

l and

inte

rmed

iate

leve

l reg

iona

l cap

acity

to a

naly

se a

nd li

nk d

ata

from

an

d be

twee

n, s

tren

gthe

ned

early

-war

ning

sur

veill

ance

, inc

ludi

ng in

tero

pera

ble1 ,

inte

rcon

nect

ed e

lect

roni

c to

ols.

Thi

s w

ould

inco

rpor

ate

epid

emio

logi

cal,

clin

ical

, la

bora

tory

, env

ironm

enta

l tes

ting,

pro

duct

saf

ety

and

qual

ity, a

nd b

ioin

form

atic

s da

ta; a

nd a

dvan

cem

ent i

n fu

lfilli

ng th

e co

re c

apac

ity re

quire

men

ts fo

r sur

veill

ance

in

acc

orda

nce

with

the

IHR

and

OIE

gui

delin

es.

As m

easu

red

by: (

1) S

urve

illan

ce2

for

at le

ast

thre

e co

re s

yndr

omes

3 in

dica

tive

of p

oten

tial p

ublic

hea

lth e

mer

genc

ies

cond

ucte

d ac

cord

ing

to in

tern

atio

nal

stan

dard

s. (2

) Reg

ular

ana

lysi

s an

d re

port

ing

of s

urve

illan

ce d

ata.

Desi

red

impa

ct: (

1) A

func

tioni

ng p

ublic

hea

lth s

urve

illan

ce s

yste

m4 c

apab

le o

f ide

ntify

ing

pote

ntia

l eve

nts

of c

once

rn fo

r pub

lic h

ealth

and

hea

lth s

ecur

ity5 .

(2)

Enha

nced

nat

iona

l and

inte

rmed

iate

leve

l reg

iona

l cap

acity

to

anal

yse

and

link

data

from

and

bet

wee

n th

e di

ffere

nt le

vels

of

the

stre

ngth

ened

ear

ly-w

arni

ng

surv

eilla

nce

syst

em6 .

1 -

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 s

ubse

quen

tly p

rese

nt th

at d

ata

in a

man

ner t

hat c

an b

e un

ders

tood

by

the

user

(defi

nitio

n by

Hea

lthca

re In

form

atio

n an

d M

anag

emen

t Sys

tem

s So

ciet

y).

2 - S

urve

illan

ce, 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

hea

lth re

spon

se a

s ne

cess

ary.

3 -

Inte

rnat

iona

lly re

cogn

ized

sta

ndar

ds fo

r syn

drom

ic s

urve

illan

ce a

re a

vaila

ble

for t

he fo

llow

ing

five

synd

rom

es: (

i) se

vere

acu

te re

spira

tory

syn

drom

e, (i

i) ac

ute

flacc

id p

aral

ysis

, (iii

) acu

te h

aem

orrh

agic

feve

r, (iv

) acu

te w

ater

y di

arrh

oea

with

deh

ydra

tion,

and

(v) a

cute

jaun

dice

syn

drom

e. T

hree

cor

e sy

ndro

mes

are

cho

sen

depe

ndin

g on

nat

iona

l dis

ease

con

trol

prio

ritie

s. T

he s

urve

illan

ce s

yste

m s

houl

d in

clud

e ep

idem

iolo

gica

l dat

a an

d la

bora

tory

find

ings

, w

hich

sho

uld

be a

naly

sed

by tr

aine

d ep

idem

iolo

gist

s.4

- St

rong

sur

veill

ance

will

sup

port

the

timel

y re

cogn

ition

of t

he e

mer

genc

e of

rela

tivel

y ra

re o

r pre

viou

sly

unde

scrib

ed p

atho

gens

in s

peci

fic c

ount

ries.

5 -

Each

cou

ntry

has

to d

efine

a “p

oten

tial r

isk

to p

ublic

hea

lth”,

perf

orm

risk

map

ping

and

iden

tify

prio

rity

dise

ases

.6

- Co

untr

ies

will

sup

port

the

use

of in

tero

pera

ble,

inte

rcon

nect

ed s

yste

ms

capa

ble

of li

nkin

g an

d in

tegr

atin

g m

ultis

ecto

ral s

urve

illan

ce d

ata

and

usin

g re

sulti

ng in

form

atio

n to

enh

ance

the

capa

city

to q

uick

ly d

etec

t and

resp

ond

to

deve

lopi

ng b

iolo

gica

l thr

eats

. Fou

ndat

iona

l cap

acity

is n

eces

sary

for b

oth

IBS

and

EBS,

in o

rder

to s

uppo

rt p

reve

ntio

n an

d co

ntro

l act

iviti

es a

nd 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

publ

ic h

ealth

thre

ats.

DE

TE

CT



Scor

eIn

dica

tors

: Sur

veill

ance

D.

2.1

Surv

eilla

nce

syst

ems7,

8,9

D.2.

2 U

se o

f ele

ctro

nic

tool

sD.

2.3

Anal

ysis

of s

urve

illan

ce d

ata

No

capa

city

- 1

The

coun

try

has

no s

urve

illan

ce s

yste

m f

or d

i-se

ases

/syn

drom

es/e

vent

sTh

ere

is n

o el

ectr

onic

tool

to c

olle

ct, r

epor

t or a

na-

lyse

sur

veill

ance

dat

aTh

ere

is n

o ca

paci

ty to

ana

lyse

repo

rted

dat

a

Lim

ited

ca

paci

ty -

2

Surv

eilla

nce

syst

em is

in p

lace

rely

ing

eith

er o

n IB

S or

EBS

or b

oth10

(inc

ludi

ng s

yndr

omic

sur

veill

ance

) an

d su

ppor

ted

by S

OPs

and

/or t

echn

ical

gui

delin

es

for

surv

eilla

nce.

The

re i

s no

sys

tem

atic

11 i

mm

e-di

ate

repo

rtin

g an

d w

eekl

y re

port

ing

of e

vent

s an

d/or

dat

a

Ad h

oc e

lect

roni

c to

ols

have

bee

n de

velo

ped

to fa

-ci

litat

e th

e co

llect

ion,

rep

ortin

g or

the

ana

lysi

s of

su

rvei

llanc

e da

ta a

nd e

vent

s (e

.g.

Exce

l sp

read

-sh

eets

), or

cou

ntry

is

deve

lopi

ng a

n in

tegr

ated

el

ectr

onic

rea

l-tim

e re

port

ing

syst

em f

or p

ublic

he

alth

sur

veill

ance

Spor

adic

repo

rts

are

anal

ysed

on

som

e pr

iorit

y di

-se

ases

or u

nusu

al e

vent

s ar

e pr

oduc

ed, o

ften

with

de

lay

Deve

lope

d ca

paci

ty -

3

Both

IBS

and

EBS

are

in p

lace

at

the

cent

ral a

nd

inte

rmed

iate

lev

els,

and

rec

eive

im

med

iate

and

w

eekl

y re

port

ing

from

the

loca

l lev

el o

n an

ad

hoc

basi

s.

Info

rmat

ion

tech

nolo

gy to

ols

avai

labl

e at

the

natio

-na

l lev

el th

at p

erm

it m

anag

emen

t of a

sur

veill

ance

da

taba

se a

nd a

n ev

ent m

anag

emen

t sys

tem

Regu

lar

annu

al o

r m

onth

ly r

epor

ting

of d

ata

with

so

me

dela

y an

d m

inim

um a

naly

sis

of d

ata

is d

one

by a

n ad

hoc

team

Dem

onst

rate

d ca

paci

ty -

4

Both

IBS

and

EBS

are

in p

lace

at a

ll th

e le

vels

(nat

io-

nal,

inte

rmed

iate

and

loca

l) an

d re

ceiv

e im

med

iate

an

d w

eekl

y re

port

s fr

om a

ll he

alth

faci

litie

s12 o

f the

co

untr

y an

d so

me

mec

hani

sm13

of

cros

s-bo

rder

su

rvei

llanc

e is

in p

lace

Coun

try

has

in p

lace

a s

ecur

e in

tegr

ated

ele

ctro

nic

surv

eilla

nce

tool

for p

ublic

hea

lth s

urve

illan

ce a

t all

leve

ls o

f the

hea

lth s

yste

mTh

is to

ol p

erm

its th

e an

alys

is o

f dat

a an

d th

e au

to-

mat

ic p

rodu

ctio

n of

epi

dem

iolo

gica

l bul

letin

s

Mor

e of

ten

than

wee

kly

repo

rtin

g w

ith a

naly

sis

Asse

ssm

ent o

f ris

k is

don

e by

an

expe

rtRe

gula

r epi

dem

iolo

gica

l bul

letin

s ar

e di

ssem

inat

ed

Sust

aina

ble

capa

city

- 5

The

perf

orm

ance

of t

he s

urve

illan

ce s

yste

m is

re-

gula

rly e

valu

ated

and

upd

ated

at

all l

evel

s in

the

co

untr

y an

d ha

s th

e ca

paci

ty t

o su

ppor

t ot

her

coun

trie

s in

dev

elop

ing

surv

eilla

nce

syst

ems

and/

or c

ontr

ibut

es t

o re

gion

al o

r in

tern

atio

nal s

urve

il-la

nce

netw

orks

14

The

surv

eilla

nce

syst

em i

s eq

uipp

ed w

ith a

ful

-ly

sec

ure

inte

rope

rabl

e, e

lect

roni

c to

ol f

or p

ublic

he

alth

sur

veill

ance

tha

t is

: con

nect

ed t

o ot

her

re-

leva

nt e

lect

roni

c to

ols

(e.g

. ani

mal

hea

lth),

and

can

easi

ly s

hare

dat

a w

ith o

ther

ele

ctro

nic

tool

s us

ed

eith

er a

t reg

iona

l or i

nter

natio

nal l

evel

s

Mor

e fr

eque

ntly

than

wee

kly

syst

emat

ic re

port

ing

Ded

icat

ed te

am in

pla

ce fo

r dat

a an

alys

is, r

isk

as-

sess

men

t and

repo

rtin

g

7 -

The

indi

cato

r ref

ers

to s

urve

illan

ce c

apac

ity fo

r the

cou

ntry

.8

- Th

e su

rvei

llanc

e sy

stem

sho

uld

incl

ude:

• a

bilit

y 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;

• abi

lity

to p

rovi

de re

port

s an

d da

ta to

hig

h-le

vel p

ublic

hea

lth d

ecis

ion-

mak

ers

in th

e co

untr

y, an

d fe

edba

ck to

low

er le

vels

impl

emen

ting

the

cont

rol p

rogr

amm

es; a

nd• l

inka

ges

to la

bora

tory

and

oth

er in

form

atio

n sy

stem

s to

pro

vide

a c

ompl

ete

surv

eilla

nce

repr

esen

tatio

n.9

- Th

ere

is c

ritic

al c

ompe

tenc

y in

the

PVS

tool

CC

II-5:

Epi

dem

iolo

gica

l sur

veill

ance

and

ear

ly d

etec

tion.

10-

EBS

is d

efine

d as

the

orga

nize

d co

llect

ion,

mon

itorin

g, a

sses

smen

t and

inte

rpre

tatio

n of

mai

nly

unst

ruct

ured

ad

hoc

info

rmat

ion

rega

rdin

g he

alth

eve

nts

or ri

sks,

whi

ch m

ay re

pres

ent a

n ac

ute

risk

to h

uman

hea

lth. E

BS is

a

func

tiona

l com

pone

nt o

f ear

ly w

arni

ng a

nd re

spon

se.

11 -

Met

hodi

cal i

n pr

oced

ure

or p

lan

(mar

ked

by th

orou

ghne

ss a

nd re

gula

rity

of th

e ef

fort

).12

- P

ublic

and

priv

ate

heal

th fa

cilit

ies

at a

ll le

vels

of t

he p

ublic

hea

lth s

yste

m.

13 -

Mec

hani

sm fo

r cro

ss-b

orde

r sur

veill

ance

– a

gree

d cr

oss-

bord

er s

urve

illan

ce s

yste

m a

t poi

nts

of e

ntry

or s

ome

othe

r mec

hani

sm o

f reg

ular

ly s

harin

g da

ta a

nd in

form

atio

n be

twee

n ne

ighb

ourin

g co

untr

ies

whe

re a

pplic

able

.14

- A

t the

nat

iona

l lev

el to

iden

tify

publ

ic h

ealth

eve

nts,

use

dis

ease

thre

shol

ds o

f IBS

or i

mpl

emen

t a s

peci

fic tr

iage

pro

cess

to c

heck

if th

e ev

ent i

s un

usua

l or u

nexp

ecte

d. R

efer

to W

HO

gui

danc

e fo

r the

use

of A

nnex

2 o

f the

In

tern

atio

nal H

ealth

Reg

ulat

ions

(200

5) fo

r Dec

isio

n in

stru

men

t for

the

asse

ssm

ent a

nd n

otifi

catio

n of

eve

nts

that

may

con

stitu

te a

pub

lic h

ealth

em

erge

ncy

of in

tern

atio

nal c

once

rn (h

ttp:

//w

ww

.who

.int/

ihr/

publ

icat

ions

/ann

ex_2

_gu

idan

ce/e

n/, a

cces

sed

24 N

ovem

ber 2

017)

.

DE

TE

CT



Cont

extu

al q

uest

ion:

1.

Doe

s th

e co

untr

y ha

ve a

list

of n

otifi

able

prio

rity

dise

ases

?2.

Is

the

surv

eilla

nce

of in

fect

ious

dis

ease

s lin

ked

in o

ne n

atio

nal s

urve

illan

ce s

yste

m v

ersu

s a

sepa

rate

sys

tem

for d

iffer

ent d

isea

ses?

3.

How

doe

s da

ta fr

om th

e la

bora

torie

s fe

ed in

to th

e su

rvei

llanc

e sy

stem

?4.

H

ow d

oes

the

coun

try

utili

ze e

lect

roni

c to

ols

for n

otifi

able

dis

ease

s fo

r hum

an h

ealth

and

ani

mal

hea

lth?

5.

If no

ele

ctro

nic

syst

ems

(tool

s) e

xist

in th

e co

untr

y, ar

e th

ere

plan

s to

impl

emen

t in

the

futu

re?

6.

Are

data

from

thes

e sy

stem

s sh

ared

bet

wee

n se

ctor

s, o

r ind

epen

dent

?

Tech

nica

l que

stio

ns:

D.2.

1 Su

rvei

llanc

e sy

stem

s1.

D

escr

ibe

in-c

ount

ry E

BS.

a. D

escr

ibe

sour

ces

utili

zed

by E

BS a

nd m

echa

nism

s of

col

lect

ing

info

rmat

ion.

b. D

oes

EBS

exis

t at a

ny s

ubna

tiona

l (in

term

edia

te o

r loc

al) l

evel

?2.

D

escr

ibe

IBS

and

mec

hani

sms

of c

olle

ctin

g da

ta.

a. L

ist o

f prio

rity

dise

ases

, con

ditio

ns, s

yndr

omes

and

cas

e de

finiti

ons.

b. D

oes

the

coun

try

have

com

plet

enes

s an

d tim

elin

ess

of re

port

ing

from

at l

east

80%

of a

ll re

port

ing

units

? 3.

D

escr

ibe

data

val

idat

ion

and

qual

ity a

ssur

ance

sys

tem

s/ef

fort

s.4.

D

escr

ibe

synd

rom

ic s

urve

illan

ce s

yste

ms

that

are

in p

lace

with

in th

e co

untr

y:a.

Des

crib

e va

rious

syn

drom

es a

nd p

atho

gens

that

are

det

ecte

d an

d re

port

ed.

b. D

escr

ibe

how

man

y si

tes

part

icip

ate

in e

ach

surv

eilla

nce

syst

em.

c. D

escr

ibe

how

dat

a ar

e va

lidat

ed.

d. D

escr

ibe

any

synd

rom

ic s

urve

illan

ce s

yste

m th

at u

tiliz

es e

lect

roni

c re

port

ing.

e. D

escr

ibe

repo

rts

that

are

pro

duce

d by

eac

h su

rvei

llanc

e sy

stem

and

how

they

are

use

d by

pub

lic h

ealth

dec

isio

n m

aker

s. A

re th

ese

repo

rts

shar

ed w

ith

any

othe

r min

istr

ies

with

in th

e co

untr

y?f.

Des

crib

e an

y lin

kage

s th

at e

xist

bet

wee

n sy

stem

s at

the

natio

nal l

evel

.

D.2.

2 U

se o

f ele

ctro

nic

tool

s1.

H

ow a

re p

ublic

hea

lth s

taff

trai

ned

on d

isea

se s

urve

illan

ce s

yste

ms?

2.

How

are

clin

ical

sta

ff tr

aine

d to

repo

rt o

n no

tifiab

le d

isea

ses?

3.

Do

publ

ic h

ealth

sta

ff at

nat

iona

l/int

erm

edia

te/r

egio

nal l

evel

s ha

ve th

e sk

ills

to a

naly

se s

urve

illan

ce d

ata

to c

reat

e in

form

atio

n tr

igge

ring/

supp

ortin

g ac

tion?

4.

How

doe

s th

e co

untr

y ut

ilize

ele

ctro

nic

repo

rtin

g sy

stem

s fo

r not

ifiab

le d

isea

ses

for h

uman

hea

lth a

nd a

nim

al h

ealth

? 5.

Ar

e th

ese

syst

ems

shar

ed b

etw

een

sect

ors,

or a

re th

ey in

depe

nden

t?6.

If

no e

lect

roni

c re

port

ing

syst

ems

exis

t in

the

coun

try,

are

ther

e pl

ans

to im

plem

ent e

lect

roni

c re

port

ing

in th

e fu

ture

?

DE

TE

CT



7.

Des

crib

e th

e re

port

ing

and

feed

back

to in

term

edia

te/r

egio

nal a

nd lo

cal l

evel

s.8.

D

escr

ibe

repo

rtin

g to

nat

iona

l and

inte

rmed

iate

/reg

iona

l lev

el s

take

hold

ers.

9.

Des

crib

e pu

blic

repo

rtin

g.

D.2.

3 An

alys

is o

f sur

veill

ance

dat

a1.

D

escr

ibe

how

sur

veill

ance

dat

a ar

e an

alys

ed.

2.

Are

ther

e tr

aine

d he

alth

car

e w

orke

rs to

ana

lyse

at n

atio

nal a

nd in

term

edia

te le

vels

?3.

Is

ther

e a

mec

hani

sm in

pla

ce to

link

epi

dem

iolo

gica

l and

labo

rato

ry d

ata?

4.

Is th

ere

a ca

paci

ty to

con

duct

risk

ass

essm

ent a

t nat

iona

l, in

term

edia

te a

nd/o

r loc

al le

vels

?5.

H

ow is

the

risk

asse

ssm

ent i

nfor

mat

ion

diss

emin

ated

and

to w

hom

?6.

Is

ther

e a

cent

rally

loca

ted

mec

hani

sm fo

r int

egra

ting

data

from

clin

ical

cas

e re

port

ing

and

data

from

clin

ical

or r

efer

ence

mic

robi

olog

ical

labo

rato

ries?

7.

How

ofte

n ar

e re

port

s pu

blis

hed

and

diss

emin

ated

? a.

Is

it pu

blis

hed

syst

emat

ical

ly e

very

wee

k or

mon

thly

or a

nnua

lly?

b. W

ho d

oes

the

anal

ysis

and

at w

hat l

evel

?c.

Doe

s th

e co

untr

y pr

oduc

e an

d pu

blis

h an

epi

dem

iolo

gica

l bul

letin

? If

yes,

wha

t is

the

freq

uenc

y?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Sam

ples

of s

urve

illan

ce re

port

s us

ed b

y pu

blic

hea

lth d

ecis

ion-

mak

ers

in th

e co

untr

yl

List

ing

of c

ore

synd

rom

es in

dica

tive

of a

pub

lic h

ealth

em

erge

ncy

l

Plan

s fo

r enh

anci

ng s

yndr

omic

sur

veill

ance

l

Plan

s fo

r dev

elop

ing

or e

nhan

cing

EBS

l

OIE

repo

rts

(Wor

ld A

nim

al H

ealth

Info

rmat

ion

Syst

em –

WAH

IS)

l

Surv

eilla

nce

data

base

s an

d fo

rms

Refe

renc

es:

l

Early

det

ectio

n, a

sses

smen

t an

d re

spon

se t

o ac

ute

publ

ic h

ealth

eve

nts:

Impl

emen

tatio

n of

ear

ly w

arni

ng a

nd r

espo

nse

with

a f

ocus

on

even

t-ba

sed

surv

eilla

nce.

Inte

rim v

ersi

on. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

4 (h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/1

1266

7/1/

WH

O_H

SE_G

CR_L

YO_2

014.

4_en

g.pd

f?ua

=1, a

cces

sed

23 N

ovem

ber 2

017)

.l

Inte

rnat

iona

l Hea

lth R

egul

atio

ns (2

005)

. 2nd

editi

on. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

2008

(htt

p://

whq

libdo

c.w

ho.in

t/pu

blic

atio

ns/2

008/

9789

2415

8041

0_en

g.pd

f, ac

cess

ed 2

3 N

ovem

ber 2

017;

incl

udes

list

s of

dis

ease

that

hav

e “…

dem

onst

rate

d ab

ility

to c

ause

ser

ious

pub

lic h

ealth

impa

ct“)

.l

Terr

estr

ial a

nim

al h

ealth

cod

e (2

017)

. Vol

ume

1. G

ener

al p

rovi

sion

s. W

orld

Org

anis

atio

n fo

r An

imal

Hea

lth [w

ebsi

te] (

http

://w

ww

.oie

.int/

inte

rnat

iona

l-st

anda

rd-s

ettin

g/te

rres

tria

l-co

de/a

cces

s-on

line/

, acc

esse

d 23

Nov

embe

r 201

7).

l

Man

ual o

f dia

gnos

tic te

sts

and

vacc

ines

for t

erre

stria

l ani

mal

s (2

017)

. Wor

ld O

rgan

isat

ion

for A

nim

al H

ealth

[web

site

] (ht

tp:/

/ww

w.o

ie.in

t/en

/int

erna

tiona

l-st

anda

rd-s

ettin

g/te

rres

tria

l-m

anua

l/ac

cess

-onl

ine/

, acc

esse

d 23

Nov

embe

r 201

7).

DE

TE

CT



REPO

RTIN

GTa

rget

: Tim

ely

and

accu

rate

dis

ease

repo

rtin

g ac

cord

ing

to W

HO

requ

irem

ents

and

con

sist

ent r

elay

of i

nfor

mat

ion

to F

AO a

nd O

IE.

As m

easu

red

by: E

stab

lishm

ent

of a

sys

tem

1 to

repo

rt p

oten

tial p

ublic

hea

lth e

vent

s of

inte

rnat

iona

l con

cern

to

WH

O, a

nd t

o m

eet

the

need

s of

oth

er o

ffici

al

repo

rtin

g sy

stem

s, s

uch

as O

IE-W

AHIS

.

Desi

red

impa

ct: T

he N

atio

nal I

HR

Foca

l Poi

nts,

the

OIE

Del

egat

e, a

nd W

AHIS

Nat

iona

l Foc

al P

oint

will

hav

e ac

cess

to a

tool

kit o

f bes

t pra

ctic

es, m

odel

pro

cedu

res,

re

port

ing

tem

plat

es, a

nd t

rain

ing

mat

eria

ls t

o fa

cilit

ate

rapi

d (w

ithin

24

hour

s) n

otifi

catio

n of

eve

nts

that

may

con

stitu

te a

pot

entia

l pub

lic h

ealth

em

erge

ncy

of in

tern

atio

nal c

once

rn (P

HEI

C) to

WH

O a

nd li

sted

dis

ease

s to

OIE

, as

wel

l as

be a

ble

to re

spon

d ra

pidl

y (w

ithin

24/

48 h

ours

) to

com

mun

icat

ions

from

thes

e or

gani

zatio

ns.

1 -

Exis

tenc

e of

pro

toco

ls, p

roce

sses

, reg

ulat

ions

and

/or l

egis

latio

n go

vern

ing

repo

rtin

g an

d pr

oces

ses

for m

ultis

ecto

ral c

oord

inat

ion

in re

spon

se to

a p

oten

tial P

HEI

C to

WH

O a

nd to

the

OIE

for r

elev

ant z

oono

tic d

isea

ses.

DE

TE

CT



Scor

eIn

dica

tors

: Rep

ortin

g2,3,

4

D.3.

1 Sy

stem

for e

ffici

ent r

epor

ting

to F

AO, O

IE a

nd W

HO

5 D.

3.2

Repo

rtin

g ne

twor

k an

d pr

otoc

ols

in c

ount

ry

No

capa

city

- 1

No

Nat

iona

l IH

R Fo

cal P

oint

, OIE

Del

egat

e an

d/or

WAH

IS N

atio

nal F

ocal

Poi

nt

has

been

iden

tified

and

/or

the

iden

tified

foca

l poi

nt/d

eleg

ate

does

not

hav

e ac

cess

to

the

lear

ning

pac

kage

and

bes

t pr

actic

es a

s pr

ovid

ed b

y FA

O, O

IE

and

WH

O

Coun

try

does

not

hav

e pr

otoc

ols

or p

roce

sses

for

rep

ortin

g to

FAO

, OIE

or

WH

O; a

nd d

oes

not h

ave

plan

s to

est

ablis

h pl

ans

and

prot

ocol

s fo

r rep

ortin

g w

ithin

the

next

yea

r

Lim

ited

ca

paci

ty -

2

Coun

try

has

iden

tified

the

Nat

iona

l IH

R Fo

cal P

oint

, the

OIE

Del

egat

e an

d W

A-H

IS N

atio

nal F

ocal

Poi

nt; a

nd th

e fo

cal p

oint

/del

egat

e ha

s ac

cess

to th

e le

ar-

ning

pac

kage

and

bes

t pra

ctic

es a

s pr

ovid

ed b

y FA

O, O

IE a

nd W

HO

Coun

try

is in

the

proc

ess

of d

evel

opin

g an

d es

tabl

ishi

ng p

roto

cols

, pro

cess

es,

regu

latio

ns, a

nd/o

r le

gisl

atio

n go

vern

ing

repo

rtin

g to

sta

rt im

plem

enta

tion

with

in a

yea

r

Deve

lope

d ca

paci

ty -

3

Coun

try

has

dem

onst

rate

d ab

ility

to id

entif

y a

pote

ntia

l PH

EIC

and

file

a re

-po

rt to

WH

O a

nd s

imila

rly to

the

OIE

(acc

ordi

ng to

OIE

pro

cess

es) f

or re

leva

nt

zoon

otic

dis

ease

s, b

ased

on

an e

xerc

ise

or re

al e

vent

Coun

try

has

esta

blis

hed

prot

ocol

s, p

roce

sses

, reg

ulat

ions

and

/or l

egis

latio

n go

vern

ing

repo

rtin

g an

d pr

oces

ses

for m

ultis

ecto

ral c

oord

inat

ion

in re

spon

se

to a

pot

entia

l PH

EIC

to W

HO

and

to th

e O

IE fo

r rel

evan

t zoo

notic

dis

ease

s

Dem

onst

rate

d ca

paci

ty -

4

Coun

try

has

dem

onst

rate

d ab

ility

to id

entif

y a

pote

ntia

l PH

EIC

and

file

a re

port

to

WH

O w

ithin

24

hour

s an

d si

mila

rly to

the

OIE

(acc

ordi

ng to

OIE

pro

cess

es)

for r

elev

ant z

oono

tic d

isea

ses,

bas

ed o

n an

exe

rcis

e or

real

eve

nt

Coun

try

dem

onst

rate

s tim

ely

repo

rtin

g of

a p

oten

tial P

HEI

C to

WH

O a

nd to

the

OIE

for r

elev

ant z

oono

tic d

isea

ses

in a

lignm

ent w

ith n

atio

nal a

nd in

tern

atio

nal

stan

dard

s in

sel

ecte

d in

term

edia

te le

vels

(dis

tric

ts o

r re

gion

s), b

ased

on

an

exer

cise

or r

eal e

vent

Sust

aina

ble

capa

city

- 5

Coun

try

has

dem

onst

rate

d ab

ility

to id

entif

y a

pote

ntia

l PH

EIC

and

file

a re

-po

rt w

ithin

24

hour

s, a

nd s

imila

rly t

o th

e O

IE (

acco

rdin

g to

OIE

pro

cess

es)

for

rele

vant

zoo

notic

dis

ease

s, a

nd h

as a

mul

tisec

tora

l pro

cess

in p

lace

for

asse

ssin

g po

tent

ial e

vent

s fo

r rep

ortin

g

Coun

try

dem

onst

rate

s tim

ely

repo

rtin

g of

a p

oten

tial P

HEI

C to

the

WH

O fr

om

dist

rict t

o na

tiona

l and

inte

rnat

iona

l lev

els

and

to th

e O

IE fo

r rel

evan

t zoo

notic

di

seas

es, b

ased

on

an e

xerc

ise

or re

al e

vent

Coun

try

has

a su

stai

nabl

e pr

oces

s fo

r m

aint

aini

ng a

nd im

prov

ing

repo

rtin

g an

d co

mm

unic

atio

n ca

pabi

litie

s, a

nd c

omm

unic

atio

n m

echa

nism

s ar

e ba

cked

by

est

ablis

hed

docu

men

tatio

n (s

uch

as p

roto

cols

, reg

ulat

ions

, leg

isla

tion)

2 -A

ll qu

estio

ns s

houl

d be

ans

wer

ed to

refle

ct h

uman

and

ani

mal

dis

ease

s.3

- N

eed

to e

nsur

e th

at a

nim

al h

ealth

offi

cial

s (F

AO a

nd O

IE) s

houl

d be

pre

sent

for t

his

tech

nica

l are

a. T

his

is d

irect

ly re

late

d to

pro

toco

ls fo

r rep

ortin

g m

echa

nism

s ac

ross

age

ncie

s in

bot

h in

dica

tors

. 4

- In

dica

tor D

.3.1

is re

late

d to

whe

ther

the

Nat

iona

l IH

R Fo

cal P

oint

can

repo

rt (a

n ef

ficie

nt s

yste

m e

xist

s); I

ndic

ator

D.3

.2 is

the

deta

iled

stru

ctur

e an

d pr

oced

ures

beh

ind

the

Nat

iona

l IH

R Fo

cal P

oint

and

how

the

Nat

iona

l IH

R Fo

cal

Poin

t gat

hers

info

rmat

ion

and

verifi

es a

s pa

rt o

f the

repo

rtin

g pr

oces

s.5

- N

ot a

ll co

untr

ies

will

hav

e re

port

ed a

pot

entia

l PH

EIC

to th

e W

HO

or r

epor

ted

to th

e O

IE fo

r rel

evan

t zoo

notic

dis

ease

s.

Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

D.3.

1 Sy

stem

for e

ffici

ent r

epor

ting

to F

AO, O

IE a

nd W

HO

1.

Whi

ch m

inis

try

or o

ffice

with

in th

e co

untr

y ha

s be

en id

entifi

ed a

s th

e N

atio

nal I

HR

Foca

l Poi

nt a

nd in

form

ed to

the

WH

O?

a. I

s th

e N

atio

nal I

HR

Foca

l Poi

nt a

ble

to c

over

all

inci

dent

s (b

iolo

gica

l, ch

emic

al, r

adia

tion)

und

er IH

R an

d cu

rren

tly o

pera

tiona

l?

b. I

s th

ere

an o

pera

tiona

l OIE

Con

tact

Poi

nt?

c. A

re fo

od s

afet

y is

sues

due

to m

icro

biol

ogic

al o

rigin

repo

rted

thro

ugh

the

Nat

iona

l IH

R Fo

cal P

oint

and

to th

e O

IE?

DE

TE

CT



d. I

s th

ere

a m

echa

nism

to e

nsur

e th

at th

e N

atio

nal I

HR

Foca

l Poi

nt a

nd O

IE C

onta

ct P

oint

s ex

chan

ge in

form

atio

n w

hen

need

ed (e

.g. f

or z

oono

tic d

isea

ses)

? e.

Des

crib

e th

e tr

aini

ng th

at th

e N

atio

nal I

HR

Foca

l Poi

nt/O

IE C

onta

ct P

oint

resp

onsi

ble

pers

on(s

) hav

e un

derg

one

for t

his

spec

ific

role

.f.

List

the

min

istri

es (s

uch

as h

ealth

, agr

icul

ture

) tha

t the

se fo

cal p

oint

s re

pres

ent f

or th

e W

HO/

OIE

and

whi

ch o

ne re

ports

thro

ugh

the

Nat

iona

l IH

R Fo

cal p

oint

. 2.

W

hat a

re th

e m

echa

nism

s fo

r pub

lic h

ealth

, ani

mal

hea

lth a

nd s

ecur

ity a

utho

ritie

s to

mak

e de

cisi

ons

on re

port

ing?

3.

Des

crib

e if

the

coun

try

has

mul

tilat

eral

regi

onal

(int

erna

tiona

l) or

bila

tera

l nei

ghbo

urin

g co

untr

y re

port

ing

requ

irem

ents

. If y

es, s

peci

fy.

4.

Is th

ere

anyt

hing

that

lim

its th

e pe

rfor

man

ce o

f the

Nat

iona

l IH

R Fo

cal P

oint

? (T

his

may

incl

ude

qual

ity a

nd ti

mel

ines

s of

info

rmat

ion

rece

ived

, and

obs

tacl

es

caus

ed b

y co

ordi

natio

n w

ith o

ther

leve

ls a

nd s

ecto

rs.)

a. D

oes

the

Nat

iona

l IH

R Fo

cal P

oint

use

info

rmal

con

sulta

tion

mec

hani

sms

with

WH

O u

nder

Art

icle

8 o

f the

IHR?

b. D

oes

the

Nat

iona

l IH

R Fo

cal P

oint

use

bila

tera

l exc

hang

e m

echa

nism

s w

ith o

ther

Nat

iona

l IH

R Fo

cal P

oint

s?

D.3.

2 Re

port

ing

netw

ork

and

prot

ocol

s in

cou

ntry

1.

Des

crib

e th

e m

ost r

ecen

t exe

rcis

e (o

r eve

nt) t

hat t

este

d th

e co

untr

y’s

syst

ems

to id

entif

y an

d re

port

on

a po

tent

ial P

HEI

C.

a. H

ow w

as th

e he

alth

eve

nt id

entifi

ed?

Wha

t sur

veill

ance

sys

tem

s w

ere

linke

d?b.

How

wer

e pu

blic

hea

lth d

ecis

ion-

mak

ers

and

othe

r lea

ders

hip

cons

ulte

d in

the

deci

sion

-mak

ing

proc

ess?

c. W

hich

min

istr

ies

wer

e en

gage

d in

the

exer

cise

or e

vent

(hea

lth, d

efen

ce, a

gric

ultu

re)?

d. I

f the

cou

ntry

has

not

yet

exe

rcis

ed P

HEI

C re

port

ing,

iden

tify

if th

ere

are

any

plan

s to

do

so w

ithin

the

next

yea

r.2.

H

as th

e co

untr

y pa

ssed

legi

slat

ion

or o

ther

pol

icie

s re

late

d to

pro

cedu

res

and/

or a

ppro

vals

for r

epor

ting

on a

pot

entia

l PH

EIC

to th

e W

HO

? If

so, d

escr

ibe

the

part

ies

invo

lved

in a

ppro

vals

as

wel

l as

the

maj

or s

teps

in a

ppro

vals

. If p

ossi

ble,

pro

vide

a c

opy

of re

leva

nt le

gisl

atio

n or

pol

icie

s.3.

D

oes

the

coun

try

have

SO

Ps in

pla

ce fo

r app

rovi

ng a

nd re

port

ing

on a

pot

entia

l PH

EIC

to W

HO

?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

WH

O IH

R An

nex

2l

OIE

Ter

rest

rial A

nim

als

and

Hea

lth C

ode

– S

ectio

n 1

l

IHR

repo

rts

to th

e W

HA

l

Legi

slat

ion,

pro

toco

ls o

r oth

er p

olic

ies

rela

ted

to re

port

ing

to W

HO

and

OIE

l

WAH

IS

Refe

renc

es:

l

Anne

x 2

of th

e In

tern

atio

nal H

ealth

Reg

ulat

ions

(200

5). W

orld

Hea

lth O

rgan

izat

ion

[web

site

] (ht

tp://

ww

w.w

ho.in

t/ih

r/an

nex_

2/en

/, ac

cess

ed 2

3 N

ovem

ber 2

017)

.l

Terr

estr

ial a

nim

al h

ealth

cod

e (2

017)

. Vol

ume

1. G

ener

al p

rovi

sion

s. W

orld

Org

anis

atio

n fo

r Ani

mal

Hea

lth [w

ebsi

te] (

http

://w

ww

.oie

.int/

inte

rnat

iona

l-st

anda

rd-

setti

ng/t

erre

stria

l-co

de/a

cces

s-on

line/

, acc

esse

d 23

Nov

embe

r 201

7).

l

Dec

isio

n N

o. 1

082/

2013

/EU

of

the

Euro

pean

Par

liam

ent

and

of t

he C

ounc

il of

22

Oct

ober

201

3 on

ser

ious

cro

ss-b

orde

r th

reat

s to

hea

lth a

nd r

epea

ling.

D

ecis

ion

No.

211

9/98

/EC,

Offi

cial

Jou

rnal

of

the

Euro

pean

Uni

on 2

013;

293

:1-1

5 (h

ttps:

//ec

.eur

opa.

eu/h

ealth

/site

s/he

alth

/file

s/pr

epar

edne

ss_r

espo

nse/

docs

/dec

isio

n_se

rious

_cro

ssbo

rder

_thr

eats

_221

0201

3_en

.pdf

, acc

esse

d 23

Nov

embe

r 201

7).

DE

TE

CT



HU

MAN

RES

OU

RCES

Targ

et: S

tate

s Pa

rtie

s w

ith s

kille

d an

d co

mpe

tent

hea

lth p

erso

nnel

for s

usta

inab

le a

nd fu

nctio

nal p

ublic

hea

lth s

urve

illan

ce a

nd re

spon

se a

t all

leve

ls o

f the

hea

lth

syst

em a

nd th

e ef

fect

ive

impl

emen

tatio

n of

the

IHR.

Hum

an re

sour

ces

incl

ude

nurs

es a

nd m

idw

ives

, phy

sici

ans,

pub

lic h

ealth

and

env

ironm

enta

l spe

cial

ists

, so

cial

sci

entis

ts, c

omm

unic

atio

n, o

ccup

atio

nal h

ealth

, lab

orat

ory

scie

ntis

ts/t

echn

icia

ns, b

iost

atis

ticia

ns, i

nfor

mat

ion

tech

nolo

gy (I

T) s

peci

alis

ts a

nd b

iom

edic

al

tech

nici

ans.

The

re is

a c

orre

spon

ding

wor

kfor

ce in

the

anim

al s

ecto

r of

vet

erin

aria

ns, a

nim

al h

ealth

pro

fess

iona

ls, p

ara-

vete

rinar

ians

, epi

dem

iolo

gist

s an

d IT

sp

ecia

lists

.Th

e re

com

men

ded

dens

ity o

f doc

tors

, nur

ses

and

mid

wiv

es p

er 1

000

popu

latio

n fo

r ope

ratio

nal r

outin

e se

rvic

es is

4.4

5 pl

us 3

0% s

urge

cap

acity

. The

opt

imal

ta

rget

for s

urve

illan

ce is

one

trai

ned

(fiel

d) e

pide

mio

logi

st (o

r equ

ival

ent)

per

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

.

As m

easu

red

by: (

1) A

tra

ined

hea

lth w

orkf

orce

tha

t in

clud

es n

urse

s an

d m

idw

ives

, phy

sici

ans,

pub

lic h

ealth

and

env

ironm

enta

l spe

cial

ists

, soc

ial s

cien

tists

, la

bora

tory

sci

entis

ts/t

echn

icia

ns, b

iost

atis

ticia

ns, I

T sp

ecia

lists

and

bio

med

ical

tech

nici

ans.

(2) E

xist

ence

of a

cor

resp

ondi

ng w

orkf

orce

in th

e an

imal

sec

tor o

f ve

terin

aria

ns, p

ara-

vete

rinar

ians

, ani

mal

hea

lth p

rofe

ssio

nals

, epi

dem

iolo

gist

s, IT

spe

cial

ists

, and

oth

ers.

Desi

red

impa

ct: P

reve

ntio

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.

DE

TE

CT



Scor

e5

Indi

cato

rs: H

uman

reso

urce

s (a

nim

al1 a

nd h

uman

hea

lth s

ecto

rs)

D.4.

1 An

up-

to-d

ate

mul

tisec

tora

l w

orkf

orce

str

ateg

y is

in p

lace

2 D.

4.2

Hum

an re

sour

ces

are

avai

labl

e to

eff

ectiv

ely

impl

emen

t IH

R D.

4.3.

In-s

ervi

ce tr

aini

ngs

are

avai

labl

e 3

D.4.

4 FE

TP4 or

oth

er a

pplie

d ep

idem

iolo

gy tr

aini

ng p

rogr

amm

e is

in

pla

ce

No

capa

city

- 1

No

stra

tegy

in p

lace

to d

evel

op a

mul

-tis

ecto

ral h

ealth

wor

kfor

ce

Coun

try

does

not

hav

e ap

prop

riate

hu

man

res

ourc

es5

capa

city

in

rele

-va

nt s

ecto

rs r

equi

red

for

epid

emic

pr

epar

edne

ss a

nd c

ontr

ol

No

cont

inui

ng p

rofe

ssio

nal e

duca

tion

(CPE

) pr

ogra

mm

e th

roug

h in

-ser

vice

tr

aini

ng c

ours

e is

in p

lace

No

FETP

or

ap

plie

d ep

idem

iolo

gy

trai

ning

pro

gram

me

is e

stab

lishe

d

Lim

ited

ca

paci

ty –

2

A st

rate

gy t

o de

velo

p he

alth

car

e w

orkf

orce

6 exi

sts

but d

oes

not i

nclu

de

all

rele

vant

sec

tors

of

publ

ic h

ealth

pr

ofes

sion

s (s

uch

as

epid

emio

lo-

gist

s, s

ocia

l sci

entis

ts, I

T sp

ecia

lists

, ve

terin

aria

ns/l

ives

tock

sp

ecia

lists

an

d co

mm

unity

hea

lth w

orke

rs)

Basi

c da

ta o

n hu

man

res

ourc

es f

or

heal

th a

re a

vaila

ble

Appr

opria

te

hum

an

reso

urce

s ar

e av

aila

ble

at n

atio

nal

leve

l fo

r ep

ide-

mic

pre

pare

dnes

s an

d co

ntro

l

Ad h

oc t

rain

ings

are

ava

ilabl

e fo

r va

rious

pro

fess

ions

/cad

res

thro

ugh

dise

ase

spec

ific

prog

ram

mes

or

ta

rget

ed in

itiat

ives

No

FETP

or a

pplie

d ep

idem

iolo

gy tr

ai-

ning

pro

gram

me

is e

stab

lishe

d w

it-hi

n th

e co

untr

y at

the

nat

iona

l lev

el,

but

staf

f pa

rtic

ipat

e in

a p

rogr

amm

e ho

sted

in a

noth

er c

ount

ry th

roug

h an

ex

istin

g ag

reem

ent (

at a

ny le

vel)

Deve

lope

d ca

paci

ty -

3

A m

ultis

ecto

ral

publ

ic

heal

th

wor

kfor

ce s

trat

egy

exis

ts, b

ut is

not

re

gula

rly re

view

ed, u

pdat

ed o

r im

ple-

men

ted

cons

iste

ntly

Appr

opria

te

hum

an

reso

urce

s ar

e av

aila

ble

in r

elev

ant

sect

ors

and

at

natio

nal a

nd in

term

edia

te le

vels

Regu

lar

trai

ning

s,

incl

udin

g O

ne

Hea

lth

appr

oach

fo

r zo

onot

ic

di-

seas

es,

are

avai

labl

e fo

r va

rious

pr

ofes

sion

s/ca

dres

th

roug

h di

-se

ase-

spec

ific

prog

ram

mes

or t

arge

-te

d in

itiat

ives

One

leve

l of F

ETP

(bas

ic, in

term

edia

te,

or a

dvan

ced)

7 or

com

para

ble

appl

ied

epid

emio

logy

tr

aini

ng

prog

ram

me

is

in

plac

e in

th

e co

untr

y or

in

an

othe

r co

untr

y th

roug

h an

exi

stin

g ag

reem

ent

Dem

onst

rate

d ca

paci

ty -

4

A pu

blic

hea

lth w

orkf

orce

str

ateg

y8 ha

s be

en a

dopt

ed a

nd i

mpl

emen

ted

cons

iste

ntly

, and

is re

view

ed, t

rack

ed

and

repo

rted

on

annu

ally

Hum

an r

esou

rces

are

ava

ilabl

e as

re

quire

d in

rel

evan

t se

ctor

s an

d at

re

leva

nt l

evel

s of

the

pub

lic h

ealth

sy

stem

(su

ch a

s ep

idem

iolo

gist

at

natio

nal a

nd in

term

edia

te le

vels

, and

as

sist

ant

epid

emio

logi

st

(or

shor

t co

urse

trai

ned

epid

emio

logi

st) a

t the

lo

cal l

evel

)

Trai

ning

pl

ans

are

deve

lope

d an

d re

gula

r tr

aini

ngs

are

cond

ucte

d by

pr

ofes

sion

al b

odie

s or

rel

evan

t in

s-tit

utio

ns/u

nits

to

es

tabl

ish

skill

s an

d co

mpe

tenc

y st

anda

rds

for

the

wor

kfor

ce a

t the

nat

iona

l lev

el

Two

leve

ls o

f FE

TP (

basi

c, i

nter

me-

diat

e an

d/or

adv

ance

d) o

r co

mpa

-ra

ble

appl

ied

epid

emio

logy

tra

inin

g pr

ogra

mm

e(s)

ar

e in

pl

ace

in

the

coun

try

or in

ano

ther

cou

ntry

thro

ugh

an e

xist

ing

agre

emen

t

Sust

aina

ble

capa

city

- 5

Publ

ic h

ealth

wor

kfor

ce r

eten

tion

is

trac

ked

and

plan

s ar

e in

pla

ce to

pro

-vi

de c

ontin

uous

edu

catio

n, a

s w

ell

as r

etai

n an

d pr

omot

e a

qual

ified

w

orkf

orce

with

in th

e na

tiona

l sys

tem

Coun

try

has

capa

city

to s

end

and

re-

ceiv

e m

ultid

isci

plin

ary

pers

onne

l wit-

hin

the

coun

try

(shi

ftin

g re

sour

ces)

an

d in

tern

atio

nally

to

as

sist

ot

her

coun

trie

s in

dev

elop

ing

capa

citie

s fo

r ep

idem

ic p

repa

redn

ess

and

cont

rol

In-s

ervi

ce

trai

ning

s ar

e re

gula

rly

cond

ucte

d at

na

tiona

l an

d su

bnat

iona

l le

vels

, an

d pr

ofes

sion

al

bodi

es o

r re

leva

nt i

nstit

utio

ns/u

nits

re

gula

rly r

evie

w a

nd u

pdat

e tr

aini

ng

offe

rs

Thre

e le

vels

of

FETP

(ba

sic,

int

er-

med

iate

and

adv

ance

d) o

r co

mpa

-ra

ble

appl

ied

epid

emio

logy

tra

inin

g pr

ogra

mm

e(s)

9 ar

e in

pla

ce i

n th

e co

untr

y or

in a

noth

er c

ount

ry th

roug

h an

exi

stin

g ag

reem

ent,

with

sus

tai-

nabl

e na

tiona

l fun

ding

DE

TE

CT



1 -

Ther

e is

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C I-

1: P

rofe

ssio

nal a

nd te

chni

cal s

taffi

ng o

f the

vet

erin

ary

serv

ices

; CC

I-2:

Com

pete

ncie

s of

the

vete

rinar

ians

and

vet

erin

ary

para

-pro

fess

iona

ls; a

nd C

C I-

3: C

ontin

uing

edu

catio

n.2

- Th

e in

dica

tor D

.4.1

refe

rs to

a m

ultis

ecto

ral p

ublic

hea

lth w

orkf

orce

cap

acity

for t

he c

ount

ry. T

his

incl

udes

prim

ary

care

ser

vice

pro

vide

rs.

3 -

In-s

ervi

ce tr

aini

ngs

offe

r CPE

thro

ugh

face

-to-

face

trai

ning

s, b

lend

ed o

r e-l

earn

ing

offe

rs, s

hort

cou

rses

, exe

rcis

es, a

nd a

dvan

ced

trai

ning

s th

at c

ompl

emen

t and

/or a

dvan

ce k

now

ledg

e, s

kills

and

com

pete

ncie

s. T

hese

can

be

offe

red

by n

atio

nal/

regi

onal

trai

ning

inst

itute

s, u

nive

rsiti

es o

r nat

iona

l pro

fess

iona

l bod

ies

and

shou

ld re

spon

d to

a n

atio

nally

agr

eed

CPE

prog

ram

me.

4 -

Fiel

d ep

idem

iolo

gy tr

aini

ng p

rogr

amm

e: C

heck

Glo

ssar

y.5

- Ap

prop

riate

hum

an re

sour

ces:

Hum

an re

sour

ces

incl

ude

nurs

es a

nd m

idw

ives

, phy

sici

ans,

pub

lic h

ealth

and

env

ironm

enta

l spe

cial

ists

, soc

ial s

cien

tists

, com

mun

icat

ion

spec

ialis

ts, o

ccup

atio

nal h

ealth

spe

cial

ists

, lab

orat

ory

scie

ntis

ts/t

echn

icia

ns, b

iost

atis

ticia

ns, I

T sp

ecia

lists

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

, ani

mal

hea

lth p

rofe

ssio

nals

, par

a-ve

terin

aria

ns, e

pide

mio

logi

sts

and

IT

spec

ialis

ts, e

tc.

6 -

Wor

kfor

ce d

evel

opm

ent i

s a

cros

s-cu

ttin

g el

emen

t, an

d IH

R im

plem

enta

tion

will

dep

end

on a

str

ong

publ

ic h

ealth

wor

kfor

ce. I

mpl

emen

tatio

n of

IHR

depe

nds

on th

e av

aila

bilit

y of

suf

ficie

nt a

nd w

ell-

trai

ned

epid

emio

logi

sts,

so

cial

sci

entis

ts, l

abor

ator

y an

d pu

blic

hea

lth s

peci

alis

ts a

s w

ell a

s th

e ca

paci

ty o

f med

ical

and

nur

sing

sta

ff to

cor

rect

ly m

anag

e th

ose

affe

cted

and

han

dle

emer

genc

ies.

Dep

endi

ng o

n th

e co

untr

y, th

ese

forc

es c

an b

e in

the

publ

ic

and/

or p

rivat

e se

ctor

.7

- FE

TP B

asic

Lev

el T

rain

ing

is fo

r loc

al h

ealth

sta

ff an

d co

nsis

ts o

f lim

ited

clas

sroo

m h

ours

inte

rspe

rsed

thro

ugho

ut a

s a

thre

e-to

-five

mon

th o

n-th

e-jo

b fie

ld a

ssig

nmen

t to

build

cap

acity

in c

ondu

ctin

g tim

ely

outb

reak

det

ectio

n,

publ

ic h

ealth

resp

onse

and

pub

lic h

ealth

sur

veill

ance

. FET

P In

term

edia

te L

evel

Tra

inin

g is

for d

istr

ict/

regi

on/s

tate

-lev

el e

pide

mio

logi

sts,

and

con

sist

s of

lim

ited

clas

sroo

m h

ours

inte

rspe

rsed

thro

ugho

ut a

s a

six-

to-n

ine

mon

th

on-t

he-j

ob m

ento

red

field

ass

ignm

ent t

o bu

ild c

apac

ity in

con

duct

ing

outb

reak

inve

stig

atio

ns, p

lann

ed e

pide

mio

logi

c st

udie

s, a

nd p

ublic

hea

lth s

urve

illan

ce a

naly

ses

and

eval

uatio

ns. F

ETP

Adva

nced

Lev

el T

rain

ing

is fo

r adv

ance

d ep

idem

iolo

gist

s an

d co

nsis

ts o

f lim

ited

clas

sroo

m h

ours

inte

rspe

rsed

thro

ugho

ut th

e 24

mon

ths

of m

ento

red

field

ass

ignm

ents

to b

uild

cap

acity

in o

utbr

eak

inve

stig

atio

ns, p

lann

ed e

pide

mio

logi

c st

udie

s, p

ublic

hea

lth s

urve

illan

ce

anal

yses

and

eva

luat

ions

, sci

entifi

c co

mm

unic

atio

n, a

nd e

vide

nce-

base

d de

cisi

on m

akin

g fo

r dev

elop

men

t of e

ffect

ive

publ

ic h

ealth

pro

gram

min

g w

ith a

nat

iona

l foc

us. A

nim

al h

ealth

pro

fess

iona

ls c

an b

e en

gage

d in

thes

e FE

TP

trai

ning

s. 8

- P

ublic

hea

lth w

orkf

orce

pla

nnin

g sh

ould

cov

er b

oth

the

anim

al a

nd h

uman

hea

lth s

ecto

rs a

nd s

houl

d in

clud

e:• P

ublic

hea

lth s

peci

alis

ts, e

pide

mio

logi

sts,

soc

ial s

cien

tists

, bio

stat

istic

ians

, vet

erin

ary

epid

emio

logi

sts,

vet

erin

ary

publ

ic h

ealth

spe

cial

ists

and

oth

er p

ublic

hea

lth p

erso

nnel

.• P

rimar

y ca

re p

rovi

ders

(phy

sici

ans,

nur

ses,

mid

wiv

es),

vete

rinar

ians

and

par

a-ve

terin

aria

ns.

• Com

mun

ity h

ealth

wor

kers

and

sta

ff in

form

atio

n sy

stem

s sp

ecia

lists

(suc

h as

labo

rato

ry s

peci

alis

ts/t

echn

icia

ns, b

iom

edic

al te

chni

cian

s), f

or s

uppo

rtiv

e fu

nctio

ns.

Publ

ic h

ealth

wor

kfor

ce p

lann

ing

shou

ld a

lso

incl

ude:

• I

ndic

atio

n of

trai

ning

s th

at h

ave

been

pro

vide

d at

the

natio

nal l

evel

or a

re a

vaila

ble

to s

taff

from

a p

artn

er e

ntity

. Des

crip

tion

of lo

ng-t

erm

trai

ning

pro

gram

mes

that

are

ava

ilabl

e to

hel

p ex

pand

the

pipe

line

of q

ualifi

ed p

ublic

he

alth

pro

fess

iona

ls w

ithin

the

coun

try.

Des

crip

tion

of im

plem

enta

tion

of o

ccup

atio

nal s

afet

y an

d he

alth

to a

ll pu

blic

and

priv

ate

heal

th c

are

faci

litie

s an

d to

farm

s.9

-Com

para

ble

appl

ied

epid

emio

logy

trai

ning

pro

gram

mes

or t

hose

spe

cial

ized

in e

pide

mio

logy

wou

ld b

e si

mila

r to

thes

e le

vels

defi

ned

abov

e.

Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

D.4.

1 An

upd

ated

wor

kfor

ce s

trat

egy

is in

pla

ce1.

Is

ther

e a

stra

tegy

to e

nsur

e th

at a

ppro

pria

te w

orkf

orce

and

hum

an re

sour

ces

for t

he h

ealth

sec

tor a

re in

pla

ce?

a. D

oes

this

cov

er th

e fu

ll ra

nge

of ta

sks

and

serv

ices

in th

e (p

ublic

and

priv

ate)

hea

lth s

ecto

r (pr

even

tion/

dete

ctio

n an

d re

spon

se, c

are

and

reha

bilit

atio

n)?

2.

Des

crib

e w

hich

car

eer t

rack

s ar

e 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, d

octo

rs,

nurs

es)?

a. A

re c

omm

unity

hea

lth w

orke

rs a

par

t of t

he fo

rmal

hea

lth w

orkf

orce

?b.

Are

the

re jo

b de

scrip

tions

for

the

var

ious

car

eer

trac

ks a

nd p

ositi

ons

with

in t

hem

(su

ch a

s pe

rfor

man

ce a

ppra

isal

, com

pete

ncy

stan

dard

s, c

aree

r la

dder

)?3.

Is

attr

ition

a c

once

rn fo

r the

nat

iona

l pub

lic h

ealth

sys

tem

(may

be

caus

ed b

y ag

ing

empl

oyee

s, s

taff

depa

rtur

es o

r oth

er re

ason

s)?

a. W

hat i

s th

e 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 ins

titut

es?

b. A

re th

ere

ince

ntiv

es in

pla

ce to

mai

ntai

n th

e ex

istin

g pu

blic

hea

lth w

orkf

orce

in th

e co

untr

y?

DE

TE

CT



i. D

escr

ibe

effo

rts

in p

lace

to re

tain

the

publ

ic h

ealth

wor

kfor

ce.

ii.

Are

ther

e sp

ecifi

c in

cent

ives

for a

ny w

orkf

orce

spe

cial

ties

(may

incl

ude

phys

icia

ns, n

urse

s, v

eter

inar

ians

, bio

stat

istic

ians

labo

rato

ry a

ssis

tant

s an

d sp

ecia

lists

, or a

nim

al h

ealth

pro

fess

iona

ls)?

4.

How

is th

e w

orkf

orce

str

ateg

y be

ing

impl

emen

ted

and

trac

ked?

a.

Pro

vide

a c

opy

of th

e st

rate

gy, i

f ava

ilabl

e.b.

Pro

vide

a c

opy

of th

e w

orkf

orce

str

ateg

y tr

acki

ng re

port

, if a

vaila

ble.

5.

Doe

s th

e st

rate

gy a

ddre

ss o

ccup

atio

nal s

afet

y an

d he

alth

in h

ealth

car

e fa

cilit

ies?

a. I

f yes

, wha

t is

the

cove

rage

of o

ccup

atio

nal s

afet

y an

d he

alth

in p

ublic

hea

lth s

yste

ms?

b. I

f not

, how

is th

e oc

cupa

tiona

l saf

ety

and

heal

th a

ddre

ssed

in h

ealth

car

e fa

cilit

ies.

6.

How

is th

e na

tiona

l pub

lic h

ealth

wor

kfor

ce fi

nanc

ed w

ithin

the

coun

try?

a. A

re th

e po

sitio

ns fo

r the

var

ious

cad

res

avai

labl

e, fi

nanc

ed a

nd fi

lled?

7.

Is th

ere

a se

para

te w

orkf

orce

str

ateg

y fo

r hum

an re

sour

ces

in p

lace

for t

he a

nim

al h

ealth

sec

tor?

8.

Is

ther

e a

trai

ning

pla

n to

upd

ate

the

wor

kfor

ce w

ith p

olic

y an

d st

rate

gies

?

D.4.

2 H

uman

reso

urce

s ar

e av

aila

ble

to e

ffec

tivel

y im

plem

ent I

HR

1.

Des

crib

e th

e cu

rren

t hum

an re

sour

ces

capa

city

in th

e co

untr

y.

a. W

hat i

s th

e ex

istin

g ca

paci

ty o

n ep

idem

iolo

gist

s, c

linic

ians

, bio

stat

istic

ians

, inf

orm

atio

n sy

stem

s sp

ecia

lists

, vet

erin

aria

ns, s

ocia

l sci

entis

ts, l

abor

ator

y te

chni

cian

s/sp

ecia

lists

and

oth

er p

ublic

hea

lth p

erso

nnel

for d

iffer

ent l

evel

s of

the

heal

th s

yste

m (l

ocal

, int

erm

edia

te a

nd n

atio

nal)?

b. T

o w

hat e

xten

t are

thes

e ca

paci

ties

avai

labl

e (o

nly

at n

atio

nal l

evel

or b

elow

)?c.

Doe

s ea

ch lo

cal a

nd/o

r int

erm

edia

te le

vel h

ave

som

e ca

paci

ty fo

r epi

dem

iolo

gy, c

ase

man

agem

ent,

labo

rato

ry s

ervi

ces,

and

oth

ers?

2.

Des

crib

e ho

w m

ultid

isci

plin

ary

task

forc

es a

re fo

rmed

and

com

mun

icat

e w

ith o

ther

act

ors

(at n

atio

nal,

inte

rmed

iate

and

per

iphe

ral l

evel

s).

a. H

ow a

re m

ultid

isci

plin

ary

task

forc

es o

rgan

ized

? H

ow d

o di

ffere

nt p

rofe

ssio

nals

inte

ract

and

is th

is o

rgan

ized

thro

ugh

a ta

sk fo

rce?

b.

Dis

cuss

ava

ilabi

lity

and

dist

ribut

ion

of in

divi

dual

hum

an re

sour

ces

capa

citie

s:i.

Epid

emio

logi

sts

(incl

udin

g fie

ld e

pide

mio

logy

sho

rt te

rm a

nd lo

ng te

rm)

ii.

Clin

icia

ns a

nd c

linic

al a

ssis

tant

siii

. N

urse

siv

. La

bora

tory

spe

cial

ists

and

tech

nici

ans

v.

Info

rmat

ion

spec

ialis

ts a

nd a

ssis

tant

svi

. So

cial

sci

entis

tsvi

i. Ve

terin

aria

ns, v

eter

inar

y te

chni

cian

s an

d pa

ra-v

eter

inar

ians

vii.

Oth

er re

leva

nt p

ublic

hea

lth p

erso

nnel

.3.

D

escr

ibe

how

pro

fess

iona

ls a

t the

nat

iona

l, in

term

edia

te a

nd lo

cal l

evel

s co

mm

unic

ate

on a

regu

lar b

asis

. Are

ther

e st

anda

rd re

port

ing

conn

ectio

ns b

etw

een

thes

e le

vels

?

DE

TE

CT



4.

Des

crib

e ho

w p

rofe

ssio

nals

at t

he n

atio

nal,

inte

rmed

iate

and

loca

l lev

els

com

mun

icat

e du

ring

an in

fect

ious

dis

ease

out

brea

k. A

re th

ere

stan

dard

repo

rtin

g co

nnec

tions

bet

wee

n th

ese

leve

ls d

urin

g ou

tbre

aks?

5.

How

man

y tr

aine

d fie

ld e

pide

mio

logi

sts

are

avai

labl

e to

sup

port

inv

estig

atio

ns t

hrou

ghou

t th

e co

untr

y? I

s th

ere

a si

mpl

e m

easu

re o

f th

e nu

mbe

rs o

f ep

idem

iolo

gist

s pe

r uni

t of t

otal

pop

ulat

ion

that

may

hel

p di

ffere

ntia

te q

ualit

y le

vels

– fo

r exa

mpl

e: le

ss th

an 1

per

500

000

in c

apac

ity le

vels

1 o

r 2; 1

per

20

0 00

0 to

500

000

in c

apac

ity le

vel 3

; or m

ore

than

1 p

er 2

00 0

00 in

cap

acity

leve

ls 4

or 5

. 6.

D

oes

the

coun

try

have

est

ablis

hed

proc

edur

es fo

r sur

ge o

f the

se p

rofe

ssio

nals

?7.

D

oes

each

inte

rmed

iate

leve

l/dis

tric

t (or

oth

er s

imila

r adm

inis

trat

ive

divi

sion

s) h

ave

field

epi

dem

iolo

gy c

apac

ity?

8.

Doe

s th

e co

untr

y ha

ve a

hum

an re

sour

ces

data

base

? If

yes,

how

is th

e da

taba

se m

aint

aine

d an

d up

date

d?

D.4.

3 In

-ser

vice

trai

ning

s ar

e av

aila

ble

1.

Are

ther

e CP

E pr

ogra

mm

es fo

r pub

lic h

ealth

offi

cers

, sur

veill

ance

offi

cers

, nur

ses,

mid

wiv

es, g

ener

al m

edic

al p

ract

ition

ers,

vet

erin

aria

ns, p

ara-

vete

rinar

ians

th

at in

clud

e ou

tbre

ak p

repa

redn

ess

and

cont

rol?

2.

Whi

ch p

rofe

ssio

ns/c

adre

s ha

ve re

ceiv

ed s

peci

al tr

aini

ngs

on o

utbr

eak

prep

ared

ness

and

resp

onse

? 3.

D

escr

ibe

any

shor

t-/l

ong-

term

tra

inin

g pr

ogra

mm

es t

hat

are

avai

labl

e to

hel

p ex

pand

the

num

ber

of q

ualifi

ed p

ublic

hea

lth p

rofe

ssio

nals

with

in t

he

coun

try,

i.e.

a. P

hysi

cian

s (p

ublic

hea

lth a

nd/o

r clin

ical

car

e)b.

Nur

ses

(pub

lic h

ealth

and

/or c

linic

al c

are)

c. V

eter

inar

ians

(pub

lic h

ealth

, agr

icul

tura

l and

/or p

rivat

e pr

actic

e) a

nd p

ara-

vete

rinar

ians

d. B

iost

atis

ticia

nse.

Oth

er p

ublic

hea

lth o

ffice

rs/s

urve

illan

ce o

ffice

rsf.

Labo

rato

ry a

ssis

tant

s an

d sp

ecia

lists

g. L

ives

tock

pro

fess

iona

ls.

4.

Des

crib

e pr

ogra

mm

es a

nd in

stitu

tions

/pro

fess

iona

l bod

ies

in-c

harg

e of

CPE

and

/or

trai

ning

s, o

r th

eir

capa

city

in tu

rn o

f del

iver

ing

trai

ning

. How

are

they

fu

nded

?5.

Is

ther

e an

y tr

aini

ng re

late

d to

con

tinge

ncy

plan

ning

, man

agem

ent o

f em

erge

ncy

situ

atio

ns, o

r ris

k co

mm

unic

atio

ns?

6.

Is th

ere

any

trai

ning

that

incl

udes

join

t exe

rcis

es fo

r mul

tidis

cipl

inar

y te

ams?

a.

If y

es, d

escr

ibe

brie

fly (r

egul

ar/o

n de

man

d).

D.4.

4 F

ETP

or o

ther

app

lied

epid

emio

logy

trai

ning

pro

gram

me

in p

lace

1.

D

escr

ibe

curr

ent fi

eld

epid

emio

logy

cap

acity

in th

e co

untr

y.a.

Des

crib

e th

e tr

aini

ng p

rogr

amm

e fo

r fiel

d ep

idem

iolo

gist

s. W

ho c

ondu

cts

this

trai

ning

? b.

How

is fi

eld

epid

emio

logy

cap

acity

trac

ked

in th

e co

untr

y?2.

Is

ther

e an

FET

P or

oth

er s

tand

ard

epid

emio

logy

trai

ning

pro

gram

me

in th

e co

untr

y?a.

Des

crib

e cu

rren

t fiel

d ep

idem

iolo

gy c

apac

ity in

the

coun

try.

DE

TE

CT



b. D

oes

the

epid

emio

logy

trai

ning

pro

gram

me

targ

et c

urre

nt m

embe

rs o

f the

pub

lic h

ealth

wor

kfor

ce, o

r stu

dent

s, o

r bot

h?c.

How

is fi

eld

epid

emio

logy

cap

acity

trac

ked

in th

e co

untr

y?d.

Des

crib

e ho

w e

pide

mio

logi

sts

at th

e na

tiona

l, in

term

edia

te a

nd lo

cal l

evel

s co

mm

unic

ate

on a

regu

lar b

asis

. Are

ther

e st

anda

rd re

port

ing

conn

ectio

ns

betw

een

thes

e le

vels

?e.

Hav

e ve

terin

aria

ns p

artic

ipat

ed in

the

epid

emio

logy

trai

ning

pro

gram

me?

f.

Prov

ide

mea

sure

s on

the

num

ber o

f epi

dem

iolo

gy tr

aini

ng p

rogr

amm

e gr

adua

tes

in th

e co

untr

y an

d th

eir c

urre

nt p

ositi

ons.

g. D

escr

ibe

the

men

tors

hip

prog

ram

me

for e

pide

mio

logy

trai

ning

pro

gram

me

resi

dent

s.h.

Is

ther

e 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?

i. H

ow m

any

trai

ned

field

epi

dem

iolo

gist

s ar

e av

aila

ble

to s

uppo

rt in

vest

igat

ions

thro

ugho

ut th

e co

untr

y?j.

Doe

s ea

ch in

term

edia

te le

vel/

dist

rict (

or o

ther

sim

ilar a

dmin

istr

ativ

e di

visi

on) h

ave

field

epi

dem

iolo

gy c

apac

ity?

3.

Des

crib

e an

y ot

her l

ong-

term

trai

ning

pro

gram

mes

that

are

ava

ilabl

e to

hel

p ex

pand

the

num

ber o

f qua

lified

pub

lic h

ealth

pro

fess

iona

ls w

ithin

the

coun

try,

i.e.

a. P

hysi

cian

s (p

ublic

hea

lth a

nd/o

r clin

ical

car

e)b.

Nur

ses

(pub

lic h

ealth

and

/or c

linic

al c

are)

c. V

eter

inar

ians

(pub

lic h

ealth

, agr

icul

tura

l and

/or p

rivat

e pr

actic

e)d.

Bio

stat

istic

ians

e. L

abor

ator

y as

sist

ants

and

spe

cial

ists

.4.

Is

ther

e a

prof

essi

onal

vet

erin

aria

n as

soci

atio

n in

the

coun

try?

Doe

s it

have

a C

PE?

If ye

s, w

hat d

oes

it co

ver?

How

is it

fina

nced

? 5.

Is

ther

e a

spec

ific

trai

ning

on

zoon

osis

in th

e hu

man

med

icin

e cu

rric

ulum

or i

n an

y CP

E pr

ogra

mm

e fo

r med

ical

pra

ctiti

oner

s?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Sam

ple

field

epi

dem

iolo

gy tr

aini

ng c

urric

ulum

use

d in

the

coun

try

• Num

ber o

f gra

duat

es/y

ear,

and

if av

aila

ble,

pos

ition

s af

ter t

rain

ing

l

Publ

ic h

ealth

wor

kfor

ce/h

uman

reso

urce

pla

n/st

rate

gy, i

f ava

ilabl

e an

d la

test

str

ateg

y dr

afte

d/en

acte

dl

Annu

al re

port

s ba

sed

on w

orkf

orce

str

ateg

yl

Plan

ning

and

ava

ilabi

lity

of re

sour

ces

l

Term

s of

refe

renc

e/jo

b de

scrip

tions

of p

rovi

ncia

l/di

stric

t rap

id re

spon

se te

ams

l

Job

desc

riptio

n/te

rms

of re

fere

nce

of p

rovi

ncia

l/di

stric

t pub

lic h

ealth

offi

cer i

n-ch

arge

of o

utbr

eak

prep

ared

ness

l

Budg

et fo

r hum

an re

sour

ces

for h

ealth

(ani

mal

and

hum

an h

ealth

sec

tor)

, don

or c

ontr

ibut

ions

DE

TE

CT



l

Des

crip

tion

of th

e hu

man

reso

urce

s m

anag

emen

t inf

orm

atio

n sy

stem

• L

ist o

f var

iabl

es u

sed

l

Dat

a fr

om h

uman

reso

urce

info

rmat

ion

syst

ems,

if a

vaila

ble

• P

ost a

nd s

taff

list,

if av

aila

ble;

sta

ff tu

rnov

er, a

nd n

umbe

r of s

taff

atte

ndin

g in

-ser

vice

trai

ning

l

Annu

al re

port

s ba

sed

on w

orkf

orce

str

ateg

yl

List

s of

in-s

ervi

ce tr

aini

ng a

vaila

ble

in th

e co

untr

yl

List

s of

nat

iona

l tra

inin

g in

stitu

tes/

prof

essi

onal

bod

ies/

scho

ols

of p

ublic

hea

lth/n

ursi

ng/m

idw

ifery

/vet

erin

ary/

med

ical

col

lege

s/un

iver

sitie

s th

at p

rovi

de in

-se

rvic

e tr

aini

ng c

ours

es

l

Num

ber o

f gra

duat

es/t

rain

ees

per y

ear

l

CPE

prog

ram

me

and

cour

se li

st (i

f ava

ilabl

e)l

Trai

ning

cou

rse

list f

or p

rofe

ssio

nals

that

do

not h

ave

CPE

prog

ram

mes

l

Evid

ence

of t

rain

ing

on is

sues

rela

ted

to o

ccup

atio

nal h

ealth

, saf

ety

and

secu

rity.

DE

TE

CT



RESP

ON

DEM

ERG

ENCY

PRE

PARE

DN

ESS

Targ

et:

Stat

es P

artie

s ar

e in

“em

erge

ncy

prep

ared

ness

” (d

efine

d as

, the

kno

wle

dge

and

capa

citie

s an

d or

gani

zatio

nal s

yste

ms

deve

lope

d by

gov

ernm

ents

, re

spon

se a

nd re

cove

ry o

rgan

izat

ions

, com

mun

ities

and

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, 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, a

nd o

rgan

izin

g to

bui

ld, s

usta

in a

nd im

prov

e op

erat

iona

l ca

pabi

litie

s at

nat

iona

l, int

erm

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. T

he s

trat

egic

risk

ass

essm

ent i

dent

ifies

, ana

lyse

s an

d ev

alua

tes

the

rang

e of

ris

ks in

a c

ount

ry a

nd e

nabl

es r

isks

to

be a

ssig

ned

a le

vel o

f pr

iorit

y an

d in

clud

es a

naly

ses

of p

oten

tial h

azar

ds e

xpos

ures

and

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 t

o m

anag

e th

e ris

ks o

f ou

tbre

aks

and

othe

r em

erge

ncie

s. E

mer

genc

y pr

epar

edne

ss a

pplie

s to

any

haz

ard

that

may

cau

se a

n em

erge

ncy

and

incl

udes

bi

olog

ical

, che

mic

al, r

adio

logi

cal a

nd n

ucle

ar, n

atur

al, o

ther

tech

nolo

gica

l and

soc

ieta

l haz

ards

.

As m

easu

red

by: (

1) )

Exis

tenc

e of

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

fter

-act

ion

and

othe

r rev

iew

s of

effe

ctiv

e an

d ef

ficie

nt m

ultis

ecto

ral e

mer

genc

y re

spon

se o

pera

tions

fo

r out

brea

ks a

nd o

ther

pub

lic h

ealth

em

erge

ncie

s.

Desi

red

impa

ct: 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 re

ady

for

timel

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.

RE

SP

ON

D



Scor

eIn

dica

tors

: Em

erge

ncy

prep

ared

ness

R.1.

1 St

rate

gic

emer

genc

y ris

k as

sess

men

ts1

cond

ucte

d an

d em

erge

ncy

reso

urce

s id

entifi

ed a

nd m

appe

dR.

1.2

Nat

iona

l mul

tisec

tora

l mul

tihaz

ard

emer

genc

y pr

epar

edne

ss m

easu

res,

in

clud

ing

emer

genc

y re

spon

se p

lans

2 , ar

e de

velo

ped,

impl

emen

ted

and

test

ed

No

capa

city

- 1

A na

tiona

l em

erge

ncy

risk

profi

le b

ased

on

a st

rate

gic

mul

tihaz

ard

emer

genc

y ris

k as

sess

men

t is

not a

vaila

ble

or h

as n

ot b

een

upda

ted

in th

e pa

st fi

ve y

ears

Nat

iona

l lev

el in

vent

orie

s an

d m

aps

of m

ultis

ecto

ral r

esou

rces

for e

mer

genc

y re

spon

se a

re n

ot a

vaila

ble

or h

ave

not b

een

upda

ted

in th

e pa

st fi

ve y

ears

A na

tiona

l mul

tisec

tora

l mul

tihaz

ard

plan

for

stre

ngth

enin

g em

erge

ncy

pre-

pare

dnes

s is

not

ava

ilabl

e3 A

natio

nal m

ultis

ecto

ral m

ultih

azar

d em

erge

ncy

resp

onse

pla

n is

not

ava

i-la

ble

Lim

ited

ca

paci

ty -

2

A na

tiona

l st

rate

gic

mul

tihaz

ard

emer

genc

y ris

k as

sess

men

t ha

s be

en

cond

ucte

d in

the

pas

t fiv

e ye

ars

and

docu

men

ted

in a

nat

iona

l he

alth

em

erge

ncy

risk

profi

leN

atio

nal l

evel

inve

ntor

ies

and

map

s of

hea

lth s

ecto

r res

ourc

es fo

r em

erge

ncy

resp

onse

are

ava

ilabl

e an

d ha

ve b

een

upda

ted

in th

e pa

st fi

ve y

ears

A na

tiona

l m

ultis

ecto

ral

mul

tihaz

ard

plan

tha

t id

entifi

es k

ey m

easu

res

for

stre

ngth

enin

g em

erge

ncy

prep

ared

ness

for p

riorit

y ris

ks is

in p

lace

4 . A

natio

nal m

ultih

azar

d em

erge

ncy

resp

onse

pla

n w

ith S

OPs

for

cor

e em

er-

genc

y re

spon

se c

oord

inat

ion

func

tions

has

bee

n de

velo

ped

with

in t

he p

ast

two

year

s to

resp

ond

to e

mer

genc

ies,

incl

udin

g PH

EICs

Deve

lope

d ca

paci

ty -

3

Nat

iona

l res

ourc

es fo

r em

erge

ncy

resp

onse

in a

ll re

leva

nt s

ecto

rs h

ave

been

id

entifi

ed a

nd m

appe

d (s

uch

as lo

gist

ics,

sta

ff/ex

pert

s, fi

nanc

e) in

the

pas

t tw

o ye

ars

A pl

an fo

r the

man

agem

ent a

nd d

istr

ibut

ion

of n

atio

nal s

tock

pile

s is

in p

lace

Emer

genc

y pr

epar

edne

ss m

easu

res2

are

impl

emen

ted

at n

atio

nal l

evel

s by

pu

blic

hea

lth, a

nim

al h

ealth

and

oth

er r

elev

ant

sect

ors,

incl

udin

g po

ints

of

entr

y an

d m

ass

gath

erin

g ev

ents

Nat

iona

l m

ultis

ecto

ral

mul

tihaz

ard

emer

genc

y re

spon

se p

lans

hav

e be

en

exer

cise

d or

use

d in

act

ual r

espo

nse

oper

atio

ns in

the

past

two

year

s

Dem

onst

rate

d ca

paci

ty -

4

Stra

tegi

c m

ultih

azar

d em

erge

ncy

risk

asse

ssm

ents

and

map

ping

of r

esou

rces

fo

r em

erge

ncy

resp

onse

at

subn

atio

nal

leve

ls h

ave

been

dev

elop

ed i

n th

e pa

st tw

o ye

ars

Nat

iona

l lev

el r

esou

rce

map

ping

has

bee

n re

view

ed a

t le

ast

on a

n an

nual

ba

sis,

and

sto

ckpi

les

(crit

ical

sto

ck le

vels

) for

resp

ondi

ng to

prio

rity

biol

ogic

al,

chem

ical

and

radi

olog

ical

eve

nts

and

othe

r em

erge

ncie

s ar

e ac

cess

ible

Emer

genc

y pr

epar

edne

ss m

easu

res2 a

re im

plem

ente

d at

nat

iona

l, su

bnat

io-

nal a

nd lo

cal l

evel

s by

pub

lic h

ealth

, ani

mal

hea

lth a

nd o

ther

rele

vant

sec

tors

Mul

tisec

tora

l mul

tihaz

ard

emer

genc

y re

spon

se p

lans

and

SO

Ps a

re in

pla

ce

at s

ubna

tiona

l and

loca

l lev

els,

as

wel

l as

at th

e po

ints

of e

ntry

; and

impl

e-m

ente

d or

test

ed in

the

past

two

year

s an

d up

date

d ac

cord

ingl

y

Sust

aina

ble

capa

city

– 5

Nat

iona

l pr

ofile

s on

ris

k an

d re

sour

ce m

aps,

are

mon

itore

d an

d re

gula

rly

upda

ted

(e.g

. on

ann

ual

basi

s) t

o ac

com

mod

ate

emer

ging

thr

eats

and

is

shar

ed re

gula

rly a

mon

g se

ctor

s

Ther

e ar

e de

dica

ted

hum

an re

sour

ces

and

regu

lar b

udge

t fun

ding

to s

uppo

rt

coor

dina

tion

and

impl

emen

tatio

n of

em

erge

ncy

prep

ared

ness

mea

sure

s by

pu

blic

hea

lth, a

nim

al h

ealth

and

oth

er re

leva

nt s

ecto

rs

Ded

icat

ed re

sour

ces

are

in p

lace

for i

mpl

emen

tatio

n of

mul

tisec

tora

l, m

ulti-

haza

rd e

mer

genc

y re

spon

se p

lans

, con

tinge

ncy

plan

s an

d SO

Ps a

t nat

iona

l, su

bnat

iona

l and

loca

l lev

els,

and

are

test

ed, r

evie

wed

and

upd

ated

on

a re

gu-

lar b

asis

1 -

Ther

e is

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C II-

3: R

isk

anal

ysis

2 -

Emer

genc

y re

spon

se p

lans

sho

uld

be s

cala

ble

and

flexi

ble

to a

ddre

ss k

now

n an

d em

ergi

ng h

azar

ds, i

nclu

ding

dis

ease

thre

ats.

Con

tinge

ncy

plan

s fo

r res

pons

e to

hig

h pr

iorit

y ris

ks s

houl

d be

dev

elop

ed3

- An

y em

erge

ncy

prep

ared

ness

mea

sure

s th

at a

re c

ondu

cted

, sho

uld

be d

one

on a

n ad

hoc

bas

is

4 -

Risk

s ar

e id

entifi

ed a

nd p

riorit

ized

by

stra

tegi

c em

erge

ncy

risk

asse

ssm

ents

. Em

erge

ncy

prep

ared

ness

mea

sure

s in

clud

e st

rate

gic

risk

asse

ssm

ents

, em

erge

ncy

resp

onse

pla

ns, c

ontin

genc

y pl

ans,

trai

ning

, exe

rcis

ing,

sur

ge

capa

city

dev

elop

men

t, bu

sine

ss c

ontin

uity

pla

n. P

lans

sho

uld

be m

ultih

azar

d, m

ultis

ecto

ral a

nd m

ultid

isci

plin

ary,

and

inte

rope

rabl

e w

ith n

atio

nal m

ultis

ecto

ral a

nd m

ultih

azar

d pl

ans.

Em

erge

ncy

prep

ared

ness

cou

ld a

ddre

ss a

ny

risks

and

not

be

limite

d to

thos

e as

soci

ated

with

bio

logi

cal,

chem

ical

and

radi

olog

ical

haz

ards

.

RE

SP

ON

D



Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

R.1.

1 St

rate

gic

emer

genc

y ris

k as

sess

men

ts c

ondu

cted

and

em

erge

ncy

reso

urce

s id

entifi

ed a

nd m

appe

d1

Doe

s th

e co

untr

y ha

ve a

nat

iona

l em

erge

ncy

risk

profi

le b

ased

on

stra

tegi

c m

ultih

azar

d em

erge

ncy

risk

asse

ssm

ents

? a.

Whe

n w

as th

e la

st n

atio

nal s

trat

egic

mul

tihaz

ard

risk

asse

ssm

ent c

ondu

cted

? W

hich

sec

tors

par

ticip

ated

in th

e ris

k as

sess

men

t?b.

Wha

t are

the

findi

ngs

of th

e na

tiona

l str

ateg

ic e

mer

genc

y ris

k as

sess

men

t?c.

Are

str

ateg

ic r

isk

asse

ssm

ents

con

duct

ed b

y al

l se

ctor

s? D

o he

alth

sec

tor

stra

tegi

c ris

k as

sess

men

ts c

ontr

ibut

e to

nat

iona

l m

ultis

ecto

ral

risk

asse

ssm

ents

?d.

Are

str

ateg

ic r

isk

asse

ssm

ents

con

duct

ed a

t su

bnat

iona

l an

d lo

cal

leve

ls?

Wha

t pr

opor

tion

of s

ubna

tiona

l or

loc

al e

ntiti

es h

as c

ondu

cted

ris

k as

sess

men

ts?

e. I

s th

ere

a ca

paci

ty to

mon

itor p

riorit

y ris

ks o

r em

ergi

ng ri

sks?

How

oft

en a

re n

atio

nal e

mer

genc

y ris

k pr

ofile

s re

view

ed a

nd u

pdat

ed to

acc

omm

odat

e em

ergi

ng th

reat

s or

cha

ngin

g ris

ks?

f. H

ow a

re n

atio

nal r

isk

profi

les

and

reso

urce

s sh

ared

am

ong

sect

ors?

Are

info

rmat

ion

tech

nolo

gy c

apac

ities

util

ized

to s

uppo

rt a

vaila

bilit

y, ac

cess

ibili

ty,

anal

ysis

, upd

atin

g, re

port

ing

and

shar

ing

of ri

sk a

sses

smen

ts?

g. A

re s

trat

egic

risk

ass

essm

ents

use

d as

the

basi

s fo

r em

erge

ncy

prep

ared

ness

mea

sure

s?

2 D

oes

the

coun

try

have

a n

atio

nal i

nven

tory

and

map

ping

of t

he a

vaila

ble

reso

urce

s fo

r em

erge

ncy

resp

onse

?a.

Doe

s th

is m

appi

ng a

ddre

ss re

sour

ces

and

capa

citie

s re

quire

d fo

r res

pons

e to

all

type

s of

em

erge

ncie

s, in

clud

ing

for p

oten

tial P

HEI

Cs?

b. D

oes

the

map

ping

of r

esou

rces

incl

ude:

i. ex

pert

ise,

ii.

staf

f,iii

. lo

gist

ics,

iv.

equi

pmen

t,v.

fin

ance

, and

vi.

faci

litie

s (e

.g. h

ealth

faci

litie

s, la

bora

torie

s)?

c. W

hen

was

the

last

map

ping

of r

esou

rces

con

duct

ed?

Whi

ch s

ecto

rs p

artic

ipat

ed?

e. W

hat i

s th

e st

atus

of s

tock

pilin

g w

ith re

spec

t to

phar

mac

eutic

als,

pro

tect

ive

equi

pmen

t and

oth

er e

quip

men

t?d.

Are

ass

essm

ents

of t

he s

afet

y an

d fu

nctio

nalit

y of

the

heal

th fa

cilit

ies

for e

mer

genc

ies

incl

uded

in re

sour

ce m

appi

ng?

i. W

hat p

rovi

sion

s ar

e m

ade

with

resp

ect t

o st

ocks

of v

acci

natio

ns, p

re-o

rder

ing/

licen

cing

/im

port

of d

rugs

and

vac

cine

s an

d pr

otec

tive

equi

pmen

t?

R.1.

2 N

atio

nal m

ultis

ecto

ral m

ultih

azar

d em

erge

ncy

prep

ared

ness

mea

sure

s, in

clud

ing

emer

genc

y re

spon

se p

lans

, are

dev

elop

ed, i

mpl

emen

ted

and

test

ed1

Doe

s th

e co

untr

y ha

ve p

lans

and

mec

hani

sms

for

coor

dina

ting

the

deve

lopm

ent

and

impl

emen

tatio

n of

mul

tisec

tora

l m

ultih

azar

d em

erge

ncy

prep

ared

ness

mea

sure

s?

RE

SP

ON

D



a.

Doe

s th

e na

tiona

l pla

n an

d m

echa

nism

s fo

r coo

rdin

atin

g em

erge

ncy

prep

ared

ness

hav

e a

mul

tihaz

ard

who

le-o

f-so

ciet

y ap

proa

ch in

volv

ing

all r

elev

ant

sect

ors?

b.

Doe

s th

e he

alth

sec

tor

have

a m

ultih

azar

d pl

an fo

r co

ordi

natin

g em

erge

ncy

prep

ared

ness

mea

sure

s th

at is

inte

grat

ed in

the

mul

tisec

tora

l pla

n? Is

em

erge

ncy

prep

ared

ness

incl

uded

in p

lans

for s

tren

gthe

ning

nat

iona

l em

erge

ncy

and

disa

ster

risk

man

agem

ent?

c.

Doe

s th

e na

tiona

l mul

tisec

tora

l mul

tihaz

ard

plan

incl

ude:

i. st

rate

gic

emer

genc

y ris

k as

sess

men

t,ii.

ca

paci

ty a

sses

smen

ts a

nd re

sour

ce m

appi

ng,

iii.

mul

tihaz

ard

emer

genc

y re

spon

se p

lann

ing

(see

bel

ow fo

r spe

cific

que

stio

ns),

iv.

cont

inge

ncy

plan

ning

for s

peci

fic h

azar

ds o

r ris

k sc

enar

ios,

v.

plan

s fo

r dev

elop

ing

emer

genc

y re

spon

se c

apac

ities

, inc

ludi

ng e

mer

genc

y op

erat

ion

cent

res

(EO

Cs),

vi.

plan

s fo

r dev

elop

ing

surg

e ca

paci

ty,

vii.

busi

ness

con

tinui

ty p

lann

ing

viii.

trai

ning

, and

ix.

exer

cisi

ng?

d.

Doe

s th

e pl

an a

ddre

ss e

mer

genc

y pr

epar

edne

ss f

or IH

R-re

leva

nt h

azar

ds, i

nclu

ding

tho

se t

hat

have

the

pot

entia

l to

caus

e PH

EICs

? D

oes

the

plan

ad

dres

s em

erge

ncy

prep

ared

ness

for a

ll ty

pes

of h

azar

ds th

at th

e co

untr

y fa

ces?

e.

Doe

s th

e pl

an a

ddre

ss th

e m

easu

res

to p

repa

re fo

r any

mas

s ga

ther

ing

even

ts?

f. D

oes

the

plan

cle

arly

ass

ign

role

s an

d re

spon

sibi

litie

s fo

r em

erge

ncy

prep

ared

ness

to s

peci

fic g

over

nmen

t uni

ts o

f all

rele

vant

sec

tors

and

poi

nts

of

entr

y?g.

Ar

e th

ere

plan

s fo

r str

engt

heni

ng e

mer

genc

y pr

epar

edne

ss a

t sub

natio

nal a

nd lo

cal l

evel

s?h.

Ar

e th

ere

dedi

cate

d hu

man

res

ourc

es a

nd r

egul

ar b

udge

t fu

ndin

g fo

r em

erge

ncy

prep

ared

ness

mea

sure

s by

pub

lic h

ealth

, ani

mal

hea

lth a

nd o

ther

re

leva

nt s

ecto

rs?

Are

hum

an re

sour

ces

brie

fed

and

trai

ned

in th

eir r

ole

and

resp

onsi

bilit

ies?

i. W

hen

was

the

natio

nal p

lan

deve

lope

d? W

hen

was

the

last

upd

ate?

2.

Doe

s th

e co

untr

y ha

ve m

ultis

ecto

ral m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns?

a. D

oes

the

natio

nal h

ealth

em

erge

ncy

resp

onse

pla

n ha

ve a

mul

tihaz

ard

who

le-o

f-so

ciet

y ap

proa

ch in

volv

ing

all r

elev

ant s

ecto

rs?

Whe

n w

as th

e pl

an

deve

lope

d? W

hen

was

the

plan

last

upd

ated

?b.

Is

the

heal

th s

ecto

r’s e

mer

genc

y re

spon

se p

lan

inte

grat

ed in

the

mul

tisec

tora

l pla

n?c.

Is

the

natio

nal m

ultis

ecto

ral m

ultih

azar

d re

spon

se p

lan

base

d on

str

ateg

ic e

mer

genc

y ris

k as

sess

men

t, ca

paci

ty a

sses

smen

ts a

nd re

sour

ce m

appi

ng?

d. D

oes

the

emer

genc

y re

spon

se p

lan

inco

rpor

ate

IHR-

rele

vant

haz

ards

, inc

ludi

ng th

ose

that

hav

e th

e po

tent

ial t

o ca

use

PHEI

Cs?

Doe

s th

e re

spon

se p

lan

addr

ess

all t

ypes

of e

mer

genc

ies

that

the

coun

try

face

s?

e. H

ave

cont

inge

ncy

plan

s be

en d

evel

oped

for h

igh

prio

rity

risks

/spe

cific

eve

nts?

Are

they

bas

ed o

n st

rate

gic

risk

asse

ssm

ents

and

reso

urce

map

ping

?

5 -

Surg

e ca

paci

ty is

defi

ned

as th

e ab

ility

to in

crea

se (o

r con

serv

e) re

sour

ces

in a

n em

erge

ncy

situ

atio

n. S

urge

cap

acity

is o

ften

dep

loye

d ra

pidl

y w

hen

rout

ine

oper

atin

g ca

paci

ties

are

insu

ffici

ent t

o de

al w

ith th

e in

crea

sed

dem

and

for r

esou

rces

in a

n em

erge

ncy.

Res

ourc

es in

clud

e pe

rson

nel,

equi

pmen

t, su

pplie

s, fi

nanc

es, a

mon

g ot

hers

. A s

urge

pla

n fo

r sca

ling

up re

spon

se o

pera

tions

sho

uld

be in

clud

ed in

the

natio

nal m

ultis

ecto

ral m

ultih

azar

d re

spon

se

plan

s.

RE

SP

ON

D



f. D

oes

the

plan

cle

arly

ass

ign

role

s an

d re

spon

sibi

litie

s fo

r em

erge

ncy

resp

onse

to s

peci

fic g

over

nmen

t uni

ts o

f all

rele

vant

sec

tors

and

poi

nts

of e

ntry

?g.

Doe

s th

e pl

an in

corp

orat

e SO

Ps th

at d

escr

ibe

the

proc

edur

es fo

r act

ivat

ing

and

impl

emen

ting

the

plan

for a

ll ke

y re

spon

se m

anag

emen

t and

tech

nica

l fu

nctio

ns in

rele

vant

sec

tors

(suc

h as

hea

lth, e

mer

genc

y m

anag

emen

t, an

imal

hea

lth, c

hem

ical

s, ra

diat

ion

and

any

mas

s ga

ther

ing

even

ts)?

h. A

re th

ere

emer

genc

y or

con

tinge

ncy

fund

s re

adily

ava

ilabl

e to

sup

port

resp

onse

by

publ

ic h

ealth

, ani

mal

hea

lth a

nd o

ther

rele

vant

sec

tors

?i.

Doe

s th

e pl

an a

naly

se a

vaila

ble

reso

urce

s (s

uch

as h

uman

reso

urce

s, e

quip

men

t, fa

cilit

ies)

in re

latio

n to

the

need

for r

egul

ar o

pera

tion

mod

e, fo

r acu

te

emer

genc

ies,

and

pro

trac

ted

cris

es?

j. Is

a s

urge

pla

n in

clud

ed in

the

natio

nal m

ultis

ecto

ral m

ultih

azar

d re

spon

se p

lans

for s

calin

g up

resp

onse

ope

ratio

ns?

k. W

hat i

s th

e m

echa

nism

to a

ddre

ss re

sour

ce g

aps?

Doe

s th

e pl

an in

clud

e SO

Ps fo

r dep

loym

ent o

f sur

ge c

apac

ity?

l. Is

sur

ge c

apac

ity a

vaila

ble

to re

spon

d to

em

erge

ncie

s, in

clud

ing

publ

ic h

ealth

em

erge

ncie

s of

nat

iona

l and

inte

rnat

iona

l con

cern

? m

. Are

ther

e m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns a

t sub

natio

nal a

nd lo

cal l

evel

s?n.

Doe

s th

e na

tiona

l em

erge

ncy

resp

onse

pla

n de

scrib

e th

e pr

oced

ures

and

pla

ns to

relo

cate

or m

obili

ze re

sour

ces

from

nat

iona

l and

inte

rmed

iate

leve

ls

to s

uppo

rt re

spon

se a

t the

loca

l lev

el?

Wha

t are

thos

e pr

oced

ures

and

pla

ns?

o. D

oes

the

natio

nal e

mer

genc

y re

spon

se p

lan

incl

ude

logi

stic

s? W

hat r

esou

rces

are

ava

ilabl

e fo

r log

istic

s?

p. H

as th

e na

tiona

l res

pons

e pl

an b

een

impl

emen

ted

in a

real

eve

nt o

r tes

ted

in a

sim

ulat

ion

exer

cise

? W

hen

was

the

last

tim

e it

was

use

d? W

as th

e pl

an

upda

ted

as a

resu

lt of

an

afte

r-ac

tion

revi

ew o

r oth

er fo

rm o

f eva

luat

ion?

q. H

ave

subn

atio

nal a

nd lo

cal m

ultih

azar

d em

erge

ncy

resp

onse

pla

ns b

een

impl

emen

ted

in a

real

eve

nt o

r tes

ted

in a

sim

ulat

ion

exer

cise

? W

hen

was

the

last

tim

e th

ese

wer

e us

ed?

Wer

e pl

ans

upda

ted

as a

resu

lt of

an

afte

r-ac

tion

revi

ew o

r oth

er fo

rm o

f eva

luat

ion?

r. H

ave

natio

nal c

ontin

genc

y pl

ans

been

impl

emen

ted

in a

real

eve

nt o

r tes

ted

in a

sim

ulat

ion

exer

cise

? W

hen

was

the

last

tim

e it

was

use

d? W

ere

the

plan

s up

date

d as

a re

sult

of a

n af

ter-

actio

n re

view

or o

ther

form

of e

valu

atio

n?s.

Wha

t are

the

key

findi

ngs

of th

e af

ter-

actio

n re

view

s or

eva

luat

ions

of e

mer

genc

y re

spon

se o

pera

tion

or S

WO

T (s

tren

gths

, wea

knes

ses,

opp

ortu

nitie

s,

thre

ats

anal

ysis

) exe

rcis

e?

Refe

renc

es:

l

Send

ai F

ram

ewor

k in

dica

tors

. Pr

even

tionW

eb [

web

site

] (h

ttp:

//w

ww

.pre

vent

ionw

eb.n

et/d

rr-f

ram

ewor

k/se

ndai

-fra

mew

ork-

mon

itor/

indi

cato

rs,

acce

ssed

27

Dec

embe

r 201

7).

l

The

Send

ai F

ram

ewor

k fo

r D

isas

ter

Risk

Red

uctio

n 20

15–

2030

. Gen

eva:

Uni

ted

Nat

ions

Offi

ce o

f D

isas

ter

Risk

Red

uctio

n; 2

015

(htt

p://

ww

w.u

nisd

r.org

/fil

es/4

3291

_sen

daifr

amew

orkf

ordr

ren.

pdf,

acce

ssed

27

Dec

embe

r 201

7).

l

A st

rate

gic

fram

ewor

k fo

r em

erge

ncy

prep

ared

ness

. G

enev

a:

Wor

ld

Hea

lth

Org

aniz

atio

n;

2017

(h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/

2548

83/1

/978

9241

5118

27-e

ng.p

df?u

a=1,

acc

esse

d 28

Dec

embe

r 201

7).

l

Inte

rage

ncy

Stan

ding

Com

mitt

ee (

IASC

) Em

erge

ncy

Resp

onse

Pre

pare

dnes

s G

uide

lines

Jul

y 20

15 -

add

ress

es R

isk

Anal

ysis

and

Mon

itorin

g M

inim

um

Prep

ared

ness

Act

ions

, Adv

ance

d Pr

epar

edne

ss A

ctio

ns a

nd C

ontin

genc

y Pl

anni

ng (

http

s://

inte

rage

ncys

tand

ingc

omm

ittee

.org

/sys

tem

/file

s/em

erge

ncy_

resp

onse

_pre

pare

dnes

s_20

15_fi

nal.p

df a

cces

sed

30 D

ecem

ber 2

017)

RE

SP

ON

D



EMER

GEN

CY R

ESPO

NSE

OPE

RATI

ON

S Ta

rget

s: C

ount

ries

will

hav

e a

coor

dina

tion

mec

hani

sm, i

ncid

ent

man

agem

ent

syst

ems,

exe

rcis

e m

anag

emen

t pr

ogra

mm

es a

nd p

ublic

hea

lth e

mer

genc

y op

erat

ion

cent

re (E

OC)

func

tioni

ng a

ccor

ding

to m

inim

um c

omm

on s

tand

ards

; mai

ntai

ning

trai

ned,

func

tioni

ng, m

ultis

ecto

ral r

apid

resp

onse

team

s, a

nd tr

aine

d EO

C st

aff c

apab

le o

f act

ivat

ing

a co

ordi

nate

d em

erge

ncy

resp

onse

with

in 1

20 m

inut

es o

f the

iden

tifica

tion

of a

n em

erge

ncy.

As m

easu

red

by: (

1) E

stab

lishm

ent o

f an

emer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm o

r inc

iden

t man

agem

ent s

yste

m. (

2) D

evel

opm

ent o

f nat

iona

l hea

lth E

OC

plan

s an

d pr

oced

ures

. (3)

Em

erge

ncy

resp

onse

sys

tem

s an

d de

cisi

on-m

akin

g ha

ve b

een

test

ed a

nd o

pera

ting

effic

ient

ly a

nd e

ffect

ivel

y.

Desi

red

impa

ct: E

ffect

ive

coor

dina

tion

and

impr

oved

man

agem

ent

of t

he r

espo

nse

to o

utbr

eaks

and

em

erge

ncie

s as

evi

denc

ed b

y sh

orte

r tim

es f

rom

ear

ly

war

ning

and

det

ectio

n to

act

ivat

ion

of re

spon

se p

lans

; im

plem

enta

tion

of a

coo

rdin

ated

mul

tisec

tora

l res

pons

e ac

ross

all

leve

ls; a

nd s

mal

ler n

umbe

rs o

f cas

es,

deat

hs a

nd o

ther

hea

lth a

nd s

ocie

tal i

mpa

cts.

RE

SP

ON

D



Scor

eIn

dica

tors

– E

mer

genc

y re

spon

se o

pera

tions

R.

2.1

Emer

genc

y re

spon

se c

oord

inat

ion1

R.2.

22 Em

erge

ncy

oper

atio

ns c

entr

e (E

OC)

3 ca

paci

ties,

pro

cedu

res

and

plan

sR.

2.3

Emer

genc

y ex

erci

se4 m

anag

emen

t pr

ogra

mm

e5

No

capa

city

- 1

An e

mer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm

is n

ot a

vaila

ble

An E

OC

has

not b

een

iden

tified

and

no

EOC

plan

s/pr

oced

ures

are

in p

lace

No

exer

cise

s ha

ve b

een

com

plet

ed in

the

past

five

ye

ars

Lim

ited

ca

paci

ty -

2

A na

tiona

l hea

lth s

ecto

r em

erge

ncy

resp

onse

ope

-ra

tion

poin

t of c

onta

ct is

ava

ilabl

e 24

/7 b

ut th

ere

is n

o fo

rmal

em

erge

ncy

coor

dina

tion

mec

hani

sm

Nat

iona

l EO

Cs o

r equ

ival

ent s

truc

ture

s ar

e es

ta-

blis

hed

on a

n ad

hoc

bas

is in

resp

onse

to e

mer

-ge

ncie

s

Tabl

e to

p ex

erci

ses

have

bee

n co

mpl

eted

in th

e pa

st fi

ve y

ears

to te

st e

mer

genc

y re

spon

se c

apa-

bilit

ies

and

deci

sion

mak

ing

at th

e na

tiona

l lev

el

Deve

lope

d ca

paci

ty -

3

A he

alth

sec

tor e

mer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sm fo

r em

erge

ncie

s in

clud

ing

PHEI

Cs

(e.g

. em

erge

ncy

resp

onse

com

mitt

ee) i

s in

pla

ce

Nat

iona

l EO

Cs o

r equ

ival

ent s

truc

ture

s ar

e es

ta-

blis

hed

on a

n ad

hoc

bas

is in

resp

onse

to e

mer

-ge

ncie

sEO

Cs a

re n

ot y

et c

apab

le o

f act

ivat

ing

a co

ordi

-na

ted

emer

genc

y re

spon

se w

ithin

120

min

utes

of

rece

ivin

g an

ear

ly w

arni

ng o

r inf

orm

atio

n of

an

emer

genc

y re

quiri

ng E

OC

activ

atio

n

A fu

nctio

nal e

xerc

ise

has

been

com

plet

ed to

test

re

spon

se o

pera

tions

cap

abili

ties

at th

e na

tiona

l le

vel,

or n

atio

nal h

ealth

resp

onse

sys

tem

s ha

ve

been

act

ivat

ed to

resp

ond

to a

maj

or e

mer

genc

y in

th

e pa

st tw

o ye

ars

Dem

onst

rate

d ca

paci

ty -

4

Ther

e ar

e em

erge

ncy

resp

onse

co

ordi

natio

n m

echa

nism

s at

the

subn

atio

nal a

nd lo

cal l

evel

sEm

erge

ncy

resp

onse

coo

rdin

atio

n m

echa

nism

at

the

natio

nal l

evel

has

bee

n te

sted

and

upd

ated

in

the

past

two

year

s

Nat

iona

l EO

Cs c

an b

e ac

tivat

ed w

ithin

120

min

utes

of

rec

eivi

ng a

n ea

rly w

arni

ng o

r in

form

atio

n of

an

emer

genc

y re

quiri

ng E

OC

activ

atio

nEO

C pl

ans,

act

ivat

ion

and

func

tions

at t

he n

atio

nal

leve

l hav

e be

en te

sted

and

upd

ated

in th

e pa

st tw

o ye

ars

EOCs

are

ava

ilabl

e at

the

sub

natio

nal

leve

l w

ith

plan

s an

d SO

Ps, r

esou

rces

and

sta

ff tr

aine

d in

EO

C SO

Ps

A co

mbi

natio

n of

exe

rcis

es is

con

duct

ed a

t le

ast

annu

ally

to

test

em

erge

ncy

resp

onse

cap

abili

ties

at n

atio

nal l

evel

with

the

invo

lvem

ent o

f sub

natio

-na

l lev

els

Sust

aina

ble

capa

city

- 5

Emer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sms

at

all l

evel

s ha

ve b

een

test

ed a

nd u

pdat

ed in

the

past

tw

o ye

ars

EOC

func

tions

at

all

leve

ls h

ave

been

tes

ted

and

upda

ted

regu

larly

EOC

oper

atio

ns c

an b

e su

stai

ned

for l

arge

sca

le o

r co

ncur

rent

em

erge

ncie

s du

e to

a n

etw

ork

of f

ul-

ly f

unct

iona

l em

erge

ncy

oper

atio

ns c

entr

es a

nd

trai

ned

staf

f

A co

mbi

natio

n of

exe

rcis

es a

re c

ondu

cted

at l

east

an

nual

ly t

o te

st e

mer

genc

y re

spon

se c

apab

ilitie

s at

all

leve

lsFo

llow

ing

exer

cise

s, c

orre

ctiv

e ac

tion

plan

s to

up-

date

pla

ns a

nd s

tren

gthe

n ca

paci

ties

wer

e de

ve-

lope

d an

d im

plem

ente

d

1 -

Emer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sms

may

em

ploy

an

inci

dent

man

agem

ent s

yste

m to

fulfi

l the

coo

rdin

atio

n fu

nctio

n.2

- Th

e in

dica

tor r

efer

s to

pub

lic h

ealth

em

erge

ncy

oper

atio

ns a

nd h

ealth

EO

Cs fo

r the

cou

ntry

.

RE

SP

ON

D



Not

e:

Ther

e is

crit

ical

com

pete

ncy

in th

e PV

S to

ol C

C II-

6: E

mer

genc

y re

spon

se.

Cont

extu

al q

uest

ions

:

1.

Dur

ing

an e

mer

genc

y, is

ther

e a

proc

ess

for s

harin

g sc

ient

ific

data

and

reco

mm

enda

tions

with

pol

icy

mak

ers

and

natio

nal l

eade

rs?

2.

Is th

ere

a m

ultis

ecto

ral c

omm

issi

on o

r a m

ultid

isci

plin

ary

emer

genc

y co

ordi

natio

n de

part

men

t or u

nit f

or p

ublic

hea

lth/a

nim

al h

ealth

? a.

If y

es, d

oes

this

incl

ude

secu

rity,

publ

ic h

ealth

, vet

erin

ary,

wild

life

and

othe

r exp

erts

? b.

Has

this

team

rece

ived

pub

lic c

omm

unic

atio

n tr

aini

ng?

c. H

ow o

ften

do

thes

e gr

oups

mee

t to

disc

uss

cros

s-cu

ttin

g is

sues

? 3.

H

ow d

o su

bnat

iona

l (in

term

edia

te a

nd lo

cal)

entit

ies

man

age

emer

genc

y re

spon

se a

ctiv

ities

?a.

Is

ther

e a

role

for p

ublic

hea

lth, o

r is

this

an

emer

genc

y m

anag

emen

t act

ivity

?4.

H

ow d

o lo

calit

ies

man

age

emer

genc

y re

spon

se a

ctiv

ities

? a.

Is

ther

e a

role

for p

ublic

hea

lth o

r do

othe

r ent

ities

(suc

h as

repr

esen

tativ

es fr

om n

atio

nal d

isas

ter m

anag

emen

t boa

rd) m

anag

e it?

5.

Is th

ere

a ho

tline

that

peo

ple/

clin

icia

ns c

an c

all f

or h

elp

on h

andl

ing

a di

seas

e of

unk

now

n or

igin

? a.

Is

ther

e a

com

para

ble

syst

em fo

r ani

mal

dis

ease

sup

port

?

Tech

nica

l que

stio

ns:

R2.1

Em

erge

ncy

resp

onse

coo

rdin

atio

n 1.

D

escr

ibe

scen

ario

s or

trig

gers

for a

ctiv

atio

n of

em

erge

ncy

resp

onse

. Are

ther

e m

ultip

le le

vels

of e

mer

genc

y re

spon

se a

ctiv

atio

n?a.

Who

dec

ides

the

chan

ge o

f lev

el?

b. I

s th

ere

a na

tiona

l poi

nt o

f con

tact

ava

ilabl

e fo

r 24/

7 co

vera

ge o

f em

erge

ncy

oper

atio

ns?

c. I

s th

ere

a na

tiona

l hea

lth s

ecto

r em

erge

ncy

resp

onse

coo

rdin

atio

n m

echa

nism

, com

mitt

ee o

r nat

iona

l hea

lth E

OC?

3 -

EOC

• The

nat

iona

l hea

lth E

OCs

are

net

wor

ked

with

hea

lth E

OCs

at s

ubna

tiona

l and

loca

l lev

els,

and

are

inte

rope

rabl

e w

ith E

OCs

in o

ther

sec

tors

, inc

ludi

ng w

ith th

e N

atio

nal D

isas

ter M

anag

emen

t Offi

ce.

- EO

C pl

ans

and

SOPs

des

crib

e ke

y st

ruct

ural

and

ope

ratio

nal e

lem

ents

; for

ms

and

tem

plat

es fo

r EO

C da

ta m

anag

emen

t, re

port

ing

and

brie

fing;

role

des

crip

tions

and

job

aids

for E

OC

func

tiona

l pos

ition

s (in

clud

ing

inci

dent

m

anag

emen

t or c

omm

and,

ope

ratio

ns, p

lann

ing,

logi

stic

s an

d fin

ance

) and

reso

urce

s in

clud

ing

info

rmat

ion

syst

ems

to c

onne

ct p

ublic

hea

lth d

ecis

ion

mak

ers

to a

ppro

pria

te d

ata

sour

ces;

- co

mm

unic

atio

ns e

quip

men

t; an

d-

staf

f tha

t are

trai

ned

and

capa

ble

of c

oord

inat

ing

an e

mer

genc

y re

spon

se.

• Nat

iona

l hea

lth E

OC

plan

s ar

e in

pla

ce fo

r fun

ctio

ns in

clud

ing

publ

ic h

ealth

sci

ence

(epi

dem

iolo

gy, m

edic

al a

nd o

ther

sub

ject

mat

ter e

xper

tise)

, pub

lic c

omm

unic

atio

ns a

nd p

artn

er li

aiso

n.• T

here

are

add

ition

al tr

aine

d st

aff w

ho c

an s

uppo

rt a

nd re

plac

e re

gula

r EO

C st

aff o

n a

rota

tiona

l bas

is.

4 -

Exer

cise

s sh

ould

tes

t th

e ca

paci

ty o

f th

e em

erge

ncy

oper

atio

ns s

yste

ms

and

staf

f to

coo

rdin

ate

a la

rge

resp

onse

to

affe

ct m

ultip

le c

omm

uniti

es, b

y in

volv

ing

mul

tisec

tora

l coo

rdin

atio

n an

d m

ass

gath

erin

g ev

ents

whe

re

appr

opria

te.

5 -

Func

tiona

l mul

tisec

tora

l exe

rcis

es s

houl

d be

hel

d on

an

annu

al b

asis

exc

ept w

hen

the

coun

try

has

cond

ucte

d m

ajor

em

erge

ncy

resp

onse

ope

ratio

ns w

hich

hav

e te

sted

the

syst

em in

a re

al e

vent

; add

ition

al d

rills

, tab

le to

p ex

erci

ses

and

sim

ulat

ions

can

sup

plem

ent t

he fu

nctio

nal e

xerc

ises

.

RE

SP

ON

D



d. I

s th

ere

a de

dica

ted

coor

dina

tion

mec

hani

sm u

nder

the

natio

nal h

ealth

EO

C fo

r act

ivat

ion

and

coor

dina

tion

of e

mer

genc

y m

edic

al te

ams

(EM

Ts) (

such

as

a E

MT

Coor

dina

tion

Cell)

?e.

Is

ther

e an

inci

dent

man

agem

ent s

yste

m in

the

heal

th s

ecto

r at t

he n

atio

nal l

evel

?f.

Are

ther

e he

alth

sec

tor e

mer

genc

y re

spon

se c

oord

inat

ion

mec

hani

sms,

com

mitt

ees

or h

ealth

EO

Cs a

t sub

natio

nal l

evel

s?g.

Is

ther

e an

inci

dent

man

agem

ent s

yste

m in

the

heal

th s

ecto

r at t

he n

atio

nal l

evel

? An

d at

sub

natio

nal l

evel

s?h.

Des

crib

e ho

w h

ealth

sec

tor s

taff

have

bee

n tr

aine

d on

em

erge

ncy

oper

atio

ns p

roce

dure

s. H

as th

ere

been

any

inci

dent

man

agem

ent s

yste

ms

trai

ning

at

natio

nal o

r sub

natio

nal l

evel

s?i.

How

are

sur

ge s

taff

for

emer

genc

y re

spon

se c

oord

inat

ion

iden

tified

? Is

the

re a

ros

ter

of s

taff?

Is t

rain

ing

avai

labl

e to

sur

ge s

taff

in a

dvan

ce o

f a

resp

onse

? Is

ther

e “ju

st in

tim

e” tr

aini

ng a

vaila

ble?

R.2.

2 Em

erge

ncy

oper

atio

ns c

entr

e (E

OC)

cap

aciti

es, p

roce

dure

s an

d pl

ans

1.

Des

crib

e th

e he

alth

EO

C at

the

natio

nal l

evel

(the

se q

uest

ions

are

to b

e an

swer

ed w

heth

er th

ere

is a

per

man

ent E

OC,

tem

pora

ry E

OC

or v

irtua

l EO

C).

a. I

f the

re is

a d

edic

ated

EO

C (p

hysi

cal),

pro

vide

a fl

oor p

lan

and

desc

riptio

n of

equ

ipm

ent.

b. W

hat i

s th

e to

tal s

taff

capa

city

for t

he E

OC?

Is th

ere

a pl

an in

pla

ce to

acc

omm

odat

e ad

ditio

nal s

taff

if ne

cess

ary?

c. I

s th

ere

a re

liabl

e po

wer

sou

rce

for t

he E

OC?

d. I

s th

ere

a re

liabl

e co

mm

unic

atio

ns s

truc

ture

for t

he E

OC?

Doe

s th

is in

clud

e In

tern

et, e

mai

l and

pho

ne c

apab

ilitie

s?e.

Is

the

orga

niza

tion

able

to

conv

ene

part

icip

ants

fro

m m

inis

trie

s an

d ag

enci

es o

f al

l rel

evan

t se

ctor

s an

d ot

her

natio

nal a

nd m

ultin

atio

nal p

artn

ers

as

appr

opria

te?

2.

Des

crib

e th

e pl

ans

and

SOPs

that

are

in p

lace

for t

he E

OC.

a. A

re th

e pl

ans

and

proc

edur

es b

ased

on

an in

cide

nt m

anag

emen

t sys

tem

? D

o th

ey in

clud

e th

e fo

llow

ing

func

tions

and

reso

urce

s:i.

in

cide

nt c

omm

and,

ii.

oper

atio

ns,

iii.

plan

ning

,iv

. lo

gist

ics,

and

v.

finan

ce?

b. W

hen

ther

e is

a n

atio

nal e

mer

genc

y, w

ho s

erve

s as

the

“inci

dent

man

ager

” for

the

heal

th E

OC?

c. I

s th

ere

a pr

oced

ure

in p

lace

for d

ecis

ion

mak

ing

in th

e EO

C?d.

Doe

s th

e na

tiona

l he

alth

EO

C pl

an i

nclu

de r

oles

for

pub

lic h

ealth

sci

ence

(ep

idem

iolo

gy,

med

ical

and

oth

er s

ubje

ct m

atte

r ex

pert

ise)

, pu

blic

co

mm

unic

atio

ns, p

artn

er li

aiso

n?e.

How

oft

en a

re th

ese

proc

edur

es u

pdat

ed?

Whe

n w

as th

e la

st ti

me

they

wer

e up

date

d?f.

How

are

EO

C re

cord

s an

d pr

oced

ures

mai

ntai

ned

and

dist

ribut

ed?

3.

How

long

afte

r the

rece

ipt o

f an

early

war

ning

or i

nfor

mat

ion

does

it ta

ke fo

r the

act

ivat

ion

of th

e EO

C?

a.

How

man

y tim

es w

as th

e EO

C ac

tivat

ed in

the

past

five

yea

rs?

4.

Are

ther

e su

bnat

iona

l hea

lth E

OCs

with

sta

ff w

ho a

re tr

aine

d in

em

erge

ncy

man

agem

ent a

nd E

OC

SOPs

?

RE

SP

ON

D



5.

How

ofte

n ar

e exe

rcis

es co

nduc

ted

to te

st n

atio

nal E

OC a

ctiv

atio

n an

d ne

twor

king

with

subn

atio

nal a

nd m

ultis

ecto

ral E

OCs?

Whe

n w

as th

e las

t tim

e thi

s hap

pene

d?6.

D

escr

ibe

role

s fo

r sta

ff th

at h

ave

been

iden

tified

for E

OC

func

tions

. Are

ther

e ro

le d

escr

iptio

ns a

nd jo

b ai

ds fo

r nat

iona

l EO

C fu

nctio

nal p

ositi

ons?

7.

Des

crib

e ho

w s

taff

have

bee

n tr

aine

d fo

r the

ir ro

le in

EO

Cs?

a. I

s th

ere

a tr

aini

ng p

rogr

amm

e fo

r EO

C st

aff?

b.

How

are

EO

C su

rge

staf

f ide

ntifi

ed?

Is th

ere

trai

ning

ava

ilabl

e to

EO

C su

rge

staf

f in

adva

nce

of a

resp

onse

? Is

ther

e “ju

st in

tim

e” tr

aini

ng a

vaila

ble?

8.

Doe

s th

e EO

C us

e st

anda

rdiz

ed fo

rms

and

tem

plat

es fo

r dat

a/in

form

atio

n m

anag

emen

t, re

port

ing,

brie

fing,

etc

.?9.

D

escr

ibe

the

avai

labi

lity/

diss

emin

atio

n of

situ

atio

nal a

war

enes

s re

port

s fro

m h

ealth

EO

C fo

r diff

eren

t tar

get g

roup

s.

R.2.

3 Em

erge

ncy

exer

cise

man

agem

ent p

rogr

amm

e1.

D

escr

ibe

heal

th e

mer

genc

y ex

erci

ses

that

hav

e be

en c

ondu

cted

, and

any

act

ivat

ion

of th

e em

erge

ncy

resp

onse

ope

ratio

ns fo

r rea

l eve

nts

in th

e pa

st fi

ve y

ears

.a.

Des

crib

e fu

nctio

nal e

xerc

ises

that

hav

e be

en c

ompl

eted

at n

atio

nal o

r sub

natio

nal l

evel

s in

the

past

two

year

s.b.

Des

crib

e ta

ble

top

exer

cise

s th

at h

ave

been

com

plet

ed a

t nat

iona

l or s

ubna

tiona

l lev

els

in th

e pa

st tw

o ye

ars.

c. D

escr

ibe

any

emer

genc

y re

spon

se a

ctiv

atio

ns a

t the

nat

iona

l lev

el in

the

past

two

year

s.d.

Pro

vide

a s

umm

ary

of a

ny im

prov

emen

t pla

ns, a

fter

-act

ion

repo

rts,

or l

esso

ns le

arne

d do

cum

ents

that

wer

e co

mpl

eted

as

a re

sult

of th

ese

exer

cise

s or

re

al e

mer

genc

y re

spon

se o

pera

tions

. Wha

t act

ion

has

been

take

n to

impl

emen

t the

reco

mm

ende

d ac

tions

?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Plan

s of

the

EOC,

and

list

ing

of a

vaila

ble

equi

pmen

tl

Trai

ning

pla

ns fo

r em

erge

ncy

oper

atio

ns s

taff

l

Exer

cise

pla

n, in

clud

ing

eval

uatio

n an

d co

rrec

tive

actio

n pl

an, i

f ava

ilabl

el

Activ

atio

n pl

an fo

r em

erge

ncy

resp

onse

, suc

h as

rost

er o

f em

erge

ncy

oper

atio

ns s

taff

and

role

Refe

renc

es:

l

Publ

ic H

ealth

Em

erge

ncy

Ope

ratio

ns C

entr

e N

etw

ork

(EO

C-N

ET).

Wor

ld H

ealth

Org

aniz

atio

n [w

ebsi

te]

(htt

p://

ww

w.w

ho.in

t/ih

r/eo

c_ne

t/en

/, ac

cess

ed

29 N

ovem

ber 2

017)

.l

Send

ai F

ram

ewor

k in

dica

tors

. Pre

vent

ionW

eb [w

ebsi

te] (

http

://w

ww

.pre

vent

ionw

eb.n

et/d

rr-f

ram

ewor

k/se

ndai

-fra

mew

ork-

mon

itor/

indi

cato

rs, a

cces

sed

23 D

ecem

ber 2

017)

.l

The

Send

ai F

ram

ewor

k fo

r Dis

aste

r Ris

k Re

duct

ion

2015

–20

30. G

enev

a: U

nite

d N

atio

ns O

ffice

of D

isas

ter R

isk

Redu

ctio

n; 2

015

(htt

p://

ww

w.u

nisd

r.org

/fil

es/4

3291

_sen

daifr

amew

orkf

ordr

ren.

pdf,

acce

ssed

27

Dec

embe

r 201

7).

RE

SP

ON

D



LIN

KIN

G P

UBL

IC H

EALT

H A

ND

SEC

URI

TY A

UTH

ORI

TIES

Ta

rget

: Cou

ntry

con

duct

s a

rapi

d, m

ultis

ecto

ral r

espo

nse1 f

or a

ny e

vent

of s

uspe

cted

or c

onfir

med

del

iber

ate

orig

in, i

nclu

ding

the

capa

city

to li

nk p

ublic

hea

lth

and

law

enf

orce

men

t, an

d to

pro

vide

tim

ely

inte

rnat

iona

l ass

ista

nce.

As m

easu

red

by: E

vide

nce

of a

t lea

st o

ne re

spon

se, i

n th

e pr

evio

us y

ear,

that

effe

ctiv

ely

links

pub

lic h

ealth

and

law

enf

orce

men

t, or

a fo

rmal

exe

rcis

e or

sim

ulat

ion

invo

lvin

g le

ader

ship

from

the

coun

try’

s pu

blic

hea

lth a

nd la

w e

nfor

cem

ent c

omm

uniti

es.

Desi

red

impa

ct: D

evel

opm

ent a

nd im

plem

enta

tion

of a

MoU

or o

ther

sim

ilar f

ram

ewor

k ou

tlini

ng ro

les,

resp

onsi

bilit

ies

and

best

pra

ctic

es fo

r sha

ring

rele

vant

in

form

atio

n be

twee

n an

d am

ong

appr

opria

te h

uman

and

ani

mal

hea

lth, l

aw e

nfor

cem

ent

and

defe

nce

pers

onne

l, an

d va

lidat

ion

of t

he M

oU t

hrou

gh p

erio

dic

exer

cise

s an

d si

mul

atio

ns. C

ount

ries

will

dev

elop

and

impl

emen

t m

odel

sys

tem

s to

con

duct

and

sup

port

join

t ep

idem

iolo

gica

l and

crim

inal

inve

stig

atio

ns t

o 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 del

iber

ate

orig

in in

col

labo

ratio

n w

ith in

divi

dual

Bio

logi

cal a

nd T

oxin

Wea

pons

Co

nven

tion

(BTW

C) o

f Sta

tes

Part

ies,

FAO

, Int

erna

tiona

l Ato

mic

Ene

rgy

Agen

cy (I

AEA)

, Int

erna

tiona

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

Wea

pons

, WH

O a

nd o

ther

rele

vant

regi

onal

and

inte

rnat

iona

l org

aniz

atio

ns a

s ap

prop

riate

. . 1

- M

ultis

ecto

ral c

olla

bora

tion

is k

ey t

o en

gagi

ng in

an

effe

ctiv

e pu

blic

hea

lth e

mer

genc

y re

spon

se. S

ecur

ity a

utho

ritie

s m

ay in

clud

e la

w e

nfor

cem

ent,

bord

er c

ontr

ol o

ffice

rs, d

efen

ce a

nd/o

r cu

stom

s en

forc

emen

t. Ef

fect

ive

mul

tisec

tora

l col

labo

ratio

n sh

ould

als

o in

clud

e fo

od s

afet

y in

spec

tors

, as

wel

l as

anim

al h

ealth

, rad

iolo

gica

l saf

ety

and

chem

ical

saf

ety

auth

oriti

es.

RE

SP

ON

D



Scor

eIn

dica

tor:

Link

ing

publ

ic h

ealth

and

sec

urity

aut

horit

ies

R.3.

1 Pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s (e

.g. l

aw 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

radi

olog

ical

eve

nt

No

capa

city

- 1

No

legi

slat

ion,

rela

tions

hips

, pro

toco

ls, M

oUs

or o

ther

agr

eem

ents

exi

st b

etw

een

publ

ic h

ealth

, ani

mal

hea

lth, r

adio

logi

cal s

afet

y, ch

emic

al s

afet

y an

d se

curit

y au

thor

ities

to a

ddre

ss a

ll ha

zard

sLi

mite

d

capa

city

- 2

Poin

ts o

f con

tact

and

trig

gers

for

notifi

catio

n an

d in

form

atio

n sh

arin

g ha

ve b

een

iden

tified

and

sha

red

betw

een

publ

ic h

ealth

, ani

mal

hea

lth, r

adio

logi

cal

safe

ty, c

hem

ical

saf

ety

and

secu

rity

auth

oriti

es to

add

ress

all

haza

rds

Deve

lope

d ca

paci

ty -

3M

oU o

r oth

er a

gree

men

t/pr

otoc

ol, t

hat i

nclu

des

at le

ast r

oles

, res

pons

ibili

ties,

SO

Ps a

nd in

form

atio

n to

be

shar

ed, e

xist

s be

twee

n pu

blic

hea

lth a

nd s

ecur

ity

auth

oriti

es w

ithin

the

coun

try

and

has

been

form

ally

acc

epte

d to

add

ress

all

haza

rds

Dem

onst

rate

d ca

paci

ty -

4

At le

ast o

ne p

ublic

hea

lth e

mer

genc

y re

spon

se o

r exe

rcis

e in

the

prev

ious

yea

r tha

t inc

lude

d in

form

atio

n sh

arin

g w

ith s

ecur

ity a

utho

ritie

s us

ing

the

form

al

MoU

or o

ther

agr

eem

ent/

prot

ocol

rela

ted

to a

ll ha

zard

sPu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s en

gage

in a

join

t tra

inin

g pr

ogra

mm

e to

orie

nt, e

xerc

ise

and

inst

itutio

naliz

e kn

owle

dge

of M

oU o

r oth

er a

gree

men

ts

rela

ted

to a

ll ha

zard

s

Sust

aina

ble

capa

city

– 5

Publ

ic h

ealth

and

sec

urity

aut

horit

ies

exch

ange

repo

rts

and

info

rmat

ion

on e

vent

s of

join

t con

cern

at n

atio

nal, i

nter

med

iate

and

loca

l lev

els

on a

regu

lar b

asis

us

ing

the

form

al M

oU o

r oth

er a

gree

men

t/pr

otoc

olPu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s en

gage

in a

join

t tra

inin

g pr

ogra

mm

e to

orie

nt, e

xerc

ise

and

inst

itutio

naliz

e kn

owle

dge

of th

e M

oU o

r oth

er a

gree

men

t re

late

d to

all

haza

rds

Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

R.3.

1 Pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s (e

.g. l

aw e

nfor

cem

ent,

bord

er c

ontr

ol, c

usto

ms)

link

ed d

urin

g a

susp

ect o

r con

firm

ed b

iolo

gica

l, ch

emic

al o

r ra

diol

ogic

al e

vent

1.

Is th

ere

a M

oU o

r oth

er a

gree

men

t bet

wee

n pu

blic

hea

lth a

nd s

ecur

ity a

utho

rity

entit

ies

at th

e na

tiona

l lev

el?

a. I

f yes

, whi

ch s

ecur

ity a

utho

rity

orga

niza

tions

are

cov

ered

by

a M

oU o

r oth

er a

gree

men

t – la

w e

nfor

cem

ent,

bord

er c

ontr

ol, c

usto

ms

enfo

rcem

ent,

food

sa

fety

insp

ectio

n, ra

diol

ogic

al s

afet

y an

d ch

emic

al s

afet

y?b.

If n

ot, i

s th

ere

a M

oU o

r oth

er a

gree

men

t bet

wee

n pu

blic

hea

lth a

nd a

noth

er s

ecto

r (s

uch

as a

gric

ultu

re, d

efen

ce, f

orei

gn a

ffairs

) tha

t cou

ld b

e us

ed

as a

sam

ple

agre

emen

t to

prom

ote

info

rmat

ion

shar

ing

and

colla

bora

tion

durin

g em

erge

ncy

even

ts?

Are

ther

e ag

reem

ents

bet

wee

n pu

blic

hea

lth a

nd

secu

rity

auth

oriti

es a

t any

inte

rmed

iate

and

/or l

ocal

leve

ls?

2.

Hav

e tr

aini

ngs

been

con

duct

ed jo

intly

(at a

n in

term

edia

te le

vel (

regi

onal

) or n

atio

nal l

evel

) inc

ludi

ng fo

r bot

h pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s on

topi

cs

rela

ted

to in

form

atio

n sh

arin

g an

d jo

int i

nves

tigat

ions

/res

pons

es?

3.

Are

ther

e SO

Ps o

r agr

eem

ents

in p

lace

for c

oord

inat

ion

of a

join

t res

pons

e to

pub

lic h

ealth

and

oth

er e

mer

genc

ies

at o

ffici

al lo

catio

ns, s

uch

as p

oint

s of

ent

ry

whe

re b

oth

publ

ic h

ealth

and

sec

urity

aut

horit

ies

have

ope

ratio

nal s

afet

y an

d he

alth

sec

urity

resp

onsi

bilit

ies?

4.

Are

ther

e SO

Ps o

r agr

eem

ents

in p

lace

for a

join

t/sh

ared

risk

ass

essm

ent d

urin

g ev

ents

of p

ublic

hea

lth a

nd s

ecur

ity s

igni

fican

ce?

RE

SP

ON

D



5.

Is th

ere

legi

slat

ion

in p

lace

that

allo

ws

the

gove

rnm

ent t

o de

tain

/qua

rant

ine

an in

divi

dual

who

pre

sent

s a

publ

ic h

ealth

risk

?6.

H

ow a

re p

oten

tial b

iolo

gica

l, ch

emic

al a

nd ra

diol

ogic

al e

vent

s th

at m

ay h

ave

delib

erat

e m

otiv

es id

entifi

ed in

the

coun

try?

Pro

vide

any

pla

ns th

at h

ave

been

dr

afte

d th

at c

over

resp

onse

to p

ossi

ble

biol

ogic

al, c

hem

ical

and

radi

olog

ical

eve

nts.

7.

Is th

ere

a fu

nctio

nal m

echa

nism

for c

olla

bora

tion

and

timel

y an

d sy

stem

atic

info

rmat

ion

exch

ange

bet

wee

n pu

blic

hea

lth a

nd la

w e

nfor

cem

ent a

genc

ies

in

case

of d

elib

erat

e an

d/or

acc

iden

tal e

vent

s?8.

Ar

e pu

blic

hea

lth e

xper

ts in

volv

ed in

em

erge

ncy

resp

onse

link

ed to

the

BTW

C? H

as th

e co

untr

y pa

rtic

ipat

ed in

an

exer

cise

, sim

ulat

ion

or re

spon

se in

the

past

ye

ar th

at in

volv

es le

ader

ship

from

bot

h pu

blic

hea

lth a

nd s

ecur

ity a

utho

ritie

s? If

yes

, des

crib

e th

e ex

erci

se, s

imul

atio

n or

resp

onse

.a.

Des

crib

e an

y co

rrec

tive

actio

ns th

at w

ere

reco

mm

ende

d on

how

the

publ

ic h

ealth

org

aniz

atio

n sh

ould

coo

rdin

ate

with

sec

urity

aut

horit

ies.

9.

Ar

e re

port

s re

gula

rly s

hare

d be

twee

n pu

blic

hea

lth a

nd a

ny s

ecur

ity a

utho

ritie

s w

ithin

the

cou

ntry

? Is

the

re a

mec

hani

sm in

pla

ce t

o en

cour

age

regu

lar

repo

rtin

g?a.

Wha

t typ

es o

f rep

orts

are

sha

red

from

pub

lic h

ealth

ent

ities

to s

ecur

ity a

utho

ritie

s re

gula

rly?

b. W

hat t

ypes

of r

epor

ts a

re s

hare

d fr

om s

ecur

ity a

utho

ritie

s to

the

publ

ic h

ealth

sys

tem

regu

larly

?c.

How

oft

en a

re th

e in

form

atio

nal r

epor

ts s

hare

d?10

. Is

ther

e a

coun

try-

spec

ific

join

t inv

estig

atio

ns c

urric

ulum

in p

lace

to tr

ain

publ

ic h

ealth

and

law

enf

orce

men

t ent

ities

on

join

t inv

estig

atio

ns?

11.

Des

crib

e ho

w th

e na

tiona

l gov

ernm

ent i

s co

nnec

ted

to IN

TERP

OL.

Wha

t min

istr

y is

cha

rged

with

inte

ract

ing

with

INTE

RPO

L?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

SOPs

or e

mer

genc

y re

spon

se p

lans

that

wou

ld in

clud

e se

curit

y au

thor

ities

l

Info

rmat

iona

l rep

orts

that

are

regu

larly

sha

red

with

sec

urity

aut

horit

ies

Refe

renc

es:

l

WH

O–

OIE

ope

ratio

nal f

ram

ewor

k fo

r go

od g

over

nanc

e at

the

hum

an¬–

anim

al in

terf

ace:

Brid

ging

WH

O a

nd O

IE t

ools

for

the

ass

essm

ent

of n

atio

nal

capa

citie

s. W

HO

and

OIE

; 201

4 (h

ttp:

//w

ww

.oie

.int/

filea

dmin

/Hom

e/fr

/Med

ia_C

ente

r/do

cs/p

df/W

HO

_OIE

_Ope

ratio

nal_

Fram

ewor

k_Fi

nal2

.pdf

acc

esse

d 29

N

ovem

ber 2

017)

.l

Terr

estr

ial

anim

al

heal

th

code

. Ch

apte

r 3.

4 Ve

terin

ary

legi

slat

ion.

W

orld

O

rgan

isat

ion

for

Anim

al

Hea

lth;

2016

(h

ttp:

//w

ww

.oie

.int/

inde

x.ph

p?id

=169

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file=

chap

itre_

vet_

legi

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esse

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Nov

embe

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l

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: O

rgan

isat

ion

for t

he P

rohi

bitio

n of

Che

mic

al W

eapo

ns (h

ttps

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ww

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lead

min

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CWC_

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cces

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ovem

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Trea

ty o

n th

e no

n-pr

olife

ratio

n of

nuc

lear

wea

pons

. Int

erna

tiona

l Ato

mic

Ene

rgy

Agen

cy [i

nfor

mat

ion

circ

ular

] IN

FCIR

C/14

0, 2

2 Ap

ril 1

970

(htt

ps:/

/ww

w.

iaea

.org

/site

s/de

faul

t/fil

es/p

ublic

atio

ns/d

ocum

ents

/inf

circ

s/19

70/i

nfci

rc14

0.pd

f, ac

cess

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9 N

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.

RE

SP

ON

D



MED

ICAL

CO

UN

TERM

EASU

RES

AND

PER

SON

NEL

DEP

LOYM

ENT

Targ

et: :

Nat

iona

l fra

mew

ork

for:

tran

sfer

ring

(sen

ding

and

rec

eivi

ng)

med

ical

cou

nter

mea

sure

s, a

nd p

ublic

hea

lth a

nd m

edic

al p

erso

nnel

fro

m in

tern

atio

nal

part

ners

dur

ing

publ

ic h

ealth

em

erge

ncie

s; a

nd p

roce

dure

s fo

r cas

e m

anag

emen

t of e

vent

s du

e to

IHR

rele

vant

haz

ards

.

As m

easu

red

by: (

1) E

vide

nce

of a

t lea

st o

ne re

spon

se to

a p

ublic

hea

lth e

mer

genc

y w

ithin

the

prev

ious

yea

r tha

t dem

onst

rate

s th

at th

e co

untr

y se

nt o

r rec

eive

d m

edic

al c

ount

erm

easu

res

and

pers

onne

l acc

ordi

ng t

o w

ritte

n na

tiona

l or

inte

rnat

iona

l pro

toco

ls, o

r a

form

al e

xerc

ise

or s

imul

atio

n th

at d

emon

stra

tes

thes

e m

easu

res.

(2) E

vide

nce

of d

emon

stra

ting

appl

icat

ion

of c

ase

man

agem

ent p

roce

dure

s fo

r eve

nts

due

to IH

R re

leva

nt h

azar

ds.

Desi

red

impa

ct:

Coun

trie

s w

ill h

ave

the

nece

ssar

y le

gal

and

regu

lato

ry p

roce

sses

and

log

istic

al p

lans

to

allo

w f

or r

apid

nat

iona

l or

cro

ss-b

orde

r de

ploy

men

t an

d re

ceip

t of

pu

blic

he

alth

an

d m

edic

al

pers

onne

l du

ring

emer

genc

ies.

Re

gion

al

(inte

rnat

iona

l) co

llabo

ratio

n w

ill

assi

st

coun

trie

s in

ove

rcom

ing

the

lega

l, lo

gist

ical

and

reg

ulat

ory

chal

leng

es t

o de

ploy

men

t of

pub

lic h

ealth

and

med

ical

per

sonn

el f

rom

one

cou

ntry

to

anot

her.

Coun

try

has

deve

lope

d ca

se m

anag

emen

t pr

oced

ures

and

im

plem

ente

d ac

ross

the

sys

tem

dur

ing

heal

th e

mer

genc

ies

due

to I

HR

rele

vant

haz

ards

..

RE

SP

ON

D



Scor

e

Indi

cato

rs: M

edic

al c

ount

erm

easu

res

and

pers

onne

l dep

loym

ent

R.4.

1 Sy

stem

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 pu

blic

hea

lth e

mer

genc

y1

R.4.

2 Sy

stem

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

heal

th e

mer

genc

y

R.4.

3 Ca

se m

anag

emen

t pro

cedu

res

impl

emen

ted

for I

HR

rele

vant

haz

ards

No

capa

city

- 1

No

natio

nal

coun

term

easu

res

plan

ha

s be

en

draf

ted

No

natio

nal p

erso

nnel

dep

loym

ent

plan

has

bee

n dr

afte

dN

o ca

se m

anag

emen

t gu

idel

ines

are

ava

ilabl

e fo

r pr

iorit

y ep

idem

ic-p

rone

dis

ease

s2

Lim

ited

ca

paci

ty -

2

Plan

s th

at

outli

ne

a sy

stem

fo

r se

ndin

g an

d re

ceiv

ing

med

ical

cou

nter

mea

sure

s du

ring

publ

ic

heal

th e

mer

genc

ies

have

bee

n dr

afte

d

Plan

s tha

t out

line a

syst

em fo

r sen

ding

and

rece

ivin

g he

alth

per

sonn

el d

urin

g pu

blic

hea

lth e

mer

genc

ies

have

bee

n dr

afte

d, i

nclu

ding

the

dev

elop

men

t of

pl

ans

for E

MTs

3 for

nat

iona

l res

pons

e

Case

m

anag

emen

t gu

idel

ines

ar

e av

aila

ble

for

prio

rity

epid

emic

-pro

ne d

isea

ses

Deve

lope

d ca

paci

ty -

3

Tabl

e to

p ex

erci

se(s

) ha

s be

en

cond

ucte

d to

de

mon

stra

te

send

ing

or

rece

ivin

g of

m

edic

al

coun

term

easu

res

durin

g a

publ

ic h

ealth

em

erge

ncy

Tabl

e to

p ex

erci

se(s

) ha

s be

en

cond

ucte

d to

de

mon

stra

te d

ecis

ion

mak

ing

and

prot

ocol

s fo

r se

ndin

g or

rece

ivin

g he

alth

per

sonn

el fr

om a

noth

er

coun

try

durin

g a

publ

ic h

ealth

em

erge

ncy,

and

trai

ning

and

equ

ipm

ent

is a

vaila

ble

for

natio

nal

EMTs

Case

man

agem

ent g

uide

lines

for o

ther

IHR

rele

vant

ha

zard

s4 are

ava

ilabl

e at

app

licab

le h

ealth

sys

tem

le

vels

and

SO

Ps a

re a

vaila

ble

for t

he m

anag

emen

t an

d tr

ansp

ort

of p

oten

tially

infe

ctio

us p

atie

nts

in

the

com

mun

ity a

nd a

t poi

nts

of e

ntry

5

Dem

onst

rate

d ca

paci

ty -

4

At le

ast

one

resp

onse

or

form

al e

xerc

ise

or s

imu-

latio

n w

ithin

the

pre

viou

s ye

ar i

n w

hich

med

ical

co

unte

rmea

sure

s w

ere

sent

or

rece

ived

by

the

coun

try

At l

east

one

res

pons

e or

for

mal

exe

rcis

e or

si-

mul

atio

n w

ithin

the

pre

viou

s ye

ar in

whi

ch h

ealth

pe

rson

nel

wer

e se

nt o

r re

ceiv

ed b

y th

e co

untr

y.

Evid

ence

of d

eplo

yabl

e EM

T ca

paci

ty/c

apab

ility

for

natio

nal r

espo

nse

Case

man

agem

ent,

patie

nt re

ferr

al a

nd tr

ansp

orta

-tio

n, a

nd m

anag

emen

t and

tran

spor

t of p

oten

tially

in

fect

ious

pat

ient

s ar

e im

plem

ente

d ac

cord

ing

to

guid

elin

es a

nd/o

r SO

Ps

Sust

aina

ble

capa

city

- 5

Coun

try

part

icip

ates

in

a

regi

onal

/int

erna

tiona

l pa

rtne

rshi

p or

has

form

al a

gree

men

t with

ano

ther

co

untr

y or

inte

rnat

iona

l org

aniz

atio

n th

at o

utlin

es

crite

ria a

nd p

roce

dure

s fo

r se

ndin

g an

d re

ceiv

ing

med

ical

cou

nter

mea

sure

s an

d ha

s pa

rtic

ipat

ed

in a

n ex

erci

se o

r re

spon

se w

ithin

the

pas

t ye

ar t

o pr

actic

e de

ploy

men

t or r

ecei

pt o

f med

ical

cou

nter

-m

easu

res

Coun

try

part

icip

ates

in

a

regi

onal

/int

erna

tiona

l pa

rtne

rshi

p or

has

form

al a

gree

men

t with

ano

ther

co

untr

y or

inte

rnat

iona

l org

aniz

atio

n th

at o

utlin

es

crite

ria a

nd p

roce

dure

s fo

r se

ndin

g an

d re

ceiv

ing

heal

th p

erso

nnel

and

has

par

ticip

ated

in a

n ex

er-

cise

or

resp

onse

with

in t

he p

ast

year

to

prac

tice

depl

oym

ent o

r rec

eipt

of h

ealth

per

sonn

el. C

ount

ry

has

an in

tern

atio

nally

dep

loya

ble

EMT

as c

lass

ified

by

WH

O o

r is

in th

e pr

oces

s of

men

tors

hip

by W

HO

In a

dditi

on t

o de

mon

stra

ted

capa

city

, app

ropr

iate

st

aff a

nd re

sour

ces

(as

defin

ed b

y th

e co

untr

y) a

re

in p

lace

in th

e m

anag

emen

t of I

HR

rele

vant

em

er-

genc

ies

1 -

If th

e co

untr

y ha

s a

stoc

kpile

of m

edic

al c

ount

erm

easu

res,

it w

ill n

ot b

e as

ked

to p

rovi

de a

list

or f

orm

ular

y.2

- Fo

r the

ani

mal

hea

lth s

ecto

r, th

is in

form

atio

n ca

n be

foun

d in

the

coun

try

PVS

Path

way

mis

sion

repo

rt, u

nder

Crit

ical

Com

pete

ncy

CC II

-6: E

mer

genc

y re

spon

se3

- EM

Ts c

onsi

st o

f hea

lth p

rofe

ssio

nals

pro

vidi

ng d

irect

clin

ical

car

e to

pop

ulat

ions

affe

cted

by

outb

reak

s, d

isas

ters

and

em

erge

ncie

s as

a s

urge

cap

acity

to s

uppo

rt th

e lo

cal h

ealth

sys

tem

. The

y co

uld

be c

ivili

an o

r mili

tary

or

nong

over

nmen

tal t

eam

s an

d in

clud

e bo

th n

atio

nal a

nd in

tern

atio

nal p

erso

nnel

.4

- N

ucle

ar, c

hem

ical

, zoo

notic

, foo

d sa

fety

, tra

uma,

exa

cerb

atio

n of

non

com

mun

icab

le d

isea

ses

and

men

tal h

ealth

con

ditio

ns.

5 -

As s

peci

fied

in A

rtic

le 5

7, 2

(d) I

HR

(200

5).

RE

SP

ON

D



Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

R.4.

1 Sy

stem

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

1.

Doe

s th

e co

untr

y ha

ve a

pla

n in

pla

ce th

at id

entifi

es p

roce

dure

s an

d de

cisi

on-m

akin

g re

late

d to

sen

ding

and

rece

ivin

g m

edic

al c

ount

erm

easu

res

durin

g a

publ

ic h

ealth

em

erge

ncy?

a. D

oes

the

plan

add

ress

regu

lato

ry c

once

rns

of re

ques

ting/

acce

ptin

g an

d re

ceiv

ing

drug

s or

dev

ices

from

an

inte

rnat

iona

l sou

rce?

b. D

oes

the

plan

add

ress

logi

stic

con

cern

s re

late

d to

sen

ding

, rec

eivi

ng a

nd d

istr

ibut

ing

med

ical

cou

nter

mea

sure

s du

ring

a pu

blic

hea

lth e

mer

genc

y?c.

Doe

s th

e pl

an a

ddre

ss s

ecur

ity c

once

rns

that

may

em

erge

rela

ted

to s

endi

ng/r

ecei

ving

/dis

trib

utin

g m

edic

al c

ount

erm

easu

res

durin

g a

shor

tage

?2.

H

as th

e co

untr

y ex

erci

sed

plan

s fo

r sen

ding

or r

ecei

ving

med

ical

cou

nter

mea

sure

s w

ithin

the

past

yea

r?a.

If y

es, d

escr

ibe

the

exer

cise

and

spe

cific

out

com

es.

3.

Doe

s th

e co

untr

y ha

ve a

sto

ckpi

le o

f med

ical

cou

nter

mea

sure

s fo

r nat

iona

l use

dur

ing

a pu

blic

hea

lth e

mer

genc

y?a.

Doe

s th

e co

untr

y ha

ve c

apac

ity to

pro

duce

ant

ibio

tics,

vac

cine

s, la

bora

tory

sup

plie

s/eq

uipm

ent o

r oth

ers?

b. D

oes

this

incl

ude

coun

term

easu

res

for u

se in

oth

er s

ecto

rs (e

.g. p

erso

nal p

rote

ctiv

e eq

uipm

ent f

or a

nim

al c

ullin

g)?

c. I

f the

cou

ntry

has

a s

tock

pile

for d

rugs

and

equ

ipm

ent,

spec

ify fo

r how

long

this

may

last

and

for h

ow m

any

patie

nts.

d.

Is

annu

al b

udge

t ava

ilabl

e fo

r sto

ckpi

ling?

4.

Doe

s th

e co

untr

y ha

ve a

gree

men

ts in

pla

ce w

ith m

anuf

actu

rers

or d

istr

ibut

ors

to p

rocu

re m

edic

al c

ount

erm

easu

res

durin

g a

publ

ic h

ealth

em

erge

ncy?

If y

es,

desc

ribe.

5.

Is th

e co

untr

y pa

rt o

f any

regi

onal

/inte

rnat

iona

l cou

nter

mea

sure

pro

cure

men

t agr

eem

ents

? If

yes,

des

crib

e.6.

Is

the

coun

try

part

of a

ny re

gion

al/in

tern

atio

nal c

ount

erm

easu

re s

harin

g ag

reem

ents

? If

yes,

des

crib

e.7.

Is

the

coun

try

part

of a

ny re

gion

al/in

tern

atio

nal c

ount

erm

easu

re d

istr

ibut

ing

agre

emen

ts?

If ye

s, d

escr

ibe.

8.

Are

ther

e de

dica

ted

reso

urce

s/st

affin

g id

entifi

ed fo

r log

istic

s re

late

d to

del

iver

y an

d re

ceip

t of c

ount

erm

easu

res?

9.

Are

ther

e de

dica

ted

reso

urce

s/st

affin

g id

entifi

ed fo

r tra

ckin

g an

d di

strib

utio

n of

cou

nter

mea

sure

s?10

. D

oes

the

coun

try

have

a p

ande

mic

pre

pare

dnes

s pl

an th

at a

ddre

sses

cou

nter

mea

sure

s? If

yes

, des

crib

e.11

. D

oes

the

coun

try

have

a p

lan,

pro

cedu

re o

r leg

al p

rovi

sion

in p

lace

for p

rocu

ring

anim

al c

ount

erm

easu

res?

If y

es, d

escr

ibe.

12.

Doe

s th

e co

untr

y ha

ve a

pla

n, p

roce

dure

or l

egal

pro

visi

on in

pla

ce fo

r dis

trib

utin

g an

imal

cou

nter

mea

sure

s? If

yes

, des

crib

e.

R.4.

2 Sy

stem

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

1.

Doe

s th

e co

untr

y ha

ve a

pla

n in

pla

ce th

at id

entifi

es p

roce

dure

s an

d de

cisi

on-m

akin

g re

late

d to

sen

ding

and

rece

ivin

g he

alth

per

sonn

el d

urin

g a

publ

ic h

ealth

em

erge

ncy?

a. D

oes

the

plan

add

ress

regu

lato

ry a

nd li

cens

ure

conc

erns

of r

eque

stin

g/ac

cept

ing

and

rece

ivin

g he

alth

per

sonn

el fr

om a

n in

tern

atio

nal s

ourc

e?

b. D

oes

the

plan

iden

tify

trai

ning

crit

eria

and

sta

ndar

ds fo

r hea

lth p

erso

nnel

who

will

be

sent

or r

ecei

ved

durin

g a

publ

ic h

ealth

em

erge

ncy?

RE

SP

ON

D



c. D

oes

the

plan

add

ress

liab

ility

con

cern

s fo

r usi

ng m

edic

al p

erso

nnel

dur

ing

an in

tern

atio

nal d

eplo

ymen

t?d.

Doe

s th

e pl

an a

ddre

ss s

afet

y co

ncer

ns fo

r hea

lth p

erso

nnel

dur

ing

a na

tiona

l or i

nter

natio

nal d

eplo

ymen

t?e.

Doe

s th

e pl

an a

ddre

ss fi

nanc

ial c

once

rns

for h

ealth

per

sonn

el d

urin

g a

natio

nal o

r int

erna

tiona

l dep

loym

ent?

f. Ar

e ot

her s

ecto

rs (i

.e. s

ecur

ity a

utho

ritie

s, a

nim

al h

ealth

) inc

lude

d in

pla

ns fo

r sen

ding

/rec

eivi

ng p

erso

nnel

dur

ing

an e

mer

genc

y?2.

D

o pl

ans

for s

urge

sta

ffing

for p

ublic

hea

lth e

mer

genc

y re

spon

se a

ctiv

atio

ns in

clud

e tr

igge

rs fo

r req

uest

ing

pers

onne

l fro

m o

ther

cou

ntrie

s?a.

Hav

e tr

aini

ng p

roce

dure

s an

d m

ater

ials

bee

n de

velo

ped

to o

rient

arr

ivin

g pe

rson

nel i

nto

the

orga

niza

tion?

3.

Doe

s th

e sy

stem

incl

ude

othe

r sec

tors

(che

mic

als,

radi

atio

n, a

nim

al h

ealth

) or d

o se

para

te s

yste

ms

exis

t?

4.

Has

the

coun

try

exer

cise

d pl

ans

for s

endi

ng o

r rec

eivi

ng h

ealth

per

sonn

el w

ithin

the

past

yea

r?a.

If

yes,

des

crib

e th

e ex

erci

se a

nd s

peci

fic o

utco

mes

.5.

Is

the

coun

try

part

of a

ny re

gion

al/in

tern

atio

nal p

erso

nnel

dep

loym

ent a

gree

men

ts, s

uch

as W

HO

Glo

bal O

utbr

eak

Aler

t and

Res

pons

e N

etw

ork

(GOA

RN)?

If

yes,

des

crib

e.a.

Are

pol

icie

s an

d re

sour

ces

in p

lace

to e

nsur

e th

at te

chni

cal i

nstit

utio

ns a

nd n

etw

orks

are

abl

e to

be

activ

e pa

rtne

rs in

the

GO

ARN

? If

yes,

des

crib

e.b.

Doe

s th

e co

untr

y ha

ve a

pan

dem

ic p

repa

redn

ess

plan

or o

ther

em

erge

ncy

prep

ared

ness

pla

n th

at a

ddre

sses

per

sonn

el d

eplo

ymen

ts?

If ye

s, d

escr

ibe.

6.

Doe

s th

e co

untr

y pa

rtic

ipat

e ac

tivel

y in

the

EMT

initi

ativ

e an

d us

e th

e EM

T gu

idin

g pr

inci

ples

and

min

imum

sta

ndar

ds?

a. H

as th

e co

untr

y de

sign

ated

EM

T fo

cal p

oint

s at

pol

icy

and

oper

atio

nal l

evel

s?

b. H

as th

e co

untr

y pa

rtic

ipat

ed in

EM

T tr

aini

ng e

vent

s or

regi

onal

/glo

bal m

eetin

gs?

c. H

as th

e co

untr

y ta

ken

on a

n ac

tive

role

in th

e EM

T in

itiat

ive

at re

gion

al o

r glo

bal l

evel

, i.e

. has

it ta

ken

on th

e ro

le o

f Reg

iona

l Cha

ir or

Vic

e-ch

air?

Has

it

offe

red

mem

bers

for E

MT

tech

nica

l wor

king

gro

ups?

Doe

s th

e co

untr

y pr

ovid

e ex

pert

s to

the

EMT

men

tors

hip

pool

? d.

Doe

s th

e co

untr

y ha

ve a

WH

O c

lass

ified

EM

T fo

r int

erna

tiona

l dep

loym

ent?

e. D

oes

the

coun

try

have

a q

ualit

y as

sura

nce

or a

ccre

dita

tion

syst

em in

pla

ce fo

r nat

iona

lly d

eplo

yabl

e EM

Ts?

R.4.

3 Ca

se m

anag

emen

t pro

cedu

res

impl

emen

ted

for I

HR

rele

vant

haz

ards

1.

Avai

labi

lity

of c

ase

man

agem

ent g

uide

lines

for p

riorit

y di

seas

es a

nd IH

R re

leva

nt h

azar

ds a

t all

heal

th s

yste

m le

vels

.2.

Av

aila

bilit

y of

SO

Ps (a

ccor

ding

to n

atio

nal o

r int

erna

tiona

l gui

delin

es) f

or th

e m

anag

emen

t and

tran

spor

t of p

oten

tially

infe

ctio

us p

atie

nts

at th

e lo

cal l

evel

and

po

ints

of e

ntry

.3.

Av

aila

bilit

y of

pat

ient

refe

rral

and

tran

spor

tatio

n m

echa

nism

with

ade

quat

e re

sour

ces

(des

igna

ted

ambu

lanc

es, h

ospi

tals

and

SO

Ps).

4.

Avai

labi

lity

of a

ppro

pria

te s

taff

trai

ned

in c

ase

man

agem

ent o

f IH

R-re

leva

nt e

mer

genc

ies,

incl

udin

g bu

t not

lim

ited

to th

e ab

ility

to re

cogn

ize,

trea

t and

refe

r in

fect

ious

dis

ease

s, tr

aum

a ca

ses,

exa

cerb

atio

n of

non

com

mun

icab

le d

isea

ses

and

othe

rs.

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

l

Coun

term

easu

res

depl

oym

ent p

lan

l

Pers

onne

l dep

loym

ent p

lan

l

Pand

emic

pre

pare

dnes

s pl

an (i

f app

licab

le)

RE

SP

ON

D



Refe

renc

es:

l

Clas

sific

atio

n an

d m

inim

um s

tand

ards

for f

orei

gn (e

mer

genc

y) m

edic

al te

ams

in s

udde

n on

set d

isas

ters

. Gen

eva:

Wor

ld H

ealth

Org

aniz

atio

n; 2

013

(http

://w

ww

.who

.int/

hac/

glob

al_h

ealth

_clu

ster

/fm

t_gu

idel

ines

_sep

tem

ber2

013.

pdf,

acce

ssed

1 D

ecem

ber 2

017)

.l

Man

agem

ent o

f lim

b in

jurie

s du

ring

disa

ster

s an

d co

nflic

ts. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

201

7 (h

ttps:

//ex

tran

et.w

ho.in

t/em

t/si

tes/

defa

ult/

files

/_A%

20Fi

eld%

20G

uide

_7.8

%20

MB.

pdf,

acce

ssed

27

Dec

embe

r 201

7).

l

Emer

genc

y m

edic

al te

ams.

Wor

ld H

ealth

Org

aniz

atio

n [w

ebsi

te] (

http

s://

extr

anet

.who

.int/

emt/

page

/hom

e, a

cces

sed

1 D

ecem

ber 2

017)

.

RE

SP

ON

D



RISK

CO

MM

UN

ICAT

ION

Ta

rget

: Sta

tes

Part

ies

use

mul

tilev

el, m

ultis

ecto

ral a

nd m

ultif

acet

ed ri

sk c

omm

unic

atio

n ca

paci

ty fo

r pub

lic h

ealth

em

erge

ncie

s. R

eal-

time

exch

ange

of i

nfor

mat

ion,

ad

vice

and

opi

nion

s du

ring

unus

ual a

nd u

nexp

ecte

d ev

ents

and

em

erge

ncie

s so

that

info

rmed

dec

isio

ns to

miti

gate

the

effe

cts

of th

reat

s, a

nd p

rote

ctiv

e an

d pr

even

tativ

e ac

tion

can

be m

ade.

Thi

s in

clud

es a

mix

of c

omm

unic

atio

n an

d en

gage

men

t str

ateg

ies,

suc

h as

med

ia a

nd s

ocia

l med

ia c

omm

unic

atio

ns, m

ass

awar

enes

s ca

mpa

igns

, hea

lth p

rom

otio

n, s

ocia

l mob

iliza

tion,

sta

keho

lder

eng

agem

ent a

nd c

omm

unity

eng

agem

ent.

As m

easu

red

by: (

1) F

orm

al g

over

nmen

t ris

k co

mm

unic

atio

ns p

lans

, arr

ange

men

ts a

nd s

yste

ms

in p

lace

. (2)

Exi

sten

ce o

f ris

k co

mm

unic

atio

n co

ordi

natio

n pl

atfo

rm a

nd m

echa

nism

s fo

r in

tern

al a

nd p

artn

er c

omm

unic

atio

n. (

3) E

vide

nce

that

pub

lic c

omm

unic

atio

n un

it or

tea

m o

pera

tes

effic

ient

ly a

nd e

ffect

ivel

y.

(4)

Evid

ence

tha

t ris

k co

mm

unic

atio

n un

its s

yste

mat

ical

ly e

ngag

e po

pula

tions

at

com

mun

ity le

vel d

urin

g em

erge

ncie

s. (

5) E

xist

ence

of

a sy

stem

to

gath

er

info

rmat

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.

Desi

red

impa

ct:

Resp

onsi

ble

entit

ies

effe

ctiv

ely

com

mun

icat

e, a

ctiv

ely

liste

n an

d re

spon

d to

con

cern

s of

the

pub

lic t

hrou

gh m

edia

, so

cial

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 e

ngag

emen

t as

wel

l as

com

mun

ity e

ngag

emen

t. Th

e de

sire

d ou

tcom

e of

effe

ctiv

e ris

k co

mm

unic

atio

n is

to m

itiga

te th

e po

tent

ial n

egat

ive

impa

ct o

f hea

lth h

azar

ds b

efor

e, d

urin

g an

d af

ter p

ublic

hea

lth e

mer

genc

ies

or u

nusu

al e

vent

s.

RE

SP

ON

D



Scor

eIn

dica

tors

: Ris

k co

mm

unic

atio

n1,2

R.5.

1 Ri

sk c

omm

unic

atio

n sy

stem

s fo

r unu

sual

/un

expe

cted

eve

nts

and

emer

genc

ies

R.5.

2 In

tern

al a

nd p

artn

er c

oord

inat

ion

for

emer

genc

y ris

k co

mm

unic

atio

nR.

5.3

Publ

ic c

omm

unic

atio

n fo

r em

erge

ncie

s

No

capa

city

- 1

No

form

al

gove

rnm

ent

risk

com

mun

icat

ion

arra

ngem

ent

No

coor

dina

tion

plat

form

and

mec

hani

sms

for

inte

rnal

and

par

tner

com

mun

icat

ion

for

enga

ging

ke

y na

tiona

l, in

term

edia

te, l

ocal

and

inte

rnat

iona

l st

akeh

olde

rs (i

nclu

ding

hea

lth c

are

wor

kers

)

No

cent

ral u

nit o

r loc

us fo

r pub

lic c

omm

unic

atio

n,

or re

spon

sive

ad

hoc

med

ia o

utre

ach

Lim

ited

ca

paci

ty -

2

Form

al g

over

nmen

t ar

rang

emen

t in

clud

ing

a na

-tio

nal

mul

tihaz

ard,

mul

tisec

tora

l em

erge

ncy

risk

com

mun

icat

ion

plan

(r

evie

wed

w

ithin

pa

st

24

mon

ths)

in p

lace

and

a d

edic

ated

cor

e te

am r

es-

pons

ible

for t

his

area

of w

ork

esta

blis

hed

Sign

ifica

nt g

aps

in c

apac

ity i

n hu

man

res

ourc

es,

com

mun

icat

ion

plat

form

s an

d re

sour

ces

to d

eal

with

a la

rge-

scal

e em

erge

ncy

Som

e ad

hoc

com

mun

icat

ion

coor

dina

tion,

suc

h as

mee

tings

with

som

e pa

rtne

rs a

nd/o

r irr

egul

ar

info

rmat

ion

shar

ing

Publ

ic c

omm

unic

atio

n un

it or

team

exi

sts

Gov

ernm

ent s

poke

sper

son

iden

tified

and

trai

ned

Proc

edur

es fo

r pub

lic c

omm

unic

atio

n in

pla

ce

Deve

lope

d ca

paci

ty -

3

Form

al g

over

nmen

t arr

ange

men

ts a

nd s

yste

ms

in

plac

e w

ith S

OPs

and

cap

acity

with

mul

tisec

tora

l an

d m

ultis

take

hold

er in

volv

emen

t, bu

t in

suffi

cien

t al

loca

tion

and

alig

nmen

t of

hum

an a

nd fi

nanc

ial

reso

urce

s

Com

mun

icat

ion

coor

dina

tion

exis

ts b

ut w

ith l

i-m

ited

part

ner

and

stak

ehol

der

enga

gem

ent

(suc

h as

hea

lth c

are

wor

kers

, civ

il so

ciet

y or

gani

zatio

ns,

priv

ate

sect

or a

nd o

ther

non

-sta

te a

ctor

s)

Proa

ctiv

e pu

blic

out

reac

h on

a m

ix o

f pl

atfo

rms

(new

spap

ers,

ra

dio,

te

levi

sion

, so

cial

m

edia

, In

tern

et) a

s ap

prop

riate

acc

ordi

ng t

o na

tiona

l and

lo

cal

pref

eren

ces,

in

rele

vant

nat

iona

l an

d lo

cal

lang

uage

s, a

nd u

nder

stan

dabl

e to

the

popu

latio

n U

se o

f loc

ally

rele

vant

tech

nolo

gies

for p

ublic

com

-m

unic

atio

n (s

uch

as m

obile

pho

nes)

Dem

onst

rate

d ca

paci

ty –

4

Fully

ope

ratio

nal n

atio

nal s

yste

m e

stab

lishe

d w

ith

reas

onab

ly s

kille

d an

d/or

tra

ined

per

sonn

el a

nd

volu

ntee

rs, a

nd fi

nanc

ial

reso

urce

s an

d ar

rang

e-m

ents

for

sca

le-u

p as

evi

denc

ed b

y a

sim

ulat

ion

exer

cise

or t

este

d du

ring

a re

al h

ealth

em

erge

ncy

Effe

ctiv

e, re

gula

r com

mun

icat

ion

coor

dina

tion

with

al

l par

tner

s, a

nd th

eir c

oord

inat

ion

evid

ence

d by

a

sim

ulat

ion

exer

cise

or

test

ed d

urin

g a

real

hea

lth

emer

genc

y

Ther

e is

pla

nned

com

mun

icat

ion

with

con

tinuo

us

enga

gem

ent

and

proa

ctiv

e m

edia

out

reac

h (in

-cl

udin

g re

gula

r m

edia

brie

fings

) gu

ided

by

risk

com

mun

icat

ion

best

pr

actic

es,

and

achi

evin

g co

mpr

ehen

sive

geo

grap

hica

l cov

erag

e, e

vide

nced

by

reg

ular

cov

erag

e of

hea

lth is

sues

and

ris

ks in

re

leva

nt la

ngua

ges,

as

wel

l as

by m

edia

and

soc

ial

med

ia a

ctiv

ity d

urin

g an

em

erge

ncy

Sust

aina

ble

capa

city

- 5

Less

ons

lear

nt fr

om c

apac

ity le

vel 4

inte

grat

ed in

to

the

revi

sion

of n

atio

nal p

lans

for c

ontin

uous

str

en-

gthe

ning

of t

he s

yste

mRe

gula

r al

loca

tion

of r

esou

rces

for

gro

wth

and

m

aint

enan

ce o

f the

sys

tem

Effe

ctiv

e,

regu

lar

and

incl

usiv

e co

mm

unic

atio

n co

ordi

natio

n w

ith p

artn

ers

and

stak

ehol

ders

incl

u-di

ng d

efini

tion

of r

oles

, sha

ring

of r

esou

rces

and

jo

int a

ctio

n pl

ans

The

gove

rnm

ent,

part

ners

and

div

erse

med

ia o

ut-

lets

are

eng

aged

in

robu

st a

nd i

ncre

asin

gly

res-

pons

ive

colla

bora

tion

to p

rovi

de h

ealth

adv

ice,

in

clud

ing

addr

essi

ng p

eopl

e’s

conc

erns

and

ru-

mou

rs, a

nd m

isin

form

atio

n

1 -

Und

er th

e IH

R ca

paci

ty a

sses

smen

t fra

mew

ork,

onl

y on

e el

emen

t of t

he k

ey c

ompo

nent

s of

risk

com

mun

icat

ion

– p

ublic

com

mun

icat

ion

– w

as a

sses

sed.

The

focu

s w

as p

redo

min

antly

on

outp

uts

of p

ublic

com

mun

icat

ions

ac

tiviti

es. T

he re

vise

d fr

amew

ork

prop

osed

her

e ad

dres

ses

risk

com

mun

icat

ions

out

com

es. T

he fr

amew

ork

build

s on

the

exis

ting

IHR

capa

city

ass

essm

ent c

onte

nt, a

nd d

raw

s on

an

evid

ence

-bas

ed “

logi

c m

odel

” for

eva

luat

ing

emer

genc

y ris

k co

mm

unic

atio

n ou

tcom

es d

evel

oped

join

tly b

y W

HO

and

Har

vard

Sch

ool o

f Pub

lic H

ealth

in 2

014.

RE

SP

ON

D



Scor

eIn

dica

tors

: Ris

k co

mm

unic

atio

nR.

5.4

Com

mun

icat

ion

enga

gem

ent w

ith a

ffec

ted

com

mun

ities

R.5.

5 Ad

dres

sing

per

cept

ions

, ris

ky b

ehav

iour

s an

d m

isin

form

atio

n

No

capa

city

- 1

No

arra

ngem

ent t

o sy

stem

atic

ally

eng

age

popu

latio

ns a

t com

mun

ity le

vel f

or

emer

genc

ies

Ther

e m

ay

be

soci

al

mob

iliza

tion,

he

alth

pr

omot

ion

or

com

mun

ity

enga

gem

ent

on h

ealth

ris

ks f

or m

ater

nal

and

child

hea

lth,

imm

uniz

atio

n,

mal

aria

, tu

berc

ulos

is,

HIV

/AID

S,

polio

, ne

glec

ted

trop

ical

di

seas

es

and

othe

r de

velo

pmen

tal p

rogr

amm

es, b

ut t

hey

are

not

syst

emat

ical

ly u

sed

for

emer

genc

ies

No

syst

em t

o ga

ther

inf

orm

atio

n on

per

cept

ions

, ris

ky b

ehav

iour

s an

d m

isin

form

atio

n to

ana

lyse

pub

lic c

once

rns

and

fear

s

Lim

ited

ca

paci

ty -

2

Com

mun

ity-l

evel

eng

agem

ent

syst

em p

artia

lly w

ith m

appi

ng o

f ex

istin

g pr

oces

ses,

pro

gram

mes

, par

tner

s an

d st

akeh

olde

rsSo

cial

m

obili

zatio

n,

beha

viou

r ch

ange

co

mm

unic

atio

n an

d co

mm

unity

en

gage

men

t in

clud

ed i

n th

e na

tiona

l ris

k co

mm

unic

atio

n st

rate

gy i

n th

e co

ntex

t of h

ealth

em

erge

ncie

sSo

me

key

stak

ehol

ders

in th

is d

omai

n id

entifi

ed a

t nat

iona

l and

inte

rmed

iate

(p

rovi

ncia

l/re

gion

al) l

evel

s

Ad h

oc s

yste

ms

in p

lace

for

gat

herin

g in

form

atio

n on

per

cept

ions

, ris

ky

beha

viou

rs a

nd m

isin

form

atio

n bu

t are

not

sys

tem

atic

ally

use

d to

gui

de th

e re

spon

se

Deve

lope

d ca

paci

ty -

3

Stak

ehol

ders

map

ped

at i

nter

med

iate

and

loc

al l

evel

s, a

nd d

ecen

tral

ized

sy

stem

(in

clud

ing

finan

cial

and

hum

an r

esou

rces

) in

pla

ce f

or c

omm

unity

en

gage

men

t in

volv

ing

com

mun

ity a

nd r

elig

ious

lead

ers,

com

mun

ity-b

ased

or

gani

zatio

ns a

nd o

ther

dec

entr

aliz

ed te

ams

Stan

dard

pr

actic

e of

de

velo

ping

in

form

atio

n ed

ucat

ion

com

mun

icat

ion

mat

eria

ls w

ith th

e in

volv

emen

t of c

omm

unity

and

key

sta

keho

lder

sCo

mm

unity

co

nsul

tatio

n m

echa

nism

s in

pl

ace

(suc

h as

ho

tline

, su

rvey

s)

A sy

stem

atic

app

roac

h fo

r ga

ther

ing

info

rmat

ion

on p

erce

ptio

ns,

risky

be

havi

ours

and

mis

info

rmat

ion

exis

ts,

but

is n

ot s

yste

mat

ical

ly u

sed

for

shap

ing

the

resp

onse

Dem

onst

rate

d ca

paci

ty –

4

Regu

lar

brie

fing,

tr

aini

ng

and

enga

gem

ent

of

soci

al

mob

iliza

tion

and

com

mun

ity e

ngag

emen

t tea

ms

incl

udin

g vo

lunt

eers

Mec

hani

sms

to h

arne

ss s

cale

-up

capa

city

exi

st a

nd a

re o

pera

tiona

l Fe

edba

ck l

oop

from

lis

teni

ng (

Dom

ain

5)3

into

com

mun

ity e

ngag

emen

t is

op

erat

iona

l

Mec

hani

sms

in p

lace

for s

yste

mat

ic g

athe

ring

of in

form

atio

n on

per

cept

ions

, ris

ky b

ehav

iour

s an

d m

isin

form

atio

n, a

nd u

sing

suc

h an

alys

is s

yste

mat

ical

ly

for s

hapi

ng th

e re

spon

se

Sust

aina

ble

capa

city

– 5

Com

mun

ities

are

equ

al p

artn

ers

in t

he r

isk

com

mun

icat

ion

proc

ess

as

evid

ence

d by

rev

iew

of

a si

mul

atio

n ex

erci

se o

r te

sted

dur

ing

a re

al h

ealth

em

erge

ncy

Feed

back

mec

hani

sm to

furt

her i

mpr

ove

this

sys

tem

and

feed

back

to im

prov

e pr

epar

edne

ss

2 - D

omai

n 5

(Dyn

amic

list

enin

g an

d ru

mou

r man

agem

ent)

sho

uld

be a

sses

sed

inde

pend

ently

as

wel

l as

in re

latio

n to

dom

ains

2 (I

nter

nal a

nd p

artn

er c

omm

unic

atio

n an

d co

ordi

natio

n), 3

(Pub

lic c

omm

unic

atio

n) a

nd 4

(Com

mun

icat

ion

enga

gem

ent w

ith a

ffect

ed c

omm

uniti

es).

3 -

Dom

ain

5. P

artn

ersh

ips:

a)

Build

ing

broa

d pa

rtne

rshi

ps f

or c

omm

unity

eng

agem

ent;

b) W

orki

ng w

ith r

elig

ious

lea

ders

; an

d c)

Wor

king

with

loc

al j

ourn

alis

ts a

nd c

omm

unity

rad

io (

sour

ce:

http

://w

ww

.ghs

pjou

rnal

.org

/co

nten

t/4/

4/62

6?ut

m_s

ourc

e=Tr

endM

D&u

tm_m

ediu

m=c

pc&u

tm_c

ampa

ign=

Glo

bal_

Hea

lth%

253A

_Sci

ence

_and

_Pra

ctic

e_Tr

endM

D_0

, acc

esse

d 25

Dec

embe

r 201

7).

RE

SP

ON

D



Cont

extu

al q

uest

ions

: N/A

Tech

nica

l que

stio

ns:

R.5.

1 Ri

sk c

omm

unic

atio

n sy

stem

s fo

r unu

sual

/une

xpec

ted

even

ts a

nd e

mer

genc

ies

1.

Is th

ere

a fu

nctio

n fo

r ris

k co

mm

unic

atio

n in

the

coun

try’

s na

tiona

l res

pons

e pl

an?

2.

Are

ther

e co

mm

unic

atio

ns p

erso

nnel

or g

over

nmen

t dep

artm

ents

that

info

rmal

ly re

spon

d to

pub

lic in

form

atio

n ne

eds

durin

g em

erge

ncie

s?

3.

Is th

ere

perm

anen

t or s

urge

sta

ff de

dica

ted

to ri

sk c

omm

unic

atio

n du

ring

emer

genc

ies?

4.

Ar

e th

e ro

les

and

resp

onsi

bilit

ies

of th

e ris

k co

mm

unic

atio

n st

aff a

rtic

ulat

ed in

a re

spon

se p

lan?

5.

Ar

e th

ere

sign

ifica

nt im

prov

emen

ts th

at c

ould

be

mad

e in

the

staf

fing,

pla

tform

s, fi

nanc

ial r

esou

rces

or o

ther

fact

ors

to im

prov

e co

mm

unic

atio

ns w

ith p

ublic

an

d pa

rtne

rs d

urin

g em

erge

ncie

s?

6.

Are

ther

e sh

ared

com

mun

icat

ion

plan

s, a

gree

men

ts a

nd/o

r SO

Ps b

etw

een

othe

r re

spon

se a

genc

ies,

suc

h as

pub

lic s

afet

y, la

w e

nfor

cem

ent,

hosp

itals

, em

erge

ncy

resp

onse

, Red

Cro

ss/C

resc

ent a

nd/o

r gov

ernm

ent a

genc

ies,

suc

h as

min

istr

ies

of d

efen

ce, a

gric

ultu

re, f

ood/

drug

?7.

Is

ther

e a

dedi

cate

d bu

dget

line

for c

omm

unic

atio

ns p

erso

nnel

, mat

eria

ls a

nd a

ctiv

ities

for e

mer

genc

ies?

8.

Ar

e pl

ans

test

ed a

t lea

st o

nce

ever

y tw

o ye

ars?

9.

W

hich

gov

ernm

ent e

ntiti

es/a

genc

ies

have

the

lead

for r

isk

com

mun

icat

ion

for d

iffer

ent t

ypes

and

mag

nitu

des

of e

mer

genc

ies?

10.

Is tr

aini

ng fo

r res

pond

ing

to lo

cal h

azar

ds p

rovi

ded

to ri

sk c

omm

unic

atio

ns p

erso

nnel

? 11

. Is

ther

e an

agr

eem

ent i

nter

nal t

o th

e ag

ency

for c

lear

ance

of m

essa

ging

to th

e pu

blic

? 12

. Is

ther

e a

dedi

cate

d bu

dget

for t

he ri

sk c

omm

unic

atio

ns s

yste

m to

gro

w s

usta

inab

ly?

Addi

tiona

l inf

orm

atio

n: A

vaila

bilit

y of

the

follo

win

g re

late

d to

R.5

.1 (d

ocum

enta

tion)

l

Nat

iona

l res

pons

e pl

ans

– c

omm

unic

atio

n se

ctio

nsl

Org

aniz

atio

nal c

hart

l

Emer

genc

y ris

k co

mm

unic

atio

n st

aff p

lans

l

Job

desc

riptio

n fo

r com

mun

icat

ion

staf

f mem

bers

l

Shar

ed a

gree

men

ts w

ith re

spon

se a

genc

ies

l

Emer

genc

y re

spon

se b

udge

t sam

ple

l

Vario

us m

eetin

g no

tes

l

Exer

cise

pla

ns a

nd re

sults

l

Trai

ning

wor

ksho

ps o

bjec

tives

/res

ults

l

Mes

sage

cle

aran

ce p

lan

l

Plan

alte

ratio

nsl

Mec

hani

sm o

f sha

ring

plan

alte

ratio

nl

Long

-ter

m b

udge

t pla

n

RE

SP

ON

D



R.5.

2 In

tern

al a

nd p

artn

er c

omm

unic

atio

n an

d co

ordi

natio

n fo

r em

erge

ncy

risk

com

mun

icat

ion

1.

Is th

ere

an in

form

al o

r for

mal

mec

hani

sm to

coo

rdin

ate

inte

rnal

com

mun

icat

ion

with

in th

e ag

ency

dur

ing

an e

mer

genc

y?

2.

Is th

ere

an in

form

al o

r for

mal

mec

hani

sm to

coo

rdin

ate

com

mun

icat

ion

amon

g na

tiona

l sta

keho

lder

s an

d re

spon

se a

genc

ies

durin

g an

em

erge

ncy?

3.

Is

ther

e an

info

rmal

or f

orm

al m

echa

nism

to c

oord

inat

e co

mm

unic

atio

n am

ong

inte

rnat

iona

l sta

keho

lder

s an

d re

spon

se a

genc

ies

durin

g an

em

erge

ncy?

4.

H

ave

ther

e be

en in

cide

nts

whe

re s

take

hold

er/p

artn

er a

genc

ies

have

rele

ased

con

trad

ictin

g in

form

atio

n?5.

H

ave

ther

e be

en in

stan

ces

of d

elay

s in

the

rele

ase

of in

form

atio

n du

e to

a la

ck o

f agr

eem

ent b

etw

een

key

part

ners

dur

ing

an e

mer

genc

y?

6.

Is th

ere

a fo

rmal

mec

hani

sm to

coo

rdin

ate

com

mun

icat

ion

with

the

hosp

ital a

nd h

ealth

car

e se

ctor

dur

ing

an e

mer

genc

y?

7.

Is th

ere

a fo

rmal

mec

hani

sm to

coo

rdin

ate

com

mun

icat

ion

amon

g ci

vil s

ocie

ty o

rgan

izat

ions

dur

ing

an e

mer

genc

y?

8.

Is th

ere

a fo

rmal

mec

hani

sm to

coo

rdin

ate

com

mun

icat

ion

with

the

priv

ate

sect

or d

urin

g an

em

erge

ncy?

9.

H

as a

n ex

erci

se fo

r tes

ting

com

mun

icat

ion

coor

dina

tion

with

par

tner

org

aniz

atio

ns b

een

cond

ucte

d?10

. H

as th

ere

been

a re

spon

se in

an

actu

al e

mer

genc

y th

at te

sted

com

mun

icat

ion

coor

dina

tion

with

par

tner

org

aniz

atio

ns?

11.

Is th

ere

a sy

stem

to re

gula

rly d

evel

op c

omm

unic

atio

n re

spon

se p

lans

toge

ther

with

ext

erna

l par

tner

s an

d st

akeh

olde

rs?

12.

Is th

ere

a co

ordi

nate

d bu

dget

for c

omm

unic

atio

ns re

spon

se w

ith e

xter

nal p

artn

ers

and

stak

ehol

ders

?

Addi

tiona

l inf

orm

atio

n: A

vaila

bilit

y of

the

follo

win

g re

late

d to

R.5

.2 (d

ocum

enta

tion)

l

Inte

rnal

and

ext

erna

l coo

rdin

atio

n ev

ents

l

Resp

onse

repo

rts

l

New

s st

orie

s du

ring

past

em

erge

ncie

sl

Plan

s fo

r com

mun

icat

ion

coor

dina

tion

with

ext

erna

l age

ncie

sl

Afte

r-ac

tion

repo

rts

from

exe

rcis

es o

r em

erge

ncy

resp

onse

sl

Agre

ed u

pon

resp

onse

pla

n an

d co

ordi

nate

d bu

dget

pla

n fo

r em

erge

ncy

com

mun

icat

ion

R.5.

3 P

ublic

com

mun

icat

ion

for e

mer

genc

ies

1.

Is th

ere

a fo

rmal

ized

func

tion

with

a tr

aine

d pu

blic

spo

kesp

erso

n?2.

Is

ther

e a

fast

-tra

ck p

roce

ss fo

r cle

arin

g m

edia

and

soc

ial m

edia

pro

duct

s?3.

Is

ther

e a

com

mun

icat

ion

team

ded

icat

ed to

med

ia a

nd s

ocia

l med

ia o

utre

ach

that

coo

rdin

ates

with

par

tner

s?4.

Ar

e ta

rget

aud

ienc

e an

alys

es c

ondu

cted

to b

ette

r und

erst

and

audi

ence

lang

uage

, tru

sted

info

rmat

ion

reso

urce

s an

d pr

efer

red

com

mun

icat

ion

chan

nels

?5.

Is

ther

e a

com

mun

icat

ion

stra

tegy

that

pro

activ

ely

reac

hes

out t

o a

varie

ty o

f med

ia p

latfo

rms

(suc

h as

new

spap

ers,

radi

o, te

levi

sion

, soc

ial m

edia

, Int

erne

t) fo

r tar

getin

g co

mm

unic

atio

n m

essa

ges

to s

peci

fic a

udie

nces

?6.

Is

info

rmat

ion

prov

ided

in lo

cal l

angu

ages

as

need

ed b

y th

e au

dien

ce?

7.

Is m

edia

rese

arch

con

duct

ed to

det

erm

ine

if a

mes

sage

reac

hes

the

targ

et a

udie

nce?

8.

Is p

ublic

hea

lth m

essa

ging

ada

pted

acc

ordi

ng to

the

geog

raph

ic lo

catio

n, la

ngua

ge a

nd m

edia

pre

fere

nce?

RE

SP

ON

D



9.

Is th

ere

any c

ontr

ibut

ion

to a

n ev

iden

ce b

ase

of w

hich

com

mun

icat

ions

met

hods

are

bes

t ena

bled

for t

arge

t aud

ienc

es to

cha

nge

beha

viou

r dur

ing

emer

genc

ies?

10.

Is th

ere

med

ia a

nd s

ocia

l med

ia m

onito

ring

follo

wed

by

addr

essi

ng m

isin

form

atio

n qu

ickl

y?

Addi

tiona

l inf

orm

atio

n: A

vaila

bilit

y of

the

follo

win

g re

late

d to

R.5

.3 (d

ocum

enta

tion)

l

Org

aniz

atio

nal c

hart

l

Med

ia d

epar

tmen

t str

ateg

yl

Com

mun

ity o

utre

ach

plan

sl

Med

ia re

spon

se p

lans

l

Com

mun

icat

ion

rese

arch

pro

toco

ls a

nd p

ublic

atio

ns (f

orm

al/in

form

al)

l

Exam

ples

of m

isin

form

atio

n an

d m

etho

ds fo

r han

dlin

g th

em

R.5.

4 Co

mm

unic

atio

n en

gage

men

t with

aff

ecte

d co

mm

uniti

es1.

Is

ther

e a

soci

al m

obili

zatio

n, h

ealth

pro

mot

ion

or c

omm

unity

eng

agem

ent d

epar

tmen

t, te

am o

r wor

king

gro

up th

at is

use

d fo

r em

erge

ncy

resp

onse

?2.

Is

the

soci

al m

obili

zatio

n, h

ealth

pro

mot

ion

or c

omm

unity

eng

agem

ent d

epar

tmen

t or t

eam

/wor

king

gro

up in

tegr

ated

with

in th

e ov

eral

l hea

lth re

spon

se a

nd

linke

d to

the

med

ia d

epar

tmen

t/te

am/f

ocal

per

son

and

coor

dina

ted

with

key

par

tner

s?3.

D

oes

the

soci

al m

obili

zatio

n, h

ealth

pro

mot

ion

or c

omm

unity

eng

agem

ent d

epar

tmen

t/te

am/w

orki

ng g

roup

hav

e m

echa

nism

s to

reac

h ou

t to

affe

cted

or a

t-ris

k po

pula

tions

dur

ing

heal

th e

mer

genc

ies

at n

atio

nal a

s w

ell a

s pr

ovin

cial

, dis

tric

t and

loca

l lev

els?

4.

Is s

ocia

l mob

iliza

tion,

hea

lth p

rom

otio

n or

com

mun

ity e

ngag

emen

t inc

lude

d in

the

natio

nal r

espo

nse

plan

?5.

Ar

e op

port

uniti

es fo

r inf

orm

atio

n sh

arin

g or

trai

ning

regu

larly

pro

vide

d be

twee

n ex

perie

nced

com

mun

ity e

ngag

emen

t exp

erts

and

vol

unte

ers

or fo

r pot

entia

l su

rge

capa

city

to b

e us

ed d

urin

g em

erge

ncie

s?6.

Is

ther

e an

ong

oing

and

func

tioni

ng fe

edba

ck lo

op b

etw

een

at-r

isk

or a

ffect

ed p

opul

atio

ns a

nd re

spon

se a

genc

ies?

7.

Are

base

line

soci

al d

ata,

inte

llige

nce

and

anal

ysis

on

fact

ors

that

may

incr

ease

the

popu

latio

n’s

risk

to (o

r the

abi

lity

to w

ithst

and)

the

top

five

haza

rds

in

the

coun

try

(suc

h as

map

ping

of

lang

uage

s, li

ving

con

ditio

ns, r

elig

ious

/cul

tura

l pra

ctic

es/t

rust

ed c

hann

els

of c

omm

unic

atio

n, in

fluen

cers

) co

nduc

ted

or

com

mis

sion

ed?

Addi

tiona

l inf

orm

atio

n: A

vaila

bilit

y of

the

follo

win

g re

late

d to

R.5

.4 (d

ocum

enta

tion)

l

Org

aniz

atio

nal c

hart

sl

Base

line

surv

eys

and

map

s of

soc

ial d

ata

rela

ted

to in

crea

sed

risk

for t

op fi

ve h

azar

dsl

Risk

ass

essm

ents

that

add

ress

the

mos

t lik

ely

loca

l pub

lic h

ealth

thre

ats

l

Nat

iona

l res

pons

e pl

anl

Surg

e ca

paci

ty p

lan

l

Dat

a fro

m p

ublic

hea

lth h

otlin

e (re

leva

nt q

uest

ions

from

the

publ

ic, e

tc.)

l

Com

mun

ity o

utre

ach

plan

l

Afte

r-ac

tion

repo

rt fr

om a

ctua

l em

erge

ncy

or e

xerc

ise

RE

SP

ON

D



R.5.

5 Ad

dres

sing

per

cept

ions

, ris

ky b

ehav

iour

s an

d m

isin

form

atio

n1.

Is

ther

e a

form

al c

omm

unic

atio

n fu

nctio

n to

mon

itor,

dete

ct a

nd a

ddre

ss p

eopl

e’s

perc

eptio

ns, u

nfou

nded

bel

iefs

, ris

ky b

ehav

iour

s an

d m

isin

form

atio

n?2.

Is

the

effe

ctiv

enes

s of

pub

lic o

utre

ach

met

hods

and

/or m

essa

ges

used

to a

ddre

ss u

nfou

nded

bel

iefs

or t

o co

rrec

t mis

info

rmat

ion

mon

itore

d?3.

Is

info

rmat

ion

on p

eopl

e’s

perc

eptio

ns, u

nfou

nded

bel

iefs

, ris

ky b

ehav

iour

s, a

nd m

isin

form

atio

n an

d st

rate

gies

to a

ddre

ss th

em re

gula

rly s

hare

d w

ith o

ther

st

akeh

olde

rs?

4.

Is c

omm

unic

atio

n fe

edba

ck, i

nclu

ding

on

perc

eptio

ns a

nd m

isin

form

atio

n, ta

ken

into

con

side

ratio

n so

as

to s

hape

an

effe

ctiv

e re

spon

se?

5.

Are

com

mun

icat

ion

resp

onse

s an

d th

e ab

ility

to a

ddre

ss p

erce

ptio

ns, r

isky

beh

avio

urs

and

mis

info

rmat

ion

to id

entif

y be

st p

ract

ice

regu

larly

eva

luat

ed?

Addi

tiona

l inf

orm

atio

n: A

vaila

bilit

y of

the

follo

win

g re

late

d to

R.5

.5 (d

ocum

enta

tion)

l

Med

ia re

spon

se p

lans

l

Dat

a fro

m p

ublic

hea

lth h

otlin

e (e

.g. r

elev

ant q

uest

ions

from

the

publ

ic)

l

Know

ledg

e, a

ttitu

de a

nd p

ract

ice

surv

eys

l

Repo

rts

from

soc

ial s

cien

tists

and

ant

hrop

olog

ists

invo

lved

in th

e re

spon

sel

Soci

al m

edia

mon

itorin

gl

Part

ner c

oord

inat

ion

mee

ting

reco

rds

RE

SP

ON

D



IHR

RELA

TED

HAZ

ARDS

AN

D PO

INTS

OF

ENTR

YPO

INTS

OF

ENTR

YTa

rget

s: S

tate

s Pa

rtie

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 spe

cific

pub

lic h

ealth

mea

sure

s re

quire

d to

man

age

a va

riety

of p

ublic

hea

lth ri

sks.

As m

easu

red

by: (

1) P

ublic

hea

lth e

mer

genc

y co

ntin

genc

y pl

an fo

r des

igna

ted

poin

ts o

f ent

ry. (

2) E

vide

nce

confi

rms

core

cap

aciti

es p

resc

ribed

in th

e IH

R An

nex

1B “1

. At a

ll tim

es” a

re d

evel

oped

and

func

tioni

ng in

an

all-

haza

rd a

nd m

ultis

ecto

ral a

ppro

ach.

Desi

red

impa

ct: T

imel

y de

tect

ion

of a

nd e

ffect

ive

resp

onse

to a

ny p

oten

tial h

azar

ds th

at o

ccur

at p

oint

s of

ent

ry.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



Scor

eIn

dica

tors

: Poi

nts

of e

ntry

PoE.

1 Ro

utin

e ca

paci

ties

esta

blis

hed

at p

oint

s of

ent

ryPo

E.2

Effe

ctiv

e pu

blic

hea

lth re

spon

se a

t poi

nts

of e

ntry

No

capa

city

- 1

No

capa

city

at p

oint

s of

ent

ry fo

r app

ropr

iate

med

ical

ser

vice

sPu

blic

hea

lth e

mer

genc

y co

ntin

genc

y pl

an1 f

or e

ach

desi

gnat

ed p

oint

of e

ntry

fo

r res

pond

ing

to p

ublic

hea

lth e

mer

genc

ies

occu

rrin

g at

poi

nts

of e

ntry

is n

ot

in p

lace

or u

nder

dev

elop

men

t.

Lim

ited

ca

paci

ty -

2

Des

igna

ted

poin

ts o

f en

try

have

acc

ess

to a

ppro

pria

te m

edic

al s

ervi

ces

incl

udin

g di

agno

stic

fac

ilitie

s fo

r th

e pr

ompt

ass

essm

ent

and

care

of

sick

tr

avel

lers

and

with

ade

quat

e st

aff,

equi

pmen

t and

pre

mis

es (A

nnex

1B,

1 (a

))

Publ

ic h

ealth

em

erge

ncy

cont

inge

ncy

plan

in p

lace

at e

ach

desi

gnat

ed p

oint

of

ent

ry f

or r

espo

ndin

g to

pub

lic h

ealth

em

erge

ncie

s oc

curr

ing

at p

oint

s of

en

try,

inte

grat

ed w

ith g

ener

ic e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se p

lan

of

each

des

igna

ted

poin

t of e

ntry

, inv

olvi

ng a

ll re

leva

nt s

ecto

rs a

nd s

ervi

ces

at

poin

ts o

f ent

ry, a

nd d

evel

oped

and

dis

sem

inat

ed to

all

key

stak

ehol

ders

Deve

lope

d ca

paci

ty -

3

Des

igna

ted

poin

ts o

f ent

ry h

ave

deve

lope

d ot

her r

outin

e ca

paci

ties

pres

crib

ed

in t

he I

HR

Anne

x 1B

“1.

At

all

times

” in

add

ition

to

appr

opria

te m

edic

al

serv

ices

, suc

h as

equ

ipm

ent a

nd p

erso

nnel

for t

he tr

ansp

ort o

f sic

k tr

avel

lers

to

an

appr

opria

te m

edic

al fa

cilit

y

Publ

ic h

ealth

em

erge

ncy

cont

inge

ncy

plan

s at

des

igna

ted

poin

ts o

f ent

ry a

re

inte

grat

ed in

to th

e na

tiona

l em

erge

ncy

resp

onse

pla

n an

d ad

hoc

mea

sure

s re

late

d to

trav

elle

rs a

t poi

nts

of e

ntry

(suc

h as

refe

rral

sys

tem

, tra

nspo

rt) f

or

the

safe

tran

sfer

of s

ick

trav

elle

rs to

app

ropr

iate

med

ical

faci

litie

s, a

re in

pla

ce

Dem

onst

rate

d ca

paci

ty -

4

All r

outin

e co

re c

apac

ities

pre

scrib

ed in

the

IHR

Anne

x 1B

“1. A

t all

times

” are

de

velo

ped

and

func

tioni

ng a

s an

all-

haza

rd, m

ultis

ecto

ral a

ppro

ach

Dem

onst

rate

d ca

paci

ties2 o

f app

lyin

g re

com

men

ded

mea

sure

s to

dis

inse

ct,

dera

t, di

sinf

ect,

deco

ntam

inat

e or

oth

erw

ise

trea

t bag

gage

, car

go, c

onta

iner

s,

conv

eyan

ces,

goo

ds o

r po

stal

par

cels

. Est

ablis

hmen

t of

reg

ular

tes

ting

and

upda

ting

of a

n al

l-ha

zard

, mul

tisec

tora

l sys

tem

of

asse

ssm

ent

and

care

of

affe

cted

ani

mal

s, p

roba

bly

impl

emen

ted

thro

ugh

arra

ngem

ents

with

loca

l ve-

terin

ary

faci

litie

s

Sust

aina

ble

capa

city

- 5

All r

outin

e co

re c

apac

ities

pre

scrib

ed in

IHR

Anne

x 1B

“1.

At

all t

imes

” ar

e fu

nctio

ning

as

an a

ll-ha

zard

, mul

tisec

tora

l app

roac

h, w

ith e

vide

nce

of p

erio

dic

eval

uatio

n an

d co

ntin

uous

impr

ovem

ent

Eval

uatio

n of

effe

ctiv

enes

s in

resp

ondi

ng to

pub

lic h

ealth

eve

nts

at p

oint

s of

en

try

cond

ucte

d, a

nd e

vide

nce

of a

n ex

istin

g pe

riodi

c ev

alua

tion

and

cont

i-nu

ous

impr

ovem

ent a

re s

hare

d w

ith re

leva

nt s

take

hold

ers

1 -

Or a

gen

eric

“poi

nts

of e

ntry

” Em

erge

ncy

Prep

ared

ness

and

Res

pons

e Pl

an a

ddre

ssin

g pu

blic

hea

lth e

mer

genc

ies

as d

efine

d by

the

IHR.

2 -

Thes

e ca

paci

ties

wou

ld in

clud

e ad

optin

g m

easu

res

rela

ted

to tr

avel

lers

at p

oint

s of

ent

ry, s

uch

as a

refe

rral

sys

tem

and

tran

spor

t for

the

safe

tran

sfer

of s

ick

trav

elle

rs to

app

ropr

iate

med

ical

faci

litie

s.

Cont

extu

al q

uest

ions

:

1.

How

man

y po

ints

of e

ntry

(airp

orts

, por

ts, g

roun

d-cr

ossi

ngs)

are

ther

e in

the

coun

try?

How

man

y of

them

are

des

igna

ted?

Lis

t the

m b

y ty

pe.

2.

Do

adeq

uate

legi

slat

ion

and/

or p

olic

ies

exis

t for

pro

visi

on o

f hea

lth s

ervi

ces

at p

oint

s of

ent

ry in

the

coun

try?

Lin

k th

is q

uest

ion

to te

chni

cal a

rea

of N

atio

nal

legi

slat

ion,

pol

icy

and

finan

ce.

Tech

nica

l que

stio

ns:

PoE.

1 Ro

utin

e ca

paci

ties

esta

blis

hed

at p

oint

s of

ent

ry1.

D

o th

e de

sign

ated

poi

nts

of e

ntry

hav

e ac

cess

to 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

trav

elle

rs, w

ith a

dequ

ate

staf

f, eq

uipm

ent a

nd p

rem

ises

(Ann

ex 1

B, 1

a)?

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



2.

Do

thes

e po

ints

of e

ntry

pro

vide

acc

ess

to e

quip

men

t and

per

sonn

el fo

r the

tran

spor

t of s

ick

trav

elle

rs to

an

appr

opria

te m

edic

al fa

cilit

y?3.

D

o th

ese

poin

ts o

f ent

ry c

arry

out

insp

ectio

n pr

ogra

mm

es to

ens

ure

safe

env

ironm

ent a

t poi

nts

of e

ntry

faci

litie

s?4.

Is

ther

e ev

iden

ce o

f con

trol o

f vec

tors

and

rese

rvoi

rs in

and

nea

r poi

nts

of e

ntry

(Ann

ex 1

b, A

rt. 1

e)?

Are

ther

e sp

ecifi

c pr

ogra

mm

es fo

r thi

s?

5.

Doe

s th

e co

untr

y ha

ve t

rain

ed p

erso

nnel

for

the

insp

ectio

n of

con

veya

nces

ava

ilabl

e at

des

igna

ted

poin

ts o

f en

try

(Ann

ex 1

b, A

rt. 1

c)?

If no

t, is

the

re a

m

echa

nism

to b

ring

them

from

out

side

?

PoE.

2 Ef

fect

ive

publ

ic h

ealth

resp

onse

at p

oint

s of

ent

ry1.

H

as th

e co

untr

y in

tegr

ated

act

iviti

es c

once

rnin

g po

ints

of e

ntry

(suc

h as

for e

arly

det

ectio

n, a

sses

smen

t, no

tifica

tion,

repo

rt o

f eve

nts)

into

nat

iona

l em

erge

ncy

resp

onse

pla

ns?

2.

Is th

e pu

blic

hea

lth e

mer

genc

y co

ntin

genc

y pl

an fo

r res

pond

ing

to p

ublic

hea

lth e

mer

genc

ies

occu

rrin

g at

poi

nts

of e

ntry

inte

grat

ed w

ith g

ener

ic e

mer

genc

y pr

epar

edne

ss a

nd re

spon

se p

lan

of e

ach

indi

vidu

al p

oint

of e

ntry

. a.

Doe

s it

invo

lve

rele

vant

sec

tors

and

ser

vice

s at

poi

nts

of e

ntry

(suc

h as

imm

igra

tion,

tran

spor

tatio

n, s

ecur

ity, m

edia

)?b.

Is

it de

velo

ped

and

diss

emin

ated

to a

ll st

akeh

olde

rs?

3.

Do

the

desi

gnat

ed p

oint

s of

ent

ry h

ave

capa

citie

s to

app

ly re

com

men

ded

heal

th m

easu

res

rela

ted

to tr

avel

lers

at p

oint

s of

ent

ry (s

uch

as a

sys

tem

in p

lace

fo

r saf

e re

ferr

al a

nd tr

ansf

er o

f sic

k tr

avel

lers

to a

ppro

pria

te m

edic

al fa

cilit

ies,

with

MoU

s, S

OPs

, tra

ined

sta

ff, e

quip

men

t and

regu

lar e

xcha

nge

of in

form

atio

n be

twee

n po

ints

of e

ntry

, hea

lth a

utho

ritie

s an

d fa

cilit

ies

for a

ll de

sign

ated

poi

nts

of e

ntry

)?4.

D

o th

e de

sign

ated

poi

nts

of e

ntry

hav

e ca

paci

ties

to a

pply

reco

mm

ende

d m

easu

res

to d

isin

sect

, der

at, d

isin

fect

, dec

onta

min

ate

or o

ther

wis

e tre

at b

agga

ge,

carg

o, c

onta

iner

s, c

onve

yanc

es, g

oods

or p

osta

l par

cels

, inc

ludi

ng w

hen

appr

opria

te, a

t loc

atio

ns s

peci

ally

des

igna

ted

and

equi

pped

for t

his

purp

ose?

5.

H

as t

he c

ount

ry e

valu

ated

the

effe

ctiv

enes

s of

poi

nts

of e

ntry

in r

espo

ndin

g to

pub

lic h

ealth

eve

nts

at p

oint

s of

ent

ry?

If ye

s, is

it s

hare

d w

ith r

elev

ant

stak

ehol

ders

and

upd

ated

regu

larly

?

Doc

umen

tatio

n or

evi

denc

e fo

r lev

el o

f cap

abili

ty:

1.

Doc

umen

ted,

regu

larly

-upd

ated

and

test

ed n

atio

nal g

uide

lines

, and

SO

Ps to

refle

ct a

ll re

leva

nt te

chni

cal a

nd o

pera

tiona

l gui

danc

e to

ols

for p

oint

s of

ent

ry in

pl

ace

and

diss

emin

ated

to a

ll re

leva

nt s

ecto

rs in

clud

ing

for:

a. d

etec

tion,

repo

rtin

g an

d re

spon

se to

eve

nts

rela

ted

to tr

avel

and

tran

spor

t;b.

pub

lic h

ealth

mea

sure

s to

be

appl

ied

at p

oint

s of

ent

ry t

hat

may

be

reco

mm

ende

d by

the

WH

O (

such

as

exit/

entr

y sc

reen

ing,

isol

atio

n, q

uara

ntin

e,

cont

act t

raci

ng);

and

c. a

pplic

atio

n of

oth

er p

ublic

hea

lth m

easu

res

that

cou

ld a

ffect

inte

rnat

iona

l tra

vel a

nd tr

ansp

ort.

2.

Doc

umen

tatio

n av

aila

ble

for a

ll re

leva

nt te

chni

cal a

nd o

pera

tiona

l gui

danc

e fo

r poi

nts

of e

ntry

– A

nnex

1B,

1e

“to

prov

ide

as fa

r as

prac

ticab

le a

pro

gram

me

and

trai

ned

pers

onne

l for

the

cont

rol o

f vec

tors

and

rese

rvoi

rs in

and

nea

r poi

nts

of e

ntry

”.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



3.

Doc

umen

tatio

n av

aila

ble

on, r

egul

arly

-upd

ated

and

test

ed n

atio

nal g

uide

lines

and

SO

Ps to

refle

ct a

ll re

leva

nt te

chni

cal a

nd o

pera

tiona

l gui

danc

e to

ols

for

poin

ts o

f en

try

in p

lace

and

the

sam

e di

ssem

inat

ed t

o al

l rel

evan

t se

ctor

s in

clud

ing

appl

icat

ion

of r

ecom

men

ded

mea

sure

s to

dis

inse

ct, d

erat

, dis

infe

ct,

deco

ntam

inat

e or

oth

erw

ise

treat

bag

gage

, car

go, c

onta

iner

s, c

onve

yanc

es, g

oods

or

post

al p

arce

ls in

clud

ing,

whe

n ap

prop

riate

, at

loca

tions

spe

cial

ly

desi

gnat

ed a

nd e

quip

ped

for t

his

purp

ose.

4.

Doc

umen

tatio

n on

sys

tem

atic

col

lect

ion

with

sta

ndar

dize

d to

ols,

ana

lysi

s an

d di

ssem

inat

ion

of d

ata

on p

ublic

hea

lth e

vent

s oc

curr

ing

at p

oint

s of

ent

ry, w

ith

upda

ted

list o

f prio

rity

cond

ition

s fo

r not

ifica

tion,

bas

elin

e da

ta tr

ends

, and

thre

shol

ds fo

r ale

rt a

nd ti

mel

y ac

tion

(i.e.

per

nat

iona

l sta

ndar

ds),

repo

rtin

g (u

sing

st

anda

rd re

port

ing

form

ats

and

tool

s), a

nd p

rovi

ding

tim

ely

and

regu

lar f

eedb

ack

on s

urve

illan

ce d

ata

and

trend

s to

rele

vant

sta

keho

lder

s us

ing

stan

dard

ized

fe

edba

ck fo

rmat

s (s

uch

as E

pi b

ulle

tins,

ele

ctro

nic

sum

mar

ies,

new

slet

ter,

surv

eilla

nce

repo

rts)

. 5.

D

ocum

enta

tion

of re

gula

r rec

eipt

of p

oint

s of

ent

ry fi

ndin

gs b

y na

tiona

l sur

veill

ance

uni

t is

avai

labl

e.

Addi

tiona

l too

ls:

l

Poin

ts o

f ent

ry c

heck

list i

n th

e “A

sses

smen

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”

. WH

O/H

SE/I

HR/

LYO

/200

9.9

(http

://w

ww

.who

.int/

ihr/

port

s_ai

rpor

ts/P

oE/e

n/in

dex.

htm

l, ac

cess

ed 2

8 N

ovem

ber 2

017)

.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



CHEM

ICAL

EVE

NTS

Targ

et: S

tate

s Pa

rtie

s w

ith 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,

indu

strie

s, tr

ansp

orta

tion

and

safe

dis

posa

l, an

imal

hea

lth a

nd th

e en

viro

nmen

t.

As m

easu

red

by: (

1) M

echa

nism

s es

tabl

ishe

d an

d fu

nctio

ning

for

det

ectin

g an

d re

spon

ding

to

chem

ical

eve

nts

or e

mer

genc

ies.

(2)

Exi

sten

ce o

f an

ena

blin

g en

viro

nmen

t, in

clud

ing

natio

nal p

olic

ies

or p

lans

or l

egis

latio

n in

pla

ce fo

r man

agem

ent o

f che

mic

al e

vent

s.

Desi

red

impa

ct: T

imel

y de

tect

ion

of a

nd e

ffect

ive

resp

onse

to p

oten

tial c

hem

ical

risk

s an

d/or

eve

nts

in c

olla

bora

tion

with

oth

er s

ecto

rs re

spon

sibl

e fo

r che

mic

al

safe

ty, i

ndus

trie

s, tr

ansp

orta

tion

and

safe

dis

posa

l.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



Scor

eIn

dica

tors

: Che

mic

al e

vent

s1,2

CE.1

Mec

hani

sms

esta

blis

hed

and

func

tioni

ng fo

r det

ectin

g3 and

resp

ondi

ng

to c

hem

ical

eve

nts

or e

mer

genc

ies

CE.2

Ena

blin

g en

viro

nmen

t in

plac

e fo

r man

agem

ent o

f che

mic

al e

vent

s

No

capa

city

- 1

No

mec

hani

sm in

pla

ceN

atio

nal p

olic

ies,

pla

ns o

r le

gisl

atio

n fo

r ch

emic

al e

vent

sur

veill

ance

, ale

rt

and

resp

onse

do

not e

xist

Lim

ited

ca

paci

ty -

2G

uide

lines

or

man

uals

on

surv

eilla

nce,

ass

essm

ent

and

man

agem

ent

of

chem

ical

eve

nts,

into

xica

tion

and

pois

onin

g ar

e av

aila

ble

Nat

iona

l pol

icie

s, p

lans

or

legi

slat

ion

for

chem

ical

eve

nt s

urve

illan

ce, a

lert

4 an

d re

spon

se e

xist

Deve

lope

d ca

paci

ty -

3

Surv

eilla

nce

is i

n pl

ace

for

chem

ical

eve

nts,

int

oxic

atio

n an

d po

ison

ings

w

ith la

bora

tory

cap

acity

or

acce

ss to

labo

rato

ry c

apac

ity to

con

firm

prio

rity

chem

ical

eve

nts

A ch

emic

al e

vent

resp

onse

pla

n is

in p

lace

that

defi

nes

role

s an

d re

spon

sibi

-lit

ies

of re

leva

nt a

genc

ies

and

take

s in

to a

ccou

nt a

ll m

ajor

haz

ard

site

s an

d fa

cilit

ies

Dem

onst

rate

d ca

paci

ty -

4

Tim

ely

and

syst

emat

ic in

form

atio

n ex

chan

ge b

etw

een

appr

opria

te c

hem

ical

un

its5 ,

surv

eilla

nce

units

and

oth

er r

elev

ant

sect

ors

abou

t ur

gent

che

mic

al

even

ts a

nd p

oten

tial c

hem

ical

risk

s an

d th

eir r

espo

nse

Func

tiona

l mec

hani

sms

for

mul

tisec

tora

l coo

rdin

atio

n an

d co

llabo

ratio

n to

m

anag

e ch

emic

al e

vent

s ar

e in

pla

ce in

clud

ing

invo

lvem

ent

in in

tern

atio

nal

chem

ical

/tox

icol

ogic

al n

etw

orks

Sust

aina

ble

capa

city

- 5

Adeq

uate

ly r

esou

rced

poi

son

cent

re(s

)6 ar

e in

pla

ce a

nd t

he c

ount

ry h

as a

de

mon

stra

ted

abili

ty to

resp

ond

to c

hem

ical

em

erge

ncie

s in

all

regi

ons7

A ch

emic

al

even

t re

spon

se

plan

ha

s be

en

test

ed

thro

ugh

occu

r-re

nce

of a

rea

l ev

ent

or t

hrou

gh s

imul

atio

n ex

erci

se a

nd i

s up

date

d as

ne

eded

1- W

hile

the

capa

citie

s fo

r thi

s te

chni

cal a

rea

shou

ld b

e av

aila

ble

coun

tryw

ide,

the

infr

astr

uctu

re d

oes

not n

eed

to b

e pr

esen

t in

all g

eogr

aphi

cal a

reas

. 2

- In

dica

tors

refe

r to

dete

ctio

n of

and

resp

onse

to c

hem

ical

eve

nts

and

enab

ling

envi

ronm

ent f

or m

anag

emen

t of c

hem

ical

eve

nts

in p

lace

with

app

ropr

iate

legi

slat

ion,

law

s or

pol

icy

and

with

invo

lvem

ent o

f mul

tiple

sec

tors

.3

- D

etec

tion

capa

city

als

o in

clud

es n

ot o

nly

surv

eilla

nce

but a

lso

the

labo

rato

ry c

apac

ity re

quire

d fo

r the

ver

ifica

tion

of a

ny e

vent

s.4

- El

emen

ts o

f ale

rt in

clud

e SO

Ps fo

r cov

erag

e, c

riter

ia o

f whe

n an

d ho

w to

ale

rt, d

uty

rost

ers,

etc

.5

- Su

ch a

s ch

emic

al s

urve

illan

ce, e

nviro

nmen

tal m

onito

ring

and

chem

ical

inci

dent

repo

rtin

g.6

- Th

e po

ison

s ce

ntre

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

entr

e sh

ould

be

wel

l use

d by

the

popu

latio

n it

serv

es (c

heck

num

ber o

f cal

ls p

er d

ay).

Refe

r to

Gui

delin

es

for p

oiso

ns c

ontr

ol. G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

199

7 (h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/4

1966

/1/9

2415

4487

2_en

g.pd

f, ac

cess

ed 1

Dec

embe

r 201

7).

7 -

This

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 s

uppo

rt m

echa

nism

s, in

fras

truc

ture

and

al

ertin

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 gov

ernm

ents

(see

als

o: W

HO

man

ual:

The

publ

ic h

ealth

man

agem

ent o

f che

mic

al in

cide

nts.

G

enev

a: W

orld

Hea

lth O

rgan

izat

ion;

200

9 (h

ttp:

//w

ww

.who

.int/

envi

ronm

enta

l_he

alth

_em

erge

ncie

s/pu

blic

atio

ns/M

anua

l_Ch

emic

al_I

ncid

ents

/en/

, acc

esse

d 1

Dec

embe

r 201

7)).

Cont

extu

al q

uest

ions

:

1.

Has

a n

atio

nal c

hem

ical

s pr

ofile

bee

n de

velo

ped

in th

e pa

st fi

ve y

ears

? If

appl

icab

le, d

escr

ibe

outc

ome/

prov

ide

repo

rt.

2.

Hav

e ch

emic

al ri

sks

been

ass

esse

d fo

r prio

rity

chem

ical

s in

the

past

five

yea

rs, f

or e

xam

ple

in te

rms

of im

pact

on

mor

bidi

ty a

nd m

orta

lity?

3.

Hav

e th

ere

been

any

maj

or c

hem

ical

inci

dent

s in

the

past

five

yea

rs?

4.

Are

any

inte

rnat

iona

l che

mic

al c

onve

ntio

ns/a

gree

men

ts ra

tified

/impl

emen

ted?

a. I

s th

e Ro

tter

dam

Con

vent

ion

on th

e Pr

ior I

nfor

med

Con

sent

Pro

cedu

re fo

r Cer

tain

Haz

ardo

us C

hem

ical

s in

Inte

rnat

iona

l Tra

de ra

tified

?b.

Is

the

Stoc

khol

m C

onve

ntio

n on

Per

sist

ent O

rgan

ic P

ollu

tant

s ra

tified

?c.

Is

the

Base

l Con

vent

ion

on th

e Co

ntro

l of T

rans

boun

dary

Mov

emen

ts o

f Haz

ardo

us W

aste

s an

d th

eir D

ispo

sal r

atifi

ed?

d. I

s th

e U

nite

d N

atio

ns E

cono

mic

Com

mis

sion

for E

urop

e Co

nven

tion

on th

e Tr

ansb

ound

ary

Effe

cts

of In

dust

rial A

ccid

ents

ratifi

ed?

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



e. I

s th

e In

tern

atio

nal L

abou

r Org

aniz

atio

n Co

nven

tion

174

on P

reve

ntio

n of

Maj

or In

dust

rial A

ccid

ents

ratifi

ed?

f. Is

the

Inte

rnat

iona

l Lab

our O

rgan

izat

ion

Conv

entio

n 17

0 on

Saf

ety

in th

e U

se o

f Che

mic

als

at W

ork

ratifi

ed?

5.

Is th

e co

untr

y w

orki

ng to

war

ds a

chie

ving

sus

tain

able

dev

elop

men

t goa

ls 3

.9 a

nd 1

2.4

(see

als

o St

rate

gic

Appr

oach

to In

tern

atio

nal C

hem

ical

s M

anag

emen

t (S

AICM

) goa

l)? 8,

9

Tech

nica

l que

stio

ns:

CE.1

Mec

hani

sms

esta

blis

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

1.

Are

guid

elin

es o

r man

uals

on

the

surv

eilla

nce,

ass

essm

ent a

nd m

anag

emen

t of c

hem

ical

eve

nts,

into

xica

tion

and

pois

onin

g av

aila

ble?

a. A

re th

ese

impl

emen

ted?

b. A

re th

ese

upda

ted

afte

r the

eve

nts

or fo

llow

-up

exer

cise

s, o

r upd

ated

regu

larly

?2.

Is

ther

e ch

emic

al in

cide

nt s

urve

illan

ce?

a. I

s th

ere

an a

utho

rity/

inst

itute

/age

ncy

with

prim

ary

resp

onsi

bilit

y fo

r che

mic

als

and

surv

eilla

nce/

mon

itorin

g?b.

Is

ther

e an

effi

cien

t inf

orm

atio

n flo

w in

che

mic

als

surv

eilla

nce/

mon

itorin

g?c.

Is

ther

e su

rvei

llanc

e of

sen

tinel

hea

lth e

vent

s th

at m

ay s

igna

l a h

azar

dous

che

mic

al e

xpos

ure?

d. I

s th

ere

envi

ronm

enta

l mon

itorin

g (w

ater

, air,

soi

l, se

dim

ent)

with

rega

rd to

che

mic

al h

azar

ds?

e. I

s th

ere

mon

itorin

g of

con

sum

er p

rodu

cts

(food

stuf

fs a

nd g

oods

) with

rega

rd to

che

mic

al h

azar

ds?

3.

Are

ther

e pr

oced

ures

for r

isk

asse

ssm

ent i

n ch

emic

als

surv

eilla

nce/

mon

itorin

g to

info

rm a

che

mic

al e

vent

resp

onse

?4.

Is

labo

rato

ry c

apac

ity a

vaila

ble

for s

yste

mat

ic a

naly

sis?

5.

Are

curr

ent h

uman

reso

urce

s su

ffici

ent t

o m

eet t

he n

eeds

for m

anag

ing

chem

ical

eve

nts?

6.

Are

curr

ent fi

nanc

ial r

esou

rces

suf

ficie

nt to

mee

t the

nee

ds fo

r che

mic

al s

afet

y?7.

Ar

e in

vest

igat

ion

repo

rts

prod

uced

in c

hem

ical

s su

rvei

llanc

e/m

onito

ring?

8.

Is th

ere

regu

lar (

i.e. w

eekl

y, m

onth

ly o

r yea

rly) f

eedb

ack

of d

ata

and

resp

onse

act

iviti

es in

che

mic

als

surv

eilla

nce/

mon

itorin

g?9.

Is

ther

e an

inve

ntor

y of

refe

renc

e he

alth

car

e fa

cilit

ies

for t

he d

iagn

oses

and

trea

tmen

t of c

hem

ical

poi

soni

ng c

ases

?10

. Ar

e th

ere

prot

ocol

s/gu

idel

ines

for c

ase

man

agem

ent w

ith re

gard

to c

hem

ical

haz

ards

?11

. Ar

e th

ere

pois

on c

entre

(s)?

How

do

they

func

tion

and

fit in

to th

e he

alth

car

e sy

stem

?

CE.2

Ena

blin

g en

viro

nmen

t in

plac

e fo

r man

agem

ent o

f che

mic

al e

vent

s 1.

Is

ther

e a

stra

tegi

c pl

an to

stre

ngth

en th

e as

sess

men

t and

man

agem

ent o

f che

mic

als

(e.g

. a n

atio

nal c

hem

ical

s pr

ofile

)? Is

it u

p-to

-dat

e an

d im

plem

ente

d?2.

D

oes

chem

ical

s le

gisl

atio

n pr

ovid

e co

mpr

ehen

sive

cov

erag

e? S

ome

area

s th

at m

ay b

e co

vere

d by

legi

slat

ion

not s

peci

fic fo

r che

mic

als

shou

ld b

e co

nsid

ered

, su

ch a

s:

8 -

In a

dopt

ing

the

2030

Age

nda

for

Sust

aina

ble

Dev

elop

men

t, go

vern

men

ts r

ecog

nize

d th

e co

ntin

ued

impo

rtan

ce o

f so

und

man

agem

ent

of c

hem

ical

s fo

r th

e pr

otec

tion

of h

uman

hea

lth, p

artic

ular

ly in

tar

get

3.9

whi

ch is

to

subs

tant

ially

redu

ce th

e nu

mbe

r of d

eath

s an

d ill

ness

es fr

om h

azar

dous

che

mic

als

and

air,

wat

er a

nd s

oil p

ollu

tion

and

cont

amin

atio

n by

203

0, a

s w

ell a

s ta

rget

12.

4 w

hich

cal

ls fo

r sou

nd m

anag

emen

t of c

hem

ical

s an

d al

l was

tes

by 2

020

to m

inim

ize

adve

rse

impa

cts

on h

uman

hea

lth a

nd th

e en

viro

nmen

t.9

- Th

e SA

ICM

goa

l is

that

by

2020

, che

mic

als

will

be

prod

uced

and

use

d in

way

s th

at m

inim

ize

sign

ifica

nt a

dver

se im

pact

s on

hum

an h

ealth

and

the

envi

ronm

ent.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



a. h

azar

dous

site

s re

gist

ratio

nb.

con

trol

of h

azar

dous

site

s (t

hrou

gh s

afet

y re

port

s an

d sa

fety

man

agem

ent s

yste

ms)

c. o

n-si

te e

mer

genc

y pl

ans

d. o

ff-si

te e

mer

genc

y pl

ans

e. s

iting

and

land

use

pla

nnin

gf.

cont

rol o

f pro

cedu

res

and

site

s fo

r dis

posa

l of h

azar

dous

was

teg.

con

trol

of c

onta

min

ated

land

, wat

er (d

rinki

ng a

nd o

ther

), cr

ops,

food

stuf

fsh.

nat

iona

l and

inte

rnat

iona

l tra

nspo

rt/t

rade

of d

ange

rous

goo

ds o

r sub

stan

ces

i. ha

zard

ous

subs

tanc

es re

gist

ratio

nj.

cont

rol o

f lab

ellin

g an

d ac

com

pany

ing

safe

ty in

form

atio

n fo

r haz

ardo

us s

ubst

ance

sk.

ins

pect

ion/

mon

itorin

g an

d en

forc

emen

tl.

publ

ic c

omm

unic

atio

nm

. inc

iden

t doc

umen

tatio

n an

d re

port

ing

n. i

ncid

ent i

nves

tigat

ion

o. e

pide

mio

logi

cal a

nd m

edic

al fo

llow

-up

p. o

ccup

atio

nal h

ealth

.3.

Is

ther

e a

natio

nal c

oord

inat

ing

body

/com

mitt

ee w

ith re

gard

to th

e as

sess

men

t and

man

agem

ent o

f che

mic

als?

4.

Is th

ere

a pu

blic

hea

lth p

lan

for c

hem

ical

inci

dent

s/em

erge

ncie

s?

5.

Doe

s a

publ

ic h

ealth

pla

n fo

r che

mic

al in

cide

nts/

emer

genc

ies

cons

ider

the

rang

e of

func

tions

requ

ired

in a

cris

is?

Des

crib

e, if

app

licab

le. C

onsi

der t

he a

vaila

bilit

y of

reso

urce

s an

d SO

Ps a

nd th

e fo

llow

ing

aspe

cts:

a. r

oles

and

resp

onsi

bilit

ies

b. p

ublic

com

mun

icat

ion

c. r

efer

ral,

tran

spor

t and

trea

tmen

t of l

arge

num

bers

of a

ffect

ed in

divi

dual

sd.

sto

ckpi

ling

of e

quip

men

t and

med

icat

ion

e. f

ollo

w-u

p of

pat

ient

sf.

deco

ntam

inat

ion

of p

eopl

e, p

rem

ises

and

env

ironm

ent

g. r

egul

ar e

valu

atio

n/re

visi

on o

f pla

nh.

res

tric

tions

, eva

cuat

ion

i. em

erge

ncy

fund

sj.

exer

cise

s or

gani

zed

on a

regu

lar b

asis

to te

st a

nd re

vise

the

plan

.6.

Ar

e th

ere

mul

tisec

tora

l/int

erdi

scip

linar

y co

ordi

natio

n m

echa

nism

s w

ith re

gard

to c

hem

ical

saf

ety?

If

appl

icab

le, d

escr

ibe

mec

hani

sms

and

indi

cate

sho

rtco

min

gs. C

oord

inat

ion

mec

hani

sms

coul

d co

nsid

er:

a. h

ealth

b. e

nviro

nmen

t

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



c. a

gric

ultu

red.

Nat

iona

l IH

R Fo

cal P

oint

e. a

ll pu

blic

hea

lth le

vels

(loc

al, i

nter

med

iate

and

nat

iona

l)f.

emer

genc

y pr

epar

edne

ssg.

em

erge

ncy

serv

ices

(fire

, pol

ice,

am

bula

nce,

med

ical

resp

onde

rs)

h. c

onsu

mer

saf

ety

i. ad

min

istr

ativ

e/po

litic

al a

utho

ritie

s at

all

leve

ls (l

ocal

, int

erm

edia

te, n

atio

nal)

j. ha

zard

ous

site

sk.

met

eoro

logi

cal s

ervi

ces

l. po

ints

of e

ntry

(por

ts, a

irpor

ts, g

roun

d cr

ossi

ngs)

, in

part

icul

ar th

ose

desi

gnat

ed u

nder

the

IHR

m. t

rans

port

n. p

rivat

e se

ctor

/ind

ustr

yo.

poi

son

cent

re(s

)p.

nat

iona

l sur

veill

ance

inst

itute

(s) w

ith re

gard

to c

hem

ical

saf

ety

q. r

efer

ence

labo

rato

ry(ie

s) w

ith re

gard

to c

hem

ical

saf

ety

r. re

fere

nce

heal

th c

are

faci

litie

s w

ith re

gard

to c

hem

ical

saf

ety.

7.

In th

e ev

ent o

f a p

ublic

hea

lth e

mer

genc

y of

che

mic

al o

rigin

, cou

ld a

bud

get b

e m

obili

zed

to m

eet a

dditi

onal

dem

ands

?8.

Is

ther

e an

aud

it/ev

alua

tion

syst

em fo

r exe

rcis

es/r

espo

nses

?9.

Is

ther

e in

volv

emen

t in

inte

rnat

iona

l che

mic

al/t

oxic

olog

ical

net

wor

ks (e

.g. I

NTO

X)?

10.

Is th

ere

a ch

emic

al d

atab

ase

or d

ata

bank

ava

ilabl

e at

all

times

(e.g

. IN

CHEM

)?

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



RAD

IATI

ON

EM

ERG

ENCI

ESTa

rget

: Sta

tes

Part

ies

shou

ld h

ave

surv

eilla

nce

and

resp

onse

cap

acity

for r

adio

logi

cal e

mer

genc

ies

and

nucl

ear a

ccid

ents

. Thi

s re

quire

s ef

fect

ive

coor

dina

tion

amon

g al

l sec

tors

invo

lved

in ra

diat

ion

emer

genc

ies

prep

ared

ness

and

resp

onse

.

As m

easu

red

by: (

1) M

echa

nism

s es

tabl

ishe

d an

d fu

nctio

ning

for d

etec

ting

and

resp

ondi

ng to

radi

olog

ical

em

erge

ncie

s. (2

) Exi

sten

ce o

f an

enab

ling

envi

ronm

ent,

incl

udin

g na

tiona

l pol

icie

s or

pla

ns o

r leg

isla

tion

in p

lace

for t

he m

anag

emen

t of r

adio

logi

cal e

mer

genc

ies.

Desi

red

impa

ct: T

imel

y de

tect

ion

and

effe

ctiv

e re

spon

se to

pot

entia

l rad

iolo

gica

l em

erge

ncie

s an

d nu

clea

r acc

iden

ts in

a c

ross

-sec

tora

l coo

rdin

ated

man

ner.

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



Scor

eIn

dica

tors

: Rad

iatio

n em

erge

ncie

s1

RE.1

Mec

hani

sms

esta

blis

hed

and

func

tioni

ng fo

r det

ectin

g2 and

resp

ondi

ng

to ra

diol

ogic

al a

nd n

ucle

ar e

mer

genc

ies

RE.2

Ena

blin

g en

viro

nmen

t in

pla

ce f

or m

anag

emen

t of

rad

iolo

gica

l an

d nu

clea

r em

erge

ncie

s

No

capa

city

- 1

Nat

iona

l po

licie

s, s

trat

egie

s or

pla

ns f

or t

he d

etec

tion,

ass

essm

ent,

and

resp

onse

to ra

diat

ion

emer

genc

ies

are

not e

stab

lishe

dN

o co

ordi

natio

n an

d co

mm

unic

atio

n m

echa

nism

bet

wee

n na

tiona

l aut

hori-

ties

resp

onsi

ble

for r

adio

logi

cal a

nd n

ucle

ar e

vent

s w

ith h

ealth

min

istr

y an

d/or

Nat

iona

l IH

R Fo

cal P

oint

Lim

ited

ca

paci

ty -

2

Nat

iona

l po

licie

s, s

trat

egie

s or

pla

ns f

or t

he d

etec

tion,

ass

essm

ent,

and

resp

onse

to ra

diat

ion

emer

genc

ies

are

esta

blis

hed

and

radi

atio

n m

onito

ring

mec

hani

sms

exis

t for

radi

atio

n em

erge

ncie

s th

at m

ay c

onst

itute

a P

HEI

C

Nat

iona

l aut

horit

ies

resp

onsi

ble

for

radi

olog

ical

and

nuc

lear

eve

nts

have

a

desi

gnat

ed f

ocal

poi

nt f

or c

oord

inat

ion

and

com

mun

icat

ion

with

the

hea

lth

min

istr

y an

d/or

Nat

iona

l IH

R Fo

cal P

oint

Deve

lope

d ca

paci

ty -

3

Tech

nica

l gu

idel

ines

or

SOPs

dev

elop

ed,

eval

uate

d an

d up

date

d fo

r th

e m

anag

emen

t of r

adia

tion

emer

genc

ies

(incl

udin

g ris

k as

sess

men

t, re

port

ing,

ev

ent c

onfir

mat

ion

and

notifi

catio

n, a

nd in

vest

igat

ion)

A ra

diat

ion

emer

genc

y re

spon

se p

lan

exis

ts (

coul

d be

par

t of

the

nat

iona

l em

erge

ncy

resp

onse

pla

n) a

nd n

atio

nal p

olic

ies,

str

ateg

ies

or p

lans

for n

atio

-na

l and

inte

rnat

iona

l tra

nspo

rt o

f ra

dioa

ctiv

e m

ater

ials

, sam

ples

and

was

te

man

agem

ent i

nclu

ding

thos

e fr

om h

ospi

tals

and

med

ical

ser

vice

s3 are

est

a-bl

ishe

d

Dem

onst

rate

d ca

paci

ty -

4

Syst

emat

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 s

urve

illan

ce u

nits

abo

ut u

rgen

t ra

diol

ogic

al e

vent

s an

d po

tent

ial r

isks

that

may

con

stitu

te a

PH

EIC

Func

tiona

l co

ordi

natio

n4 an

d co

mm

unic

atio

n m

echa

nism

s5 ex

ist

betw

een

rele

vant

nat

iona

l co

mpe

tent

aut

horit

ies

resp

onsi

ble

for

nucl

ear

regu

lato

ry

cont

rol/

safe

ty a

nd re

leva

nt s

ecto

rs6

Sust

aina

ble

capa

city

- 5

Mec

hani

sm is

in p

lace

to

acce

ss7

heal

th f

acili

ties

with

cap

acity

to

man

age

patie

nts

of ra

diat

ion

emer

genc

ies

Radi

atio

n em

erge

ncy

resp

onse

dril

ls a

nd o

ther

exe

rcis

es c

arrie

d ou

t reg

ular

ly,

incl

udin

g th

e re

ques

ting

of in

tern

atio

nal a

ssis

tanc

e (a

s ne

eded

) and

inte

rna-

tiona

l not

ifica

tion

1 - T

his

indi

cato

r ref

ers

to d

etec

tion

and

resp

onse

to ra

diol

ogic

al a

nd n

ucle

ar e

mer

genc

ies

and

an e

nabl

ing

envi

ronm

ent f

or th

e m

anag

emen

t of r

adia

tion

even

ts in

pla

ce w

ith a

ppro

pria

te le

gisl

atio

n or

pol

icy

and

with

the

invo

lvem

ent

of re

leva

nt s

ecto

rs (s

uch

as e

nviro

nmen

t, tr

ansp

ort,

trad

e, to

uris

m, c

usto

ms,

law

-enf

orce

men

t, de

fenc

e, o

ther

s).

2 -

Det

ectio

n ca

paci

ty in

clud

es n

ot o

nly

surv

eilla

nce

but a

lso

the

labo

rato

ry c

apac

ity re

quire

d fo

r the

ver

ifica

tion

of a

ny e

vent

s in

col

labo

ratio

n w

ith la

bora

tory

net

wor

ks o

utsi

de a

nd in

side

the

coun

try.

3 -

Reco

mm

ende

d th

at W

HO

dev

elop

som

e le

vel o

f spe

cific

ity fo

r pub

lic h

ealth

and

med

ical

asp

ects

(con

sist

ent w

ith th

e co

ntex

tual

and

tech

nica

l que

stio

ns) t

o av

oid

dupl

icat

ion

with

oth

er p

eer r

evie

w s

ervi

ces.

4 -

Not

e th

at c

ross

-ref

eren

ces

with

tech

nica

l are

as o

f “N

atio

nal l

egis

latio

n, p

olic

y an

d fin

anci

ng” a

nd “I

HR

coor

dina

tion,

com

mun

icat

ion

and

advo

cacy

”, an

d th

e at

trib

utes

for t

his

com

pone

nt s

houl

d be

als

o fu

lly a

ddre

ssed

und

er

thos

e co

re c

apac

ities

.5

- In

form

atio

n sh

arin

g, m

eetin

gs, S

OPs

dev

elop

ed fo

r col

labo

rativ

e re

spon

se, e

tc.

6 -

Coor

dina

tion

for r

isk

asse

ssm

ents

, ris

k co

mm

unic

atio

ns, p

lann

ing,

exe

rcis

ing,

mon

itorin

g an

d in

clud

ing

coor

dina

tion

durin

g ur

gent

radi

olog

ical

eve

nts

and

pote

ntia

l ris

ks th

at m

ay c

onst

itute

a P

HEI

C.7

- Es

tabl

ishe

d ar

rang

emen

ts a

nd m

echa

nism

s in

pla

ce to

acc

ess

thes

e ca

paci

ties

in re

leva

nt c

olla

bora

ting

inst

itutio

ns w

ithin

the

coun

try

or in

oth

er c

ount

ries.

Cont

extu

al q

uest

ions

:

1.

Hav

e th

ere

been

radi

atio

n sa

fety

ass

essm

ents

in th

e pa

st fi

ve y

ears

(suc

h as

em

erge

ncy

prep

ared

ness

revi

ew b

y IA

EA)?

If a

pplic

able

, des

crib

e th

e ou

tcom

e an

d sh

are

the

repo

rt.

2.

Hav

e th

ere

been

bas

elin

e pu

blic

hea

lth a

sses

smen

ts w

ith re

gard

to ra

diat

ion

safe

ty in

the

past

five

yea

rs, f

or e

xam

ple

cons

ider

ing

mor

bidi

ty a

nd m

orta

lity?

3.

Hav

e th

ere

been

any

maj

or ra

diat

ion

emer

genc

ies

in th

e pa

st th

at m

ay h

ave

cont

ribut

ed to

the

expe

rienc

e an

d pr

epar

edne

ss o

f the

cou

ntry

?4.

Is

the

coun

try

a si

gnat

ory

to th

e Ea

rly N

otifi

catio

n an

d As

sist

ance

in C

ase

of a

Nuc

lear

Em

erge

ncy

(198

6) c

onve

ntio

ns?

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



Tech

nica

l que

stio

ns:

RE.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 a

nd n

ucle

ar e

mer

genc

ies

1.

Are

ther

e na

tiona

l pol

icie

s, s

trat

egie

s or

pla

ns a

vaila

ble

for t

he d

etec

tion,

ass

essm

ent,

resp

onse

and

reco

very

afte

r rad

iatio

n em

erge

ncie

s?a.

Are

thes

e im

plem

ente

d, a

nd if

so,

how

?b.

Are

thes

e up

date

d af

ter a

ctua

l eve

nts

or e

xerc

ises

(or u

pdat

ed re

gula

rly)?

2.

Is th

ere

an a

utho

rity/

inst

itute

/age

ncy

with

prim

ary

resp

onsi

bilit

y fo

r rad

iatio

n an

d su

rvei

llanc

e/m

onito

ring?

3.

Is th

ere

mon

itorin

g of

con

sum

er p

rodu

cts

(e.g

. foo

dstu

ffs a

nd g

oods

) with

rega

rd to

radi

oact

ive

cont

amin

atio

n?4.

Ar

e th

ere

proc

edur

es fo

r ris

k as

sess

men

t in

radi

olog

ical

sur

veill

ance

/mon

itorin

g, to

trig

ger/

mou

nt a

resp

onse

of s

uita

ble

com

posi

tion

and

mag

nitu

de?

5.

Is t

here

labo

rato

ry c

apac

ity in

the

cou

ntry

or

acce

ss t

o la

bora

tory

ser

vice

s ab

road

for

mon

itorin

g an

d as

sess

men

t of

rad

ioac

tive

cont

amin

atio

n of

the

en

viro

nmen

t in

case

of a

radi

atio

n em

erge

ncy?

6.

Is th

ere

labo

rato

ry c

apac

ity in

the

coun

try

or a

cces

s to

labo

rato

ry s

ervi

ces

abro

ad fo

r mon

itorin

g an

d as

sess

men

t of i

nter

nal c

onta

min

atio

n an

d ra

diat

ion

expo

sure

of h

uman

s in

cas

e of

a ra

diat

ion

emer

genc

y?7.

Ar

e tr

aini

ng p

rogr

amm

es a

vaila

ble

for e

mer

genc

y re

spon

ders

in th

e co

untr

y or

is th

eir a

cces

s to

trai

ning

abr

oad?

8.

Are

curr

ent h

uman

reso

urce

s su

ffici

ent t

o m

eet t

he n

eeds

of r

adia

tion

prot

ectio

n an

d sa

fety

?9.

Ar

e cu

rren

t fina

ncia

l res

ourc

es s

uffic

ient

to m

eet t

he n

eeds

of r

adia

tion

prot

ectio

n an

d sa

fety

?10

. Is

ther

e an

inve

ntor

y of

refe

renc

e/de

sign

ated

hea

lth c

are

faci

litie

s fo

r rad

iatio

n em

erge

ncie

s?11

. Ar

e th

ere

prot

ocol

s/gu

idel

ines

for c

ase

man

agem

ent o

f per

sons

ove

r-ex

pose

d to

ioni

zing

radi

atio

n?12

. Is

ther

e a

natio

nal s

tock

pile

of p

harm

aceu

tical

age

nts

that

can

be

used

as

coun

term

easu

res

in ra

diat

ion

emer

genc

ies

(suc

h as

die

thyl

ene

tria

min

e pe

ntaa

cetic

ac

id, P

russ

ian

blue

, pot

assi

um io

dide

, cyt

okin

es)?

RE.2

Ena

blin

g en

viro

nmen

t in

plac

e fo

r man

agem

ent o

f rad

iolo

gica

l and

nuc

lear

em

erge

ncie

s1.

Is

ther

e a

polic

y or

str

ateg

ic p

lan

for e

nsur

ing

safe

use

of r

adia

tion

in th

e co

untr

y? Is

it u

p-to

-dat

e? H

ow is

it im

plem

ente

d?2.

Is

ther

e a

natio

nal c

oord

inat

ing

body

/com

mitt

ee w

ith re

gard

to ra

diol

ogic

al a

nd n

ucle

ar e

mer

genc

ies?

3.

Is th

ere

an e

mer

genc

y re

spon

se p

lan

for r

adio

logi

cal a

nd n

ucle

ar e

mer

genc

ies?

4.

Doe

s th

e em

erge

ncy

resp

onse

pla

n co

nsid

er th

e ra

nge

of fu

nctio

ns re

quire

d in

a c

risis

? D

escr

ibe,

if a

pplic

able

. Doe

s it

cons

ider

the

avai

labi

lity

of re

sour

ces

and

SOPs

? Th

e pl

an s

houl

d co

nsid

er th

e fo

llow

ing

aspe

cts:

a. r

oles

and

resp

onsi

bilit

ies

b. p

ublic

com

mun

icat

ion

c. r

efer

ral,

tran

spor

t and

trea

tmen

t of l

arge

num

bers

of a

ffect

ed in

divi

dual

sd.

sto

ckpi

ling

of e

quip

men

t and

med

icat

ion

e. d

econ

tam

inat

ion

of p

eopl

e, p

rem

ises

and

env

ironm

ent

f. re

gist

ratio

n an

d fo

llow

-up

of o

ver-

expo

sed

pers

ons

g. r

estr

ictio

ns, e

vacu

atio

n

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



h. e

mer

genc

y fu

nds

i. ex

erci

ses

orga

nize

d on

a re

gula

r bas

is to

eva

luat

e an

d re

vise

the

plan

.5.

Ar

e th

ere

mul

tisec

tora

l/int

erdi

scip

linar

y co

ordi

natio

n m

echa

nism

s w

ith re

gard

to ra

diat

ion

emer

genc

y pr

epar

edne

ss a

nd re

spon

se m

anag

emen

t?

If ap

plic

able

, des

crib

e m

echa

nism

s an

d in

dica

te s

hort

com

ings

. Coo

rdin

atio

n m

echa

nism

s co

uld

invo

lve:

a. H

ealth

sec

tor

• N

atio

nal I

HR

Foca

l Poi

nt•

Hos

pita

ls a

nd h

ealth

car

e fa

cilit

ies

(clin

ics,

labo

rato

ries,

nur

sing

hom

es)

• Al

l lev

els

of p

ublic

hea

lth in

fras

truc

ture

(loc

al, i

nter

med

iate

, nat

iona

l)•

Food

and

drin

king

wat

er s

afet

y se

rvic

es•

Labo

rato

ry(ie

s) fo

r ind

ivid

ual m

onito

ring

and

asse

ssm

ent o

f rad

iatio

n ex

posu

re in

hum

ans

• Re

fere

nce

heal

th c

are

faci

litie

s ca

pabl

e of

clin

ical

man

agem

ent o

f sev

ere

radi

atio

n in

jurie

s an

d in

tern

al c

onta

min

atio

n.b.

Env

ironm

enta

l pro

tect

ion

• N

atio

nal s

urve

illan

ce s

ervi

ces

for r

adio

logi

cal m

onito

ring

of th

e en

viro

nmen

t.c.

Nuc

lear

regu

lato

ry a

nd ra

diat

ion

safe

ty a

utho

ritie

s•

Ope

rato

rs o

f nuc

lear

inst

alla

tions

(if a

ny)

d. E

mer

genc

y se

rvic

es (fi

re, p

olic

e, a

mbu

lanc

e, m

edic

al re

spon

ders

, etc

.)e.

Con

sum

er s

afet

y, in

clud

ing

food

and

drin

king

wat

er s

afet

yf.

Adm

inis

trat

ive/

polit

ical

aut

horit

ies

at a

ll le

vels

(loc

al, i

nter

med

iate

, nat

iona

l)g.

Haz

ardo

us s

ites

man

agem

ent

h. M

eteo

rolo

gica

l ser

vice

si.

Poin

ts o

f ent

ry (p

orts

, airp

orts

, gro

und

cros

sing

s), i

n pa

rtic

ular

thos

e de

sign

ated

und

er th

e IH

Rj.

Tran

spor

tk.

Priv

ate

sect

or/i

ndus

try.

6.

In th

e ev

ent o

f a ra

diat

ion

emer

genc

y, co

uld

a bu

dget

be

mob

ilize

d to

mee

t add

ition

al d

eman

ds?

7.

Is th

ere

an a

udit/

eval

uatio

n sy

stem

for e

xerc

ises

/res

pons

es?

8.

Are

thei

r rad

iatio

n em

erge

ncy

resp

onse

dril

ls c

arrie

d ou

t reg

ular

ly?

9.

Are

plan

s fo

r na

tiona

l and

inte

rnat

iona

l tra

nspo

rt o

f ra

dioa

ctiv

e m

ater

ials

, and

was

te m

anag

emen

t in

clud

ing

thos

e fro

m h

ospi

tals

and

med

ical

ser

vice

s es

tabl

ishe

d?

10.

Are

ther

e lin

ks e

stab

lishe

d w

ith g

loba

l exp

ert n

etw

orks

, suc

h as

WH

O’s

Rad

iatio

n Em

erge

ncy

Med

ical

Pre

pare

dnes

s an

d As

sist

ance

Net

wor

k(RE

MPA

N),

WH

O’s

gl

obal

bio

dosi

met

ry n

etw

ork

of la

bora

torie

s fo

r rad

iatio

n em

erge

ncie

s (B

ioD

oseN

et),

or In

tern

atio

nal A

tom

ic E

nerg

y Ag

ency

Res

pons

e As

sist

ance

Net

wor

k (R

ANET

)

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



Refe

renc

es:

l

IAEA

saf

ety

stan

dard

s se

ries

No.

GSR

Par

t 7. P

repa

redn

ess

and

resp

onse

for a

nuc

lear

or r

adio

logi

cal e

mer

genc

y. J

oint

ly s

pons

ored

by

the

FAO,

IAEA

, ICAO

, ILO,

IM

O, IN

TERP

OL,

OEC

D/N

EA, P

AHO,

CTB

TO, U

NEP

, OCH

A, W

HO,

WM

O. G

ener

al S

afet

y Re

quire

men

ts P

art 7

. Vie

nna:

Inte

rnat

iona

l Ato

mic

Ene

rgy

Agen

cy; 2

015

(http

://w

ww

-pub

.iaea

.org

/MTC

D/P

ublic

atio

ns/P

DF/

P_17

08_w

eb.p

df, a

cces

sed

28 N

ovem

ber 2

017)

.l

IAEA

saf

ety

glos

sary

. Ter

min

olog

y us

ed in

nuc

lear

saf

ety

and

radi

atio

n pr

otec

tion

2007

edi

tion.

Vie

nna:

Inte

rnat

iona

l Ato

mic

Ene

rgy

Agen

cy; 2

009

(http

://w

ww

-pub

.iaea

.org

/MTC

D/p

ublic

atio

ns/P

DF/

Pub1

290_

web

.pdf

, acc

esse

d 28

Nov

embe

r 201

7).

IHR

RE

LA

TE

D H

AZ

AR

DS

AN

D P

OE



APPE

ND

IX 1

: GLO

SSAR

Y

Not

e: T

hese

term

s an

d de

finiti

ons

have

bee

n pr

ovid

ed fo

r use

with

in th

e co

ntex

t of t

his

tool

and

may

diff

er fr

om th

ose

used

in o

ther

doc

umen

ts. T

he p

urpo

se is

to

cla

rify

key

term

s th

at a

re IH

R re

leva

nt, a

nd re

fer t

o fo

odbo

rne

as w

ell a

s zo

onot

ic d

isea

ses

and

othe

r rel

evan

t cou

ntry

-spe

cific

pub

lic h

ealth

prio

ritie

s.

Bios

afet

y. L

abor

ator

y bi

osaf

ety

desc

ribes

the

con

tain

men

t pr

inci

ples

, tec

hnol

ogie

s an

d pr

actic

es t

hat

are

impl

emen

ted

to p

reve

nt u

nint

entio

nal e

xpos

ure

to

path

ogen

s an

d to

xins

, or t

heir

acci

dent

al re

leas

e.

Bios

ecur

ity. L

abor

ator

y bi

osec

urity

des

crib

es th

e pr

otec

tion,

con

trol

and

acc

ount

abili

ty fo

r val

uabl

e bi

olog

ical

mat

eria

ls w

ithin

labo

rato

ries

as 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, i

n or

der 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.

Case

. A p

erso

n w

ho h

as th

e pa

rtic

ular

dis

ease

, hea

lth d

isor

der o

r con

ditio

n th

at m

eets

the

case

defi

nitio

ns fo

r sur

veill

ance

and

out

brea

k in

vest

igat

ion

purp

oses

. Th

e de

finiti

on o

f a c

ase

for s

urve

illan

ce a

nd o

utbr

eak

inve

stig

atio

n pu

rpos

e is

not

nec

essa

rily

the

sam

e as

the

ordi

nary

clin

ical

defi

nitio

n (a

dapt

ed fr

om L

ast J

M,

Spas

off R

A, H

arris

, edi

tors

. A d

ictio

nary

of e

pide

mio

logy

, fou

rth

editi

on. I

nter

natio

nal E

pide

mio

logi

cal A

ssoc

iatio

n, In

c. N

ew Y

ork:

Oxf

ord

Uni

vers

ity P

ress

; 200

1).

Case

defi

nitio

n. A

set

of d

iagn

ostic

crit

eria

that

mus

t be

fulfi

lled

for a

n in

divi

dual

to b

e re

gard

ed a

s a

case

of a

par

ticul

ar d

isea

se fo

r sur

veill

ance

and

out

brea

k in

vest

igat

ion

purp

oses

. Cas

e de

finiti

ons

can

be b

ased

on

clin

ical

crit

eria

, lab

orat

ory

crite

ria o

r a

com

bina

tion

of th

e tw

o w

ith th

e el

emen

ts o

f tim

e, p

lace

and

pe

rson

. (In

the

IHR,

cas

e de

finiti

ons

are

publ

ishe

d on

the

WH

O w

ebsi

te1

for

the

four

dis

ease

s fo

r w

hich

all

case

s m

ust

be n

otifi

ed b

y St

ates

Par

ties

to W

HO,

re

gard

less

of c

ircum

stan

ces,

und

er th

e IH

R as

pro

vide

d in

Ann

ex 2

.)

Chem

ical

eve

nt. A

man

ifest

atio

n of

a d

isea

se o

r an

occu

rren

ce, w

hich

cre

ates

a p

oten

tial f

or a

dis

ease

as

a re

sult

of e

xpos

ure

to o

r con

tam

inat

ion

by a

che

mic

al

agen

t.

Clus

ter.

An a

ggre

gatio

n of

rela

tivel

y un

com

mon

eve

nts

or d

isea

ses

in s

pace

and

/or t

ime

in a

mou

nts

that

are

bel

ieve

d or

per

ceiv

ed to

be

grea

ter t

han

that

exp

ecte

d by

cha

nce

(ada

pted

from

Las

t JM

, Spa

soff

RA, H

arris

, edi

tors

. A d

ictio

nary

of e

pide

mio

logy

, fou

rth

editi

on. I

nter

natio

nal E

pide

mio

logi

cal A

ssoc

iatio

n, In

c. N

ew

York

: Oxf

ord

Uni

vers

ity P

ress

; 200

1).

Com

mun

icab

le d

isea

se (i

nfec

tious

dis

ease

). An

illn

ess

due

to a

spe

cific

infe

ctio

us a

gent

or i

ts to

xic

prod

ucts

that

aris

es th

roug

h tr

ansm

issi

on o

f tha

t age

nt o

r its

pr

oduc

ts fr

om a

n in

fect

ed p

erso

n, a

nim

al o

r res

ervo

ir to

a s

usce

ptib

le h

ost,

eith

er d

irect

ly o

r ind

irect

ly th

roug

h an

inte

rmed

iate

pla

nt o

r ani

mal

hos

t, ve

ctor

or t

he

inan

imat

e en

viro

nmen

t (ad

apte

d fr

om L

ast J

M, S

paso

ff RA

, Har

ris, e

dito

rs. A

dic

tiona

ry o

f epi

dem

iolo

gy, f

ourt

h ed

ition

. Int

erna

tiona

l Epi

dem

iolo

gica

l Ass

ocia

tion,

In

c. N

ew Y

ork:

Oxf

ord

Uni

vers

ity P

ress

; 200

1).

Com

mun

ity s

urve

illan

ce. T

he s

tart

ing

poin

t fo

r ev

ent

notifi

catio

n at

the

com

mun

ity le

vel,

gene

rally

don

e by

a c

omm

unity

wor

ker;

it ca

n be

act

ive

(look

ing

for

case

s) o

r pa

ssiv

e (r

epor

ting

case

s). I

t m

ay b

e pa

rtic

ular

ly u

sefu

l dur

ing

an o

utbr

eak

and

whe

re s

yndr

omic

cas

e de

finiti

ons

can

be u

sed

(the

iden

tifica

tion

of

com

mun

ity c

ases

of E

bola

viru

s in

fect

ion

by c

omm

unity

wor

kers

was

an

exam

ple

of a

ctiv

e co

mm

unity

sur

veill

ance

).

Com

pete

nt a

utho

rity.

An

auth

ority

resp

onsi

ble

for t

he im

plem

enta

tion

and

appl

icat

ion

of h

ealth

mea

sure

s un

der t

he IH

R.

1 -

http

://w

ww

.who

.int/

ihr/

surv

ella

nce_

resp

onse

/cas

e_de

finiti

ons/

en/



Cont

amin

atio

n. T

he p

rese

nce

of a

n in

fect

ious

or t

oxic

age

nt o

r mat

ter o

n th

e bo

dy s

urfa

ce o

f a h

uman

or a

nim

al, i

n or

on

a pr

oduc

t pre

pare

d fo

r con

sum

ptio

n or

on

oth

er in

anim

ate

obje

cts,

incl

udin

g co

nvey

ance

s th

at m

ay c

onst

itute

a p

ublic

hea

lth ri

sk.

Dang

erou

s pa

thog

ens

and

toxi

ns. T

hese

are

bio

logi

cal a

gent

s an

d to

xins

tha

t ha

ve t

he p

oten

tial t

o po

se a

sev

ere

thre

at t

o bo

th h

uman

and

ani

mal

hea

lth.

Whi

le s

ome

sele

ct a

gent

s ar

e no

rmal

ly fo

und

in th

e en

viro

nmen

t and

don

’t ca

use

hum

an d

isea

se, m

any

of th

em –

if m

anip

ulat

ed o

r rel

ease

d in

larg

e qu

antit

ies

– c

an c

ause

ser

ious

hea

lth t

hrea

ts. T

he in

form

al A

ustr

alia

Gro

up p

rovi

des

a Li

st o

f hu

man

and

ani

mal

pat

hoge

ns a

nd t

oxin

s fo

r ex

port

con

trol

(ht

tp:/

/ww

w.

aust

ralia

grou

p.ne

t/en

/hum

an_a

nim

al_p

atho

gens

.htm

l, ac

cess

ed 2

8 Au

gust

201

6).

Deco

ntam

inat

ion.

A p

roce

dure

whe

reby

hea

lth m

easu

res

are

take

n to

elim

inat

e an

infe

ctio

us o

r tox

ic a

gent

or m

atte

r on

the

body

sur

face

of a

hum

an o

r ani

mal

, in

or o

n a

prod

uct p

repa

red

for c

onsu

mpt

ion,

or o

n ot

her i

nani

mat

e ob

ject

s, in

clud

ing

conv

eyan

ces

that

may

con

stitu

te a

pub

lic h

ealth

risk

.

Des

igna

ted

labo

rato

ries.

The

se a

re la

bora

torie

s de

sign

ated

to p

erfo

rm s

peci

fic la

bora

tory

ser

vice

s by

nat

iona

l, W

HO

or o

ther

aut

horit

ies

beca

use

of th

eir p

rove

n ca

paci

ties

and

capa

bilit

ies,

suc

h as

for A

MR

test

ing.

Desi

gnat

ed p

oint

s of

ent

ry. T

hese

refe

r to

a po

rt, a

irpor

t and

pot

entia

lly a

gro

und

cros

sing

that

is d

esig

nate

d by

a S

tate

Par

ty to

str

engt

hen,

dev

elop

and

mai

ntai

n th

e ca

paci

ties

as p

er m

ain

IHR

artic

les

19, 2

0 an

d 21

, and

as

desc

ribed

in A

nnex

1 o

f the

IHR:

• The

cap

aciti

es a

t all

times

con

cern

ing

acce

ss to

med

ical

ser

vice

s fo

r pr

ompt

ass

essm

ent a

nd c

are

of il

l tra

velle

rs, a

saf

e en

viro

nmen

t for

trav

elle

rs (e

.g.

wat

er, f

ood,

was

te),

pers

onne

l for

insp

ectio

n an

d ve

ctor

con

trol

func

tions

; and

• The

cap

aciti

es to

resp

ond

spec

ifica

lly to

eve

nts

that

may

con

stitu

te a

pub

lic h

ealth

em

erge

ncy

of in

tern

atio

nal c

once

rn.

Dise

ase.

An

illne

ss o

r med

ical

con

ditio

n, ir

resp

ectiv

e of

orig

in o

r sou

rce,

that

pre

sent

s or

cou

ld p

rese

nt s

igni

fican

t har

m to

hum

ans.

Disi

nsec

tion.

The

pro

cedu

re w

here

by h

ealth

mea

sure

s ar

e ta

ken

to c

ontr

ol o

r ki

ll in

sect

vec

tors

of

hum

an d

isea

ses

pres

ent

in b

agga

ge, c

argo

, con

tain

ers,

co

nvey

ance

s, g

oods

and

pos

tal p

arce

ls.

Docu

men

ted

proc

edur

es. A

gree

d an

d ap

prov

ed s

trat

egie

s fo

r ope

ratio

n, s

tand

ard

oper

atin

g pr

oced

ures

, rol

es a

nd re

spon

sibi

litie

s, a

gree

men

ts, t

erm

s of

refe

renc

e,

chai

ns o

f com

man

d, re

port

ing

mec

hani

sms,

am

ong

othe

rs.

Early

war

ning

sys

tem

. A s

peci

fic p

roce

dure

in d

isea

se s

urve

illan

ce to

det

ect a

ny a

bnor

mal

occ

urre

nce,

or d

epar

ture

from

the

usua

l or n

orm

ally

obs

erve

d fr

eque

ncy

of p

heno

men

a (s

uch

as o

ne c

ase

of E

bola

feve

r), a

s ea

rly a

s po

ssib

le. A

n ea

rly w

arni

ng s

yste

m is

onl

y us

eful

if it

is li

nked

to m

echa

nism

s fo

r ea

rly re

spon

se

(ada

pted

from

Las

t JM

, Spa

soff

RA, H

arris

, edi

tors

. A d

ictio

nary

of e

pide

mio

logy

, fou

rth

editi

on. I

nter

natio

nal E

pide

mio

logi

cal A

ssoc

iatio

n, In

c. N

ew Y

ork:

Oxf

ord

Uni

vers

ity P

ress

; 200

1).

Epid

emic

. The

occ

urre

nce

in a

com

mun

ity o

r reg

ion

of c

ases

of a

n ill

ness

, spe

cific

hea

lth-r

elat

ed b

ehav

iour

s, o

r oth

er h

ealth

-rel

ated

eve

nts

clea

rly in

exc

ess

of

norm

al e

xpec

tanc

y. T

he c

omm

unity

or r

egio

n an

d th

e pe

riod

in w

hich

the

case

s oc

cur a

re s

peci

fied

prec

isel

y. T

he n

umbe

r of c

ases

indi

catin

g th

e pr

esen

ce o

f an

epi

dem

ic v

arie

s ac

cord

ing

to th

e ag

ent,

size

and

type

of p

opul

atio

n ex

pose

d, p

revi

ous

expe

rienc

e or

lack

of e

xpos

ure

to th

e di

seas

e, a

nd ti

me

and

plac

e of

oc

curr

ence

(ada

pted

from

Las

t JM

, Spa

soff

RA, H

arris

, edi

tors

. A d

ictio

nary

of e

pide

mio

logy

, fou

rth

editi

on. I

nter

natio

nal E

pide

mio

logi

cal A

ssoc

iatio

n, In

c. N

ew

York

: Oxf

ord

Uni

vers

ity P

ress

; 200

1).



Even

t. A

man

ifest

atio

n of

dis

ease

or a

n oc

curr

ence

that

cre

ates

a p

oten

tial f

or d

isea

se.

Even

t-ba

sed

surv

eilla

nce.

The

org

aniz

ed a

nd ra

pid

capt

ure

of in

form

atio

n ab

out e

vent

s th

at a

re a

pot

entia

l ris

k to

pub

lic h

ealth

. Thi

s in

form

atio

n ca

n be

rum

ours

an

d ot

her a

d ho

c re

port

s tr

ansm

itted

thro

ugh

form

al c

hann

els

(i.e.

est

ablis

hed

rout

ine

repo

rtin

g sy

stem

s) a

nd in

form

al c

hann

els

(i.e.

the

med

ia, h

ealth

wor

kers

an

d re

port

s fr

om n

ongo

vern

men

tal o

rgan

izat

ions

), in

clud

ing

even

ts r

elat

ed t

o th

e oc

curr

ence

of

dise

ase

in h

uman

s an

d ev

ents

rel

ated

to

pote

ntia

l hum

an

expo

sure

.

Feed

back

. The

regu

lar p

roce

ss o

f sen

ding

ana

lyse

s an

d re

port

s ab

out s

urve

illan

ce d

ata

back

thro

ugh

all l

evel

s of

the

surv

eilla

nce

syst

em s

o th

at a

ll pa

rtic

ipan

ts

can

be in

form

ed o

f tre

nds

and

perf

orm

ance

.

Fiel

d Ep

idem

iolo

gy T

rain

ing

Prog

ram

• FET

P Ba

sic

Leve

l Tra

inin

g is

for l

ocal

hea

lth s

taff

and

cons

ists

of l

imite

d cl

assr

oom

hou

rs in

ters

pers

ed th

roug

hout

as

a th

ree-

to-fi

ve m

onth

on-

the-

job

field

as

sign

men

t to

build

cap

acity

in c

ondu

ctin

g tim

ely

outb

reak

det

ectio

n, p

ublic

hea

lth re

spon

se a

nd p

ublic

hea

lth s

urve

illan

ce.

• FET

P In

term

edia

te L

evel

Tra

inin

g is

for

dist

rict/

regi

on/s

tate

-lev

el e

pide

mio

logi

sts,

and

con

sist

s of

lim

ited

clas

sroo

m h

ours

inte

rspe

rsed

thro

ugho

ut a

s a

six-

to-n

ine

mon

th o

n-th

e-jo

b m

ento

red

field

ass

ignm

ent t

o bu

ild c

apac

ity in

con

duct

ing

outb

reak

inve

stig

atio

ns, p

lann

ed e

pide

mio

logi

c st

udie

s, a

nd p

ublic

he

alth

sur

veill

ance

ana

lyse

s an

d ev

alua

tions

. • F

ETP

Adva

nced

Lev

el T

rain

ing

is fo

r adv

ance

d ep

idem

iolo

gist

s an

d co

nsis

ts o

f lim

ited

clas

sroo

m h

ours

inte

rspe

rsed

thro

ugho

ut th

e 24

mon

ths

of m

ento

red

field

ass

ignm

ents

to b

uild

cap

acity

in o

utbr

eak

inve

stig

atio

ns, p

lann

ed e

pide

mio

logi

c st

udie

s, p

ublic

hea

lth s

urve

illan

ce a

naly

ses

and

eval

uatio

ns, s

cien

tific

com

mun

icat

ion,

and

evi

denc

e-ba

sed

deci

sion

mak

ing

for

deve

lopm

ent

of e

ffect

ive

publ

ic h

ealth

pro

gram

min

g w

ith a

nat

iona

l fo

cus.

Ani

mal

hea

lth

prof

essi

onal

s ca

n be

eng

aged

in th

ese

FETP

trai

ning

s.

Func

tiona

l exe

rcis

e. A

fully

sim

ulat

ed in

tera

ctiv

e ex

erci

se th

at te

sts

the

capa

bilit

y of

an

orga

niza

tion

to re

spon

d to

a s

imul

ated

eve

nt. T

he e

xerc

ise

test

s m

ultip

le

func

tions

of t

he o

rgan

izat

ion’

s op

erat

iona

l pla

n. It

is a

coo

rdin

ated

resp

onse

to a

situ

atio

n in

a ti

me

pres

sure

d re

alis

tic s

ituat

ion

as d

escr

ibed

in W

HO

Sim

ulat

ion

Exer

cise

Man

ual 5

. A fu

nctio

nal e

xerc

ise

focu

ses

on th

e co

ordi

natio

n, in

tegr

atio

n an

d in

tera

ctio

n of

an

orga

niza

tion’

s po

licie

s, p

roce

dure

s, ro

les

and

resp

onsi

bilit

ies

befo

re, d

urin

g or

aft

er th

e si

mul

ated

eve

nt (W

HO

Sim

ulat

ion

Exer

cise

Man

ual.

HO

-WH

E-CP

I-20

17.1

0 (h

ttp:

//ap

ps.w

ho.in

t/iri

s/bi

tstr

eam

/106

65/2

5474

1/1/

WH

O-

WH

E-CP

I-20

17.1

0-en

g.pd

f?ua

=1, a

cces

sed

13 A

ugus

t 201

7).

Gro

und

cros

sing

. A p

oint

of l

and

entr

y in

to a

Sta

te P

arty

, inc

ludi

ng th

ose

utili

zed

by ro

ad v

ehic

les

and

trai

ns.

Haz

ard.

The

inhe

rent

cap

abili

ty o

f an

agen

t or s

ituat

ion

to h

ave

an a

dver

se e

ffect

; a fa

ctor

or e

xpos

ure

that

may

adv

erse

ly a

ffect

hea

lth (s

imila

r con

cept

to ri

sk

fact

or).

Hea

lth c

are

wor

ker.

Any

empl

oyee

in a

hea

lth c

are

faci

lity

who

has

clo

se c

onta

ct w

ith p

atie

nts,

pat

ient

-car

e ar

eas

or p

atie

nt-c

are

item

s; a

lso

refe

rred

to a

s “h

ealth

ca

re p

erso

nnel

”.

Hea

lth e

vent

. Any

eve

nt re

latin

g to

the

heal

th o

f an

indi

vidu

al, s

uch

as th

e oc

curr

ence

of a

cas

e of

a s

peci

fic d

isea

se o

r syn

drom

e, th

e ad

min

istr

atio

n of

a v

acci

ne

or a

n ad

mis

sion

to h

ospi

tal.

Hea

lth m

easu

re. A

pro

cedu

re a

pplie

d to

pre

vent

the

spre

ad o

f dis

ease

or c

onta

min

atio

n; it

doe

s no

t inc

lude

law

enf

orce

men

t or s

ecur

ity m

easu

res.



Inci

denc

e. T

he n

umbe

r of i

nsta

nces

of i

llnes

s co

mm

enci

ng, o

r of p

erso

ns fa

lling

ill,

durin

g a

give

n pe

riod

in a

spe

cifie

d po

pula

tion

(Pre

vale

nce

and

inci

denc

e.

WH

O B

ulle

tin 1

966;

35:7

83-7

84).

Indi

cato

r-ba

sed

surv

eilla

nce.

The

rout

ine

repo

rtin

g of

cas

es o

f dis

ease

, inc

ludi

ng fr

om n

otifi

able

dis

ease

s su

rvei

llanc

e, s

entin

el s

urve

illan

ce, l

abor

ator

y ba

sed

surv

eilla

nce.

Thi

s ro

utin

e re

port

ing

is c

omm

only

hea

lth c

are

faci

lity

base

d w

ith re

port

ing

done

on

a w

eekl

y or

mon

thly

bas

is.

Infe

ctio

n. T

he e

ntry

and

dev

elop

men

t or m

ultip

licat

ion

of a

n in

fect

ious

age

nt in

the

body

of h

uman

s an

d an

imal

s th

at m

ay c

onst

itute

a p

ublic

hea

lth ri

sk.

Infe

ctio

n co

ntro

l. M

easu

res

prac

ticed

by

heal

th c

are

pers

onne

l in

heal

th c

are

faci

litie

s to

dec

reas

e tr

ansm

issi

on a

nd a

cqui

sitio

n of

infe

ctio

us a

gent

s. T

hese

in

clud

e pr

oper

han

d hy

gien

e, s

crup

ulou

s w

ork

prac

tices

, and

the

use

of p

erso

nal p

rote

ctiv

e eq

uipm

ent (

such

as

mas

ks, r

espi

rato

rs, g

love

s, g

owns

, eye

pro

tect

ion)

. In

fect

ion

cont

rol m

easu

res

are

base

d on

how

an

infe

ctio

us a

gent

is tr

ansm

itted

and

incl

ude

stan

dard

, con

tact

, dro

plet

and

airb

orne

pre

caut

ions

.

Infe

ctio

us d

isea

se. S

ee C

omm

unic

able

dis

ease

.

Inte

rnat

iona

l Hea

lth R

egul

atio

ns (2

005)

(IH

R or

the

Regu

latio

ns).

This

is a

lega

lly-b

indi

ng in

stru

men

t of i

nter

natio

nal l

aw w

hich

has

its

orig

in in

the

Inte

rnat

iona

l Sa

nita

ry C

onve

ntio

ns o

f 185

1, c

oncl

uded

in re

spon

se to

incr

easi

ng c

once

rn a

bout

the

links

bet

wee

n in

tern

atio

nal t

rade

and

spr

ead

of d

isea

ses

(cro

ss-b

orde

r he

alth

risk

s).

Isol

atio

n. S

epar

atio

n of

sic

k or

con

tam

inat

ed p

erso

ns o

r affe

cted

bag

gage

, con

tain

ers,

con

veya

nces

, goo

ds o

r pos

tal p

arce

ls fr

om o

ther

s in

suc

h a

man

ner a

s to

pr

even

t the

spr

ead

of in

fect

ion

or c

onta

min

atio

n.

Legi

slat

ion.

The

rang

e of

lega

l, ad

min

istr

ativ

e or

oth

er g

over

nmen

tal i

nstr

umen

ts th

at m

ay b

e av

aila

ble

for S

tate

s Pa

rtie

s to

impl

emen

t the

IHR.

Thi

s in

clud

es

lega

lly b

indi

ng i

nstr

umen

ts, s

uch

as s

tate

con

stitu

tions

, law

s, a

cts,

dec

rees

, ord

ers,

reg

ulat

ions

and

ord

inan

ces;

leg

ally

non

-bin

ding

ins

trum

ents

, suc

h as

gu

idel

ines

, sta

ndar

ds, o

pera

ting

rule

s, a

dmin

istr

ativ

e pr

oced

ures

or r

ules

; and

oth

er ty

pes

of in

stru

men

ts, s

uch

as p

roto

cols

, res

olut

ions

and

inte

r-se

ctor

al o

r in

ter-

min

iste

rial a

gree

men

ts. T

his

enco

mpa

sses

legi

slat

ion

in a

ll se

ctor

s, s

uch

as h

ealth

, agr

icul

ture

, tra

nspo

rtat

ion,

env

ironm

ent,

port

s an

d ai

rpor

ts, a

nd a

t all

appl

icab

le g

over

nmen

tal l

evel

s (n

atio

nal,

inte

rmed

iate

, loc

al a

nd o

ther

).

Mul

tisec

tora

l. A

holis

tic a

ppro

ach

invo

lvin

g th

e ef

fort

s of

mul

tiple

org

aniz

atio

ns, in

stitu

tes

and

agen

cies

. It e

ncou

rage

s in

terd

isci

plin

ary p

artic

ipat

ion,

col

labo

ratio

n an

d co

ordi

natio

n of

peo

ple

of c

once

rn a

nd re

sour

ces

from

thes

e ke

y or

gani

zatio

ns fo

r pro

mot

ing

heal

th s

ecur

ity, t

o ac

hiev

e a

spec

ific

goal

.

Nat

iona

l leg

isla

tion.

See

Leg

isla

tion.

Nat

iona

l IH

R Fo

cal P

oint

. The

nat

iona

l cen

tre

desi

gnat

ed b

y ea

ch S

tate

Par

ty, w

hich

sha

ll be

acc

essi

ble

at a

ll tim

es fo

r com

mun

icat

ions

with

WH

O IH

R co

ntac

t po

ints

und

er th

e IH

R.

Not

ifiab

le d

isea

se. A

dis

ease

that

, by

stat

utor

y/le

gal r

equi

rem

ents

, mus

t be

repo

rted

to a

pub

lic h

ealth

or o

ther

com

pete

nt a

utho

rity

in th

e pe

rtin

ent j

uris

dict

ion

whe

n th

e di

agno

sis

is m

ade

(ada

pted

fro

m L

ast

JM, S

paso

ff RA

, Har

ris, e

dito

rs.

A di

ctio

nary

of

epid

emio

logy

, fou

rth

editi

on.

Inte

rnat

iona

l Epi

dem

iolo

gica

l As

soci

atio

n, In

c. N

ew Y

ork:

Oxf

ord

Uni

vers

ity P

ress

; 200

1).

Not

ifica

tion.

The

pro

cess

es b

y w

hich

cas

es o

r out

brea

ks a

re b

roug

ht to

the

know

ledg

e of

the

heal

th a

utho

ritie

s. In

the

cont

ext o

f the

IHR,

not

ifica

tion

is th

e of

ficia

l co

mm

unic

atio

n of

a d

isea

se/h

ealth

eve

nt to

the

WH

O b

y th

e he

alth

adm

inis

trat

ion

of th

e M

embe

r Sta

te a

ffect

ed b

y th

e di

seas

e/he

alth

eve

nt.



Occ

upat

iona

l saf

ety.

Occ

upat

iona

l hea

lth d

eals

with

all

aspe

cts

of h

ealth

and

saf

ety

in th

e w

orkp

lace

and

has

a s

tron

g fo

cus

on p

rimar

y pr

even

tion

of h

azar

ds.

The

heal

th o

f w

orke

rs h

as s

ever

al d

eter

min

ants

, inc

ludi

ng r

isk

fact

ors

at t

he w

orkp

lace

lead

ing

to c

ance

rs, a

ccid

ents

, mus

culo

skel

etal

dis

ease

s, r

espi

rato

ry

dise

ases

, hea

ring

loss

, circ

ulat

ory

dise

ases

, str

ess

rela

ted

diso

rder

s, c

omm

unic

able

dis

ease

s an

d ot

hers

(htt

p://

ww

w.w

ho.in

t/to

pics

/occ

upat

iona

l_he

alth

/en/

, ac

cess

ed 2

8 N

ovem

ber 2

017)

.

Occ

upat

iona

l saf

ety

and

heal

th. T

he W

HO

Glo

bal P

lan

of A

ctio

n (G

PA) o

n W

orke

rs’ H

ealth

(200

8–17

) and

con

sist

ent w

ith th

e IL

O P

rom

otio

nal F

ram

ewor

k fo

r O

ccup

atio

nal S

afet

y an

d H

ealth

Con

vent

ion,

200

6 (N

o. 1

87)

aim

s to

str

engt

hen

heal

th s

yste

ms

and

the

desi

gn o

f he

alth

car

e se

ttin

gs f

or im

prov

ing

heal

th

and

safe

ty o

f the

hea

lth w

orke

r, pa

tient

saf

ety

and

qual

ity o

f pat

ient

car

e, a

nd u

ltim

atel

y su

ppor

t a h

ealth

y an

d su

stai

nabl

e co

mm

unity

with

link

s to

gre

enin

g he

alth

sec

tor

and

gree

n jo

bs in

itiat

ives

(ht

tp:/

/ww

w.il

o.or

g/w

cmsp

5/gr

oups

/pub

lic/-

--ed

_nor

m/-

--re

lcon

f/do

cum

ents

/mee

tingd

ocum

ent/

wcm

s_14

5837

.pdf

, ac

cess

ed 2

8 N

ovem

ber 2

017)

.

One

Hea

lth. D

efine

d by

WH

O a

s an

app

roac

h to

des

igni

ng a

nd im

plem

entin

g pr

ogra

mm

es, p

olic

ies,

legi

slat

ion

and

rese

arch

in w

hich

mul

tiple

sec

tors

com

mun

icat

e an

d w

ork

toge

ther

to a

chie

ve b

ette

r pub

lic h

ealth

out

com

es (h

ttp:

//w

ww

.who

.int/

feat

ures

/qa/

one-

heal

th/e

n/, a

cces

sed

28 N

ovem

ber 2

017)

In th

e co

ntex

t of t

he W

HO

tech

nica

l fra

mew

ork

in s

uppo

rt to

IHR

mon

itorin

g an

d ev

alua

tion,

taki

ng a

One

Hea

lth a

ppro

ach

mea

ns in

clud

ing,

from

all

rele

vant

sec

tors

, na

tiona

l inf

orm

atio

n, e

xper

tise,

per

spec

tives

and

exp

erie

nce

nece

ssar

y to

con

duct

ass

essm

ents

, eva

luat

ions

and

repo

rtin

g fo

r the

impl

emen

tatio

n of

the

IHR.

Oth

er g

over

nmen

tal i

nstr

umen

ts. A

gree

men

ts, p

roto

cols

and

reso

lutio

ns o

f any

gov

ernm

ent a

utho

rity

or b

ody.

Out

brea

k. A

n ep

idem

ic li

mite

d to

loca

lized

incr

ease

in th

e in

cide

nce

of a

dis

ease

, suc

h as

in a

vill

age,

tow

n or

clo

sed

inst

itutio

n (a

dapt

ed fr

om L

ast J

M, S

paso

ff RA

, Har

ris, e

dito

rs. A

dic

tiona

ry o

f epi

dem

iolo

gy, f

ourt

h ed

ition

. Int

erna

tiona

l Epi

dem

iolo

gica

l Ass

ocia

tion,

Inc.

New

Yor

k: O

xfor

d U

nive

rsity

Pre

ss; 2

001)

.

Pers

onal

pro

tect

ive

equi

pmen

t. Sp

ecia

lized

clo

thin

g an

d eq

uipm

ent d

esig

ned

to c

reat

e a

barr

ier a

gain

st h

ealth

and

saf

ety

haza

rds;

exa

mpl

es in

clud

e go

ggle

s,

face

shi

elds

, glo

ves

and

resp

irato

rs.

Poin

t of e

ntry

. A p

assa

ge fo

r int

erna

tiona

l ent

ry o

r exi

t of t

rave

llers

, bag

gage

, car

go, c

onta

iner

s, c

onve

yanc

es, g

oods

and

pos

tal p

arce

ls, a

nd th

e ag

enci

es a

nd

area

s pr

ovid

ing

serv

ices

to th

em u

pon

entr

y or

exi

t.

Port

. A s

eapo

rt o

r a p

ort o

n an

inla

nd b

ody

of w

ater

whe

re s

hips

on

an in

tern

atio

nal v

oyag

e ar

rive

or d

epar

t.

Publ

ic h

ealth

em

erge

ncy

of in

tern

atio

nal c

once

rn (P

HEI

C). A

n ex

trao

rdin

ary

even

t (as

pro

vide

d in

the

IHR)

that

: (i)

cons

titut

es a

pub

lic h

ealth

risk

to o

ther

sta

tes

thro

ugh

the

inte

rnat

iona

l spr

ead

of d

isea

se; a

nd (i

i) po

tent

ially

requ

ires

a co

ordi

nate

d in

tern

atio

nal r

espo

nse.

Publ

ic h

ealth

risk

. The

like

lihoo

d of

an

even

t tha

t may

adv

erse

ly a

ffect

the

heal

th o

f hum

an p

opul

atio

ns, w

ith a

n em

phas

is o

n w

heth

er it

may

spr

ead

inte

rnat

iona

lly

or p

rese

nt a

ser

ious

and

dire

ct d

ange

r.

Qua

rant

ine.

The

rest

rictio

n of

act

iviti

es a

nd/o

r sep

arat

ion

from

oth

ers

of s

uspe

ct p

erso

ns w

ho a

re n

ot s

ick,

or o

f sus

pect

bag

gage

, con

tain

ers,

con

veya

nces

or

good

s in

suc

h a

man

ner s

o as

to p

reve

nt th

e po

ssib

le s

prea

d of

infe

ctio

n or

con

tam

inat

ion.

Rapi

d re

spon

se te

am. A

gro

up o

f tra

ined

indi

vidu

als

that

is re

ady

to re

spon

d qu

ickl

y to

an

even

t. Th

e co

mpo

sitio

n an

d te

rms

of re

fere

nce

are

dete

rmin

ed b

y th

e co

ncer

ned

coun

try.



Read

ines

s. It

is th

e ab

ility

to q

uick

ly a

nd a

ppro

pria

tely

resp

ond

whe

n re

quire

d to

any

em

erge

ncie

s.

Regu

latio

ns o

r adm

inis

trat

ive

requ

irem

ents

. All

regu

latio

ns, p

roce

dure

s, ru

les

and

stan

dard

s.

Rele

vant

sec

tors

. Priv

ate

and

publ

ic s

ecto

rs: s

uch

as a

ll le

vels

of t

he h

ealth

car

e sy

stem

(nat

iona

l, su

bnat

iona

l and

com

mun

ity/p

rimar

y pu

blic

hea

lth);

NG

Os;

m

inis

trie

s of

agr

icul

ture

(zoo

nosi

s, v

eter

inar

y la

bora

tory

), tr

ansp

ort

(tra

nspo

rt p

olic

y, ci

vil a

viat

ion,

por

ts a

nd m

ariti

me

tran

spor

t), t

rade

and

/or

indu

stry

(foo

d sa

fety

and

qua

lity

cont

rol),

for

eign

tra

de (

cons

umer

pro

tect

ion,

con

trol

of

com

puls

ory

stan

dard

enf

orce

men

t), c

omm

unic

atio

n, d

efen

ce, t

reas

ury

or fi

nanc

e (c

usto

ms)

, env

ironm

ent,

inte

rior,

heal

th, t

ouris

m; t

he h

ome

offic

e; m

edia

; and

regu

lato

ry b

odie

s.

Risk

com

mun

icat

ion.

For

pub

lic h

ealth

em

erge

ncie

s in

clud

es th

e ra

nge

of c

omm

unic

atio

n ca

paci

ties

requ

ired

thro

ugh

the

prep

ared

ness

, res

pons

e an

d re

cove

ry

phas

es o

f a s

erio

us p

ublic

hea

lth e

vent

to e

ncou

rage

info

rmed

dec

isio

n m

akin

g, p

ositi

ve b

ehav

iour

cha

nge

and

the

mai

nten

ance

of t

rust

.

Surv

eilla

nce.

The

sys

tem

atic

ong

oing

col

lect

ion,

col

latio

n an

d an

alys

is o

f dat

a fo

r pub

lic h

ealth

pur

pose

s an

d th

e tim

ely

diss

emin

atio

n of

pub

lic h

ealth

info

rmat

ion

for a

sses

smen

t and

pub

lic h

ealth

resp

onse

, as

nece

ssar

y.

Synd

rom

e. A

sym

ptom

com

plex

in w

hich

the

sym

ptom

s an

d/or

sig

ns c

oexi

st m

ore

freq

uent

ly th

an w

ould

be

expe

cted

by

chan

ce in

depe

nden

tly (a

dapt

ed fr

om

Last

JM

, Spa

soff

RA, H

arris

, edi

tors

. A d

ictio

nary

of

epid

emio

logy

, fou

rth

editi

on. I

nter

natio

nal E

pide

mio

logi

cal A

ssoc

iatio

n, In

c. N

ew Y

ork:

Oxf

ord

Uni

vers

ity

Pres

s; 2

001)

.

Tabl

e to

p ex

erci

se. A

fac

ilita

ted

disc

ussi

on o

f an

em

erge

ncy

situ

atio

n, g

ener

ally

in a

n in

form

al, l

ow-s

tres

s en

viro

nmen

t. It

is d

esig

ned

to e

licit

cons

truc

tive

disc

ussi

on b

etw

een

part

icip

ants

; to

iden

tify

and

reso

lve

prob

lem

s; a

nd to

refin

e ex

istin

g op

erat

iona

l pla

ns. T

his

is th

e on

ly ty

pe o

f sim

ulat

ion

exer

cise

that

doe

s no

t req

uire

an

exis

ting

resp

onse

pla

n in

pla

ce. (

WH

O S

imul

atio

n Ex

erci

se M

anua

l. H

O-W

HE-

CPI-

2017

.10

(htt

p://

apps

.who

.int/

iris/

bits

trea

m/1

0665

/254

741/

1/W

HO

-WH

E-CP

I-20

17.1

0-en

g.pd

f?ua

=1, a

cces

sed

30 N

ovem

ber 2

017)

.

Trai

ned

staf

f. In

divi

dual

s th

at h

ave

educ

atio

nal c

rede

ntia

ls a

nd/o

r rec

eive

d sp

ecifi

c in

stru

ctio

n th

at is

app

licab

le to

a ta

sk o

r situ

atio

n.

Urg

ent e

vent

. A m

anife

stat

ion

of a

dis

ease

or a

n oc

curr

ence

that

cre

ates

a p

oten

tial f

or d

isea

se th

at h

as a

ser

ious

pub

lic h

ealth

impa

ct a

nd/o

r is

unus

ual o

r of

unex

pect

ed n

atur

e, w

ith h

igh

pote

ntia

l for

spr

ead.

Not

e: th

e te

rm “

urge

nt”

has

been

use

d in

com

bina

tion

with

oth

er te

rms

(suc

h as

infe

ctio

us e

vent

, che

mic

al

even

t) in

ord

er t

o si

mul

tane

ousl

y co

nvey

bot

h th

e na

ture

of

the

even

t an

d th

e ch

arac

teris

tics

that

mak

e it

“urg

ent”

(i.e

. ser

ious

pub

lic h

ealth

impa

ct a

nd/o

r un

usua

l or u

nexp

ecte

d na

ture

with

hig

h po

tent

ial f

or s

prea

d).

Vect

or. A

n in

sect

or o

ther

ani

mal

that

nor

mal

ly tr

ansp

orts

an

infe

ctio

us a

gent

that

con

stitu

tes

a pu

blic

hea

lth ri

sk.

Verifi

catio

n. T

he p

rovi

sion

of i

nfor

mat

ion

by a

Sta

te P

arty

to W

HO

con

firm

ing

the

stat

us o

f an

even

t with

in th

e te

rrito

ry o

r ter

ritor

ies

of th

at S

tate

Par

ty.

WH

O IH

R co

ntac

t poi

nt. T

he u

nit w

ithin

WH

O th

at is

acc

essi

ble

at a

ll tim

es fo

r com

mun

icat

ions

with

the

Nat

iona

l IH

R Fo

cal P

oint

.

Zoon

otic

dis

ease

s (o

r zo

onos

es).

Any

infe

ctio

n or

infe

ctio

us d

isea

se t

hat

is n

atur

ally

tra

nsm

issi

ble

from

ver

tebr

ate

anim

als

to h

uman

s (h

ttp:

//w

ww

.who

.int/

topi

cs/z

oono

ses/

en, a

cces

sed

28 N

ovem

ber 2

017)

.

Zoon

otic

eve

nt. A

man

ifest

atio

n of

a d

isea

se in

ani

mal

s th

at c

reat

es a

pot

entia

l for

a d

isea

se in

hum

ans

as a

resu

lt of

hum

an e

xpos

ure

to th

e an

imal

sou

rce.



APPE

ND

IX 2

: SU

MM

ARY

OF

CHAN

GES

BET

WEE

N J

EE T

OO

L FI

RST

AND

SEC

ON

D E

DIT

ION

S

1.

Nam

e of

the

two

tech

nica

l are

as h

ave

been

cha

nged

a. R

eal t

ime

surv

eilla

nce

to S

urve

illan

ceb.

Wor

kfor

ce d

evel

opm

ent t

o H

uman

reso

urce

s 2.

W

here

ther

e ar

e ch

ange

s in

indi

cato

rs (a

ddin

g, c

ombi

ning

, spl

ittin

g or

mov

ing)

; “ta

rget

”, “m

easu

red

by” a

nd “d

esire

d im

pact

” hav

e be

en u

pdat

ed to

o (d

etai

ls o

f in

dica

tor c

hang

es a

re re

flect

ed b

elow

in th

e co

lum

n tit

led

“Maj

or c

hang

es in

V2”

) 3.

W

hen

anim

al a

nd h

uman

hea

lth s

core

s ar

e gi

ven,

inst

ead

of th

e av

erag

e, th

e lo

wer

sco

re o

f tho

se tw

o w

ill b

e ta

ken.

4.

Fo

otno

tes

and

Glos

sary

are

upd

ated

to e

nsur

e co

rrec

t int

erpr

etat

ion

of th

e to

ol.

Tech

nica

l are

aJE

E to

ol fi

rst e

ditio

n (V

1)JE

E to

ol s

econ

d ed

ition

(V2)

Maj

or c

hang

es in

V2

How

to in

terp

ret1

Nat

iona

l le

gisl

atio

n, p

olic

y an

d fin

anci

ng

P.1.

1 Le

gisl

atio

n, la

ws,

regu

latio

ns,

adm

inis

trat

ive

requ

irem

ents

, po

licie

s or

oth

er g

over

nmen

t in

stru

men

ts in

pla

ce a

re s

uffic

ient

for

impl

emen

tatio

n of

IHR

P.1.

2 Th

e St

ate

can

dem

onst

rate

th

at it

has

adj

uste

d an

d al

igne

d its

do

mes

tic le

gisl

atio

n, p

olic

ies

and

adm

inis

trat

ive

arra

ngem

ents

to

enab

le c

ompl

ianc

e w

ith th

e IH

R

P.1.

1 Th

e St

ate

has

asse

ssed

, ad

just

ed a

nd a

ligne

d its

do

mes

tic le

gisl

atio

n, p

olic

ies

and

adm

inis

trat

ive

arra

ngem

ents

in a

ll re

leva

nt s

ecto

rs to

ena

ble

com

plia

nce

with

the

IHR

P.1.

2 Fi

nanc

ing

is a

vaila

ble

for t

he

impl

emen

tatio

n of

IHR

capa

citie

sP.

1.3

A fin

anci

ng m

echa

nism

an

d fu

nds

are

avai

labl

e fo

r tim

ely

resp

onse

to p

ublic

hea

lth

emer

genc

ies

1. In

dica

tor P

.1.1

and

P.1

.2 o

f V1

is

com

bine

d to

P.1

.1 in

V2.

2. T

wo

new

fina

nce

indi

cato

rs a

re

adde

d P.

1.2

and

P.1.

3 in

V2

3. T

echn

ical

que

stio

ns a

re u

pdat

ed

acco

rdin

gly

1. S

core

of P

.1.1

and

P.2

.2 o

f V1

shou

ld b

e av

erag

ed a

nd th

e lo

wer

sc

ore

shou

ld b

e co

nsid

ered

as

base

line

whi

ch w

ill re

flect

indi

cato

r P.

1.1

of V

2

IHR

coor

dina

tion,

co

mm

unic

atio

n an

d ad

voca

cy

P.2.

1 A

func

tiona

l mec

hani

sm is

es

tabl

ishe

d fo

r the

coo

rdin

atio

n an

d in

tegr

atio

n of

rele

vant

sec

tors

in th

e im

plem

enta

tion

of IH

R

P.2.

1 A

func

tiona

l mec

hani

sm

esta

blis

hed

for t

he c

oord

inat

ion

and

inte

grat

ion

of re

leva

nt s

ecto

rs in

the

impl

emen

tatio

n of

IHR

1. N

o ch

ange

s at

indi

cato

r lev

el2.

Ver

y m

inor

cha

nges

in a

ttrib

utes

No

addi

tiona

l int

erpr

etat

ion

requ

ired

1- C

ount

ries

who

con

duct

ed J

EE u

sing

firs

t edi

tion

of th

e to

ol a

nd w

ould

follo

w u

p th

e pr

ogre

ss u

sing

sec

ond

editi

on (o

nly)

. Thi

s is

not

inte

nded

to c

ompa

re c

ount

ries



Antim

icro

bial

re

sist

ance

P.3.

1 An

timic

robi

al re

sist

ance

(AM

R)

dete

ctio

nP.

3.2

Surv

eilla

nce

of in

fect

ions

ca

used

by

AMR

path

ogen

sP.

3.3

Hea

lthca

re-a

ssoc

iate

d in

fect

ion

(HAI

) pre

vent

ion

and

cont

rol

prog

ram

sP.

3.4

Antim

icro

bial

ste

war

dshi

p ac

tiviti

es

P.3.

1 Ef

fect

ive

mul

tisec

tora

l co

ordi

natio

n on

AM

RP.

3.2

Surv

eilla

nce

of A

MR

P.3.

3 In

fect

ion

prev

entio

n an

d co

ntro

l P.

3.4

Opt

imiz

e us

e of

ant

imic

robi

al

med

icin

es in

hum

an a

nd a

nim

al

heal

th a

nd a

gric

ultu

re

1. P

.3.1

and

P.3

.2 o

f V1

is c

ombi

ned

as P

.3.2

2. N

ew in

dica

tor f

or e

ffect

ive

coor

dina

tion

is a

dded

as

P.3.

1 in

V2

3. In

fect

ion

prev

entio

n an

d co

ntro

l re

late

d in

dica

tor i

s ch

ange

d an

d at

trib

utes

upd

ated

in P

.3.3

of V

24.

P.3

.4 o

f V1

is c

hang

ed

to g

over

nanc

e of

use

of

antim

icro

bial

s in

V2

No

addi

tiona

l int

erpr

etat

ion

requ

ired

Zoon

otic

dis

ease

P.4.

1 Su

rvei

llanc

e sy

stem

s in

pla

ce

for p

riorit

y zo

onot

ic d

isea

ses/

path

ogen

sP.

4.2

Vete

rinar

y or

ani

mal

hea

lth

wor

kfor

ceP.

4.3

Mec

hani

sms

for r

espo

ndin

g to

in

fect

ious

zoo

nose

s an

d po

tent

ial

zoon

oses

are

est

ablis

hed

and

func

tiona

l

P.4.

1 Co

ordi

nate

d su

rvei

llanc

e sy

stem

s in

pla

ce in

the

anim

al h

ealth

an

d pu

blic

hea

lth s

ecto

rs fo

r zoo

notic

di

seas

es/p

atho

gens

iden

tified

as

join

t prio

ritie

s P.

4.2

Mec

hani

sms

for r

espo

ndin

g to

infe

ctio

us a

nd p

oten

tial z

oono

tic

dise

ases

est

ablis

hed

and

func

tiona

l

1. In

dica

tor P

.4.1

is d

etai

led

but

outp

ut/o

utco

me

mea

sure

of t

his

indi

cato

r rem

ains

sam

e2.

Indi

cato

r P.4

.2 is

inco

rpor

ated

in

indi

cato

rs o

f Hum

an re

sour

ces

of

V23.

P.4

.3 o

f V1

is s

ame

as P

.4.2

of V

2

1. U

se s

core

of P

.4.1

and

P.4

.3 o

f V1

only

2. W

orkf

orce

rela

ted

scor

e ca

n be

us

ed fo

r Hum

an re

sour

ces

Food

saf

ety

P.5.

1 M

echa

nism

s ar

e es

tabl

ishe

d an

d fu

nctio

ning

for d

etec

ting

and

resp

ondi

ng to

food

born

e di

seas

e an

d fo

od c

onta

min

atio

n

P.5.

1 Su

rvei

llanc

e sy

stem

s in

pla

ce

for t

he d

etec

tion

and

mon

itorin

g of

food

born

e di

seas

es a

nd fo

od

cont

amin

atio

nP.

5.2

Mec

hani

sms

are

esta

blis

hed

and

func

tioni

ng fo

r the

resp

onse

an

d m

anag

emen

t of f

ood

safe

ty

emer

genc

ies

1. In

dica

tor P

.5.1

of V

1 is

cha

nged

to

two

indi

cato

rs P

.5.1

and

P.5

.2 in

V2

2. A

ttrib

utes

and

tech

nica

l que

stio

ns

are

upda

ted

No

addi

tiona

l int

erpr

etat

ion

requ

ired

as P

.5.1

of V

1 is

a c

ombi

ned

vers

ion

of tw

o in

dica

tors

of V

2

Bios

afet

y an

d bi

osec

urity

P.6.

1 W

hole

-of-

gove

rnm

ent b

iosa

fety

an

d bi

osec

urity

sys

tem

is in

pla

ce

for h

uman

, ani

mal

, and

agr

icul

ture

fa

cilit

ies

P.6.

2 Bi

osaf

ety

and

bios

ecur

ity

trai

ning

and

pra

ctic

es

P.6.

1 W

hole

-of-

gove

rnm

ent b

iosa

fety

an

d bi

osec

urity

sys

tem

in p

lace

for a

ll se

ctor

s (in

clud

ing

hum

an, a

nim

al a

nd

agric

ultu

re fa

cilit

ies)

P.6.

2 Bi

osaf

ety

and

bios

ecur

ity

trai

ning

and

pra

ctic

es in

all

rele

vant

se

ctor

s (in

clud

ing

hum

an, a

nim

al a

nd

agric

ultu

re)

1. T

houg

h in

dica

tors

look

cha

nged

, th

ey a

re ju

st m

ore

deta

iled

with

no

maj

or c

hang

es2.

Min

or c

hang

es in

att

ribut

es o

nly

No

addi

tiona

l int

erpr

etat

ion

requ

ired



Imm

uniz

atio

nP.

7.1

Vacc

ine

cove

rage

(mea

sles

) as

part

of n

atio

nal p

rogr

amP.

7.2

Nat

iona

l vac

cine

acc

ess

and

deliv

ery

P.7.

1 Va

ccin

e co

vera

ge (m

easl

es) a

s pa

rt o

f nat

iona

l pro

gram

me

P.7.

2 N

atio

nal v

acci

ne a

cces

s an

d de

liver

y

1. N

o ch

ange

s in

indi

cato

rs a

nd m

inor

ch

ange

s in

att

ribut

esN

o ad

ditio

nal i

nter

pret

atio

n re

quire

d

Nat

iona

l la

bora

tory

sys

tem

D.1.

1 La

bora

tory

test

ing

for d

etec

tion

of p

riorit

y di

seas

esD.

1.2

Spec

imen

refe

rral

and

tran

spor

t sy

stem

D.1.

3 Ef

fect

ive

mod

ern

poin

t of c

are

and

labo

rato

ry b

ased

dia

gnos

tics

D.1.

4 La

bora

tory

Qua

lity

Syst

em

D.1.

1 La

bora

tory

test

ing

for d

etec

tion

of p

riorit

y di

seas

esD.

1.2

Spec

imen

refe

rral

and

tran

spor

t sy

stem

D.1.

3 Ef

fect

ive

natio

nal d

iagn

ostic

ne

twor

kD.

1.4

Labo

rato

ry q

ualit

y sy

stem

1. O

nly

indi

cato

r nam

e of

D.1

.3 o

f V1

is c

hang

ed in

D.1

.3 o

f V2

2. R

est o

f the

indi

cato

rs re

mai

n sa

me

3. A

ttrib

utes

are

upd

ated

4. T

echn

ical

que

stio

ns o

n D.

1.1

has

AMR

rela

ted

ques

tions

No

addi

tiona

l int

erpr

etat

ion

requ

ired

Surv

eilla

nce

D.2.

1 In

dica

tor a

nd e

vent

bas

ed

surv

eilla

nce

syst

ems

D.2.

2 In

tero

pera

ble,

inte

rcon

nect

ed,

elec

tron

ic re

al-t

ime

repo

rtin

g sy

stem

D.2.

3 An

alys

is o

f sur

veill

ance

dat

aD.

2.4

Synd

rom

ic s

urve

illan

ce s

yste

ms

D.2.

1 Su

rvei

llanc

e sy

stem

sD.

2.2

Use

of e

lect

roni

c to

ols

D.2.

3 An

alys

is o

f sur

veill

ance

dat

a

1. In

dica

tor D

.2.1

and

D.2

.4 o

f V1

is

com

bine

d as

D.2

.1 in

V2

2. R

est o

f the

out

put/

outc

ome

mea

sure

s of

the

indi

cato

rs re

mai

n sa

me

thou

gh th

ere

are

min

or

chan

ges

in w

ordi

ng3.

Att

ribut

es a

nd te

chni

cal q

uest

ions

ar

e up

date

d ac

cord

ingl

y

1. S

core

of D

.2.1

and

D.2

.4 o

f V1

shou

ld b

e av

erag

ed a

nd th

e lo

wer

sc

ore

shou

ld b

e co

nsid

ered

as

base

line

whi

ch w

ill b

e re

flect

ed a

s D.

2.1

of V

24.

Res

t rem

ains

sam

e

Repo

rtin

gD.

3.1

Syst

em fo

r effi

cien

t rep

ortin

g to

W

HO,

FAO

and

OIE

D.3.

2 Re

port

ing

netw

ork

and

prot

ocol

s in

cou

ntry

D.3.

1 Sy

stem

for e

ffici

ent r

epor

ting

to

FAO,

OIE

and

WH

OD.

3.2

Repo

rtin

g ne

twor

k an

d pr

otoc

ols

in c

ount

ry

1. N

o ch

ange

s an

d m

inor

cha

nges

in

the

attr

ibut

esN

o ad

ditio

nal i

nter

pret

atio

n re

quire

d

Hum

an re

sour

ces

D.4.

1 H

uman

reso

urce

s ar

e av

aila

ble

to im

plem

ent I

HR

core

cap

acity

re

quire

men

tsD.

4.2

Appl

ied

epid

emio

logy

trai

ning

pr

ogra

m in

pla

ce s

uch

as F

ETP

D.4.

3 W

orkf

orce

Str

ateg

y

D.4.

1 An

up-

to-d

ate

mul

tisec

tora

l w

orkf

orce

str

ateg

y is

in p

lace

D.4.

2 H

uman

reso

urce

s ar

e av

aila

ble

to e

ffect

ivel

y im

plem

ent I

HR

D.4.

3. In

-ser

vice

trai

ning

s ar

e av

aila

ble

D.4.

4 FE

TP o

r oth

er a

pplie

d ep

idem

iolo

gy tr

aini

ng p

rogr

amm

e is

in

pla

ce

1. A

new

indi

cato

r is

adde

d (D

.4.3

) in

V22.

Wor

kfor

ce in

dica

tor D

.4.2

of

V1 fr

om Z

oono

tic d

isea

se is

in

corp

orat

ed in

indi

cato

rs o

f H

uman

reso

urce

s of

V2

3. D

.4.1

of V

2 is

refle

cted

in D

.4.3

of V

14.

D.4

.1 o

f V1

is re

flect

ed in

D.4

.2 o

f V2

5. D

.4.2

of V

1 is

refle

cted

in D

.4.4

of V

2

1. A

vera

ge o

f tot

al s

core

s of

w

orkf

orce

indi

cato

rs a

nd w

orkf

orce

in

dica

tor P

.4.2

of Z

oono

tic d

isea

se

of V

1 an

d ta

ke th

e lo

wer

val

ue2.

Res

t rem

ains

sam

e



Emer

genc

y Pr

epar

edne

ssR.

1.1

Mul

ti-ha

zard

nat

iona

l pub

lic

heal

th e

mer

genc

y pr

epar

edne

ss

and

resp

onse

pla

n is

dev

elop

ed a

nd

impl

emen

ted

R.1.

2 Pr

iorit

y pu

blic

hea

lth ri

sks

and

reso

urce

s ar

e m

appe

d an

d ut

ilize

d

R.1.

1 St

rate

gic

emer

genc

y ris

k as

sess

men

ts c

ondu

cted

and

em

erge

ncy

reso

urce

s id

entifi

ed a

nd

map

ped

R.1.

2 N

atio

nal m

ultis

ecto

ral

mul

tihaz

ard

emer

genc

y pr

epar

edne

ss

mea

sure

s, in

clud

ing

emer

genc

y re

spon

se p

lans

are

dev

elop

ed,

impl

emen

ted

and

test

ed

1. O

utpu

t/ou

tcom

e m

easu

res

rem

ain

the

sam

e2.

Indi

cato

rs a

re m

ore

elab

orat

e an

d in

corp

orat

e ris

k as

sess

men

t, m

ultis

ecto

ral a

nd m

ultih

azar

d at

trib

utes

3. P

lans

are

sep

arat

ed a

s pr

epar

edne

ss p

lan

and

resp

onse

pl

an

No

addi

tiona

l int

erpr

etat

ion

requ

ired

Emer

genc

y re

spon

se

oper

atio

ns

R.2.

1 Ca

paci

ty to

Act

ivat

e Em

erge

ncy

Ope

ratio

nsR.

2.2

Emer

genc

y O

pera

tions

Cen

tre

Ope

ratin

g Pr

oced

ures

and

Pla

nsR.

2.3

Emer

genc

y O

pera

tions

Pro

gram

R.2.

4 Ca

se m

anag

emen

t pro

cedu

res

are

impl

emen

ted

for I

HR

rele

vant

ha

zard

s

R.2.

1 Em

erge

ncy

resp

onse

co

ordi

natio

nR.

2.2

Emer

genc

y op

erat

ions

cen

tre

(EO

C) c

apac

ities

, pro

cedu

res

and

plan

sR.

2.3

Emer

genc

y ex

erci

se

man

agem

ent p

rogr

amm

e

1. C

ase

man

agem

ent i

ndic

ator

R.

2.4

of V

1 is

mov

ed to

Med

ical

co

unte

rmea

sure

s an

d pe

rson

al

depl

oym

ent R

.4.3

of V

22.

R.2

.1 a

nd R

.2.2

of V

1 ar

e co

mbi

ned

to fo

rm in

dica

tor R

.2.2

of V

23.

Add

ition

al c

oord

inat

ion

indi

cato

r is

adde

d as

R.2

.1 in

V2

4. R

.2.3

of V

1 re

mai

ns s

ame

as R

.2.3

of

V2

thou

gh in

dica

tor n

ame

is

chan

ged

1. T

ake

low

er s

core

of a

vera

ge o

f R.

2.1

and

R.2.

2 of

V1

to re

flect

R.

2.2

of V

22.

Rem

ove

Case

man

agem

ent

indi

cato

r sco

re

3. S

core

of R

.2.3

rem

ains

sam

e

Link

ing

publ

ic

heal

th a

nd

secu

rity

auth

oriti

es

R.3.

1 Pu

blic

Hea

lth a

nd S

ecur

ity

Auth

oriti

es, (

e.g.

Law

Enf

orce

men

t, Bo

rder

Con

trol

, Cus

tom

s) a

re li

nked

du

ring

a su

spec

t or c

onfir

med

bi

olog

ical

eve

nt

R.3.

1 Pu

blic

hea

lth a

nd s

ecur

ity

auth

oriti

es (e

.g. l

aw e

nfor

cem

ent,

bord

er c

ontr

ol, c

usto

ms)

link

ed

durin

g a

susp

ect o

r con

firm

ed

biol

ogic

al, c

hem

ical

or r

adio

logi

cal

even

t

1. R

emai

ns s

ame

but e

xpan

ded

to

othe

r IH

R re

leva

nt h

azar

ds a

nd

attr

ibut

es a

re u

pdat

ed a

ccor

ding

ly

No

addi

tiona

l int

erpr

etat

ion

requ

ired

Med

ical

co

unte

rmea

sure

s an

d pe

rson

nel

depl

oym

ent

R.4.

1 Sy

stem

is in

pla

ce fo

r se

ndin

g an

d re

ceiv

ing

med

ical

co

unte

rmea

sure

s du

ring

a pu

blic

he

alth

em

erge

ncy

R.4.

2 Sy

stem

is in

pla

ce fo

r se

ndin

g an

d re

ceiv

ing

med

ical

co

unte

rmea

sure

s du

ring

a pu

blic

he

alth

em

erge

ncy

R.4.

1 Sy

stem

in p

lace

for a

ctiv

atin

g an

d co

ordi

natin

g m

edic

al

coun

term

easu

res

durin

g a

publ

ic

heal

th e

mer

genc

yR.

4.2

Syst

em in

pla

ce fo

r act

ivat

ing

and

coor

dina

ting

heal

th p

erso

nnel

du

ring

a pu

blic

hea

lth e

mer

genc

yR.

4.3

Case

man

agem

ent p

roce

dure

s im

plem

ente

d fo

r IH

R re

leva

nt h

azar

ds

1. B

oth

indi

cato

rs o

f V1

rem

ain

sam

e w

ith m

inor

upd

ates

in a

ttrib

utes

an

d te

chni

cal q

uest

ions

2. In

dica

tor o

n ca

se m

anag

emen

t is

brou

ght t

o th

is te

chni

cal a

rea

from

Em

erge

ncy

resp

onse

ope

ratio

ns,

i.e. R

.2.4

of V

1 is

mov

ed h

ere

as

R.4.

3 of

V2

1. T

ake

scor

e of

cas

e m

anag

emen

t R.

2.4

of V

1 2.

Res

t of t

he s

core

rem

ains

sam

e



Risk

co

mm

unic

atio

nR.

5.1

Risk

Com

mun

icat

ion

Syst

ems

(pla

ns, m

echa

nism

s, e

tc.)

R.5.

2 In

tern

al a

nd P

artn

er

Com

mun

icat

ion

and

Coor

dina

tion

R.5.

3 Pu

blic

Com

mun

icat

ion

R.5.

4 Co

mm

unic

atio

n En

gage

men

t w

ith A

ffect

ed C

omm

uniti

esR.

5.5

Dyn

amic

Lis

teni

ng a

nd R

umou

r M

anag

emen

t

R.5.

1 Ri

sk c

omm

unic

atio

n sy

stem

s fo

r unu

sual

/une

xpec

ted

even

ts a

nd

emer

genc

ies

R.5.

2 In

tern

al a

nd p

artn

er

coor

dina

tion

for e

mer

genc

y ris

k co

mm

unic

atio

nR.

5.3

Publ

ic c

omm

unic

atio

n fo

r em

erge

ncie

sR.

5.4

Com

mun

icat

ion

enga

gem

ent

with

affe

cted

com

mun

ities

R.5.

5 Ad

dres

sing

per

cept

ions

, ris

ky

beha

viou

rs a

nd m

isin

form

atio

n

1. O

utpu

t/ou

tcom

e m

easu

res

of a

ll th

ese

indi

cato

rs re

mai

ns s

ame

with

min

imal

cha

nges

in a

ttrib

utes

th

ough

indi

cato

r nam

es a

re

chan

ged

No

addi

tiona

l int

erpr

etat

ion

requ

ired

Poin

ts o

f ent

ryPo

E.1

Rout

ine

capa

citie

s ar

e es

tabl

ishe

d at

PoE

.Po

E.2

Effe

ctiv

e Pu

blic

Hea

lth

Resp

onse

at P

oint

s of

Ent

ry

PoE.

1 Ro

utin

e ca

paci

ties

esta

blis

hed

at p

oint

s of

ent

ryPo

E.2

Effe

ctiv

e pu

blic

hea

lth

resp

onse

at p

oint

s of

ent

ry

1. O

nly

attr

ibut

es a

re u

pdat

edN

o ad

ditio

nal i

nter

pret

atio

n re

quire

d

Chem

ical

eve

nts

CE.1

Mec

hani

sms

are

esta

blis

hed

and

func

tioni

ng fo

r det

ectin

g an

d re

spon

ding

to c

hem

ical

eve

nts

or

emer

genc

ies.

CE.2

Ena

blin

g en

viro

nmen

t is

in p

lace

fo

r man

agem

ent o

f che

mic

al E

vent

s

CE.1

Mec

hani

sms

esta

blis

hed

and

func

tioni

ng fo

r det

ectin

g an

d re

spon

ding

to c

hem

ical

eve

nts

or

emer

genc

ies

CE.2

Ena

blin

g en

viro

nmen

t in

plac

e fo

r man

agem

ent o

f che

mic

al e

vent

1. O

nly

attr

ibut

es a

re u

pdat

edN

o ad

ditio

nal i

nter

pret

atio

n re

quire

d

Radi

atio

n em

erge

ncie

sRE

.1 M

echa

nism

s ar

e es

tabl

ishe

d an

d fu

nctio

ning

for d

etec

ting

and

resp

ondi

ng to

radi

olog

ical

and

nu

clea

r em

erge

ncie

s.RE

.2 E

nabl

ing

envi

ronm

ent i

s in

pl

ace

for m

anag

emen

t of R

adia

tion

Emer

genc

ies

RE.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 a

nd

nucl

ear e

mer

genc

ies

RE.2

Ena

blin

g en

viro

nmen

t in

plac

e fo

r man

agem

ent o

f rad

iolo

gica

l and

nu

clea

r em

erge

ncie

s

1. O

nly

chan

ges

in in

dica

tor:

Radi

atio

n em

erge

ncie

s in

V1

chan

ged

to R

adio

logi

cal a

nd

nucl

ear e

mer

genc

ies

in V

22.

Attr

ibut

es a

re u

pdat

ed

No

addi

tiona

l int

erpr

etat

ion

requ

ired

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