Livingstone, 8 August 2017 - Experts from the World Health Organisation Regional Office for Africa, Organization for Animal Health, JICA, PH Sweden and WHO Country Office in Ghana, Ministry of Health inTanzania, Ministry of Agriculture in Kenya and NICDC in Nigeria are gathered in Livingstone to support the second phase of the Joint External Evaluation (JEE) of the implementation of the International Health Regulations (IHR 2005) in Zambia. The JEE is a voluntary, collaborative and multi-sectoral process which is conducted to assess a country’s capacity for preventing, detecting and rapidly responding to public health risks whether occurring naturally or due to deliberate or accidental events. This process is a key component of the World Health Organization (WHO) International Health Regulations (IHR 2005) monitoring and evaluation framework. The JEE tool has 19 technical areas arranged under the four key areas which include: preventing and reducing the likelihood of outbreaks and other public health risks and events; detecting signals of unusual health events early and rapid and effective multi-sectoral response and others covering Points of Entry, chemical events and radiation emergencies. The JEE is conducted in three phases and helps countries identify the most critical gaps within their human and animal health systems in order to prioritize opportunities for enhanced preparedness and response and to engage with current and prospective donors and partners to effectively target resources.
Zambia completed the first phase of the JEE which involved the completion of a self-evaluation in collaboration with experts representing the Ministry of Health and other related sectors for implementation of IHR (2005). The evaluation represents an internal reflection of the country’s capacities across all 19 technical areas which has provided the basis for this evaluation meeting.
The Assistant Director for Environmental Health at the Ministry of Health Mr. Mulonda Mate and the WHO Disease Prevention and Control Officer, Dr. Peter Songolo who was representing the Acting WHO Representative Dr. Custodia Mandlhate welcomed the participants to the JEE meeting. Mr. Mulonda reiterated the importance of the meeting and thanked all the relevant sectors for participating. The WHO Country Office in Zambia has worked in collaboration with the MOH to mobilise relevant financial, technical and logistical resources which have made this meeting possible.
This JEE evaluation meeting was officially opened by the director of the Zambia National Public Health Institute (ZNPHI) Dr. Victor Mukonka. In his opening address, Dr. Mukonka stated that under the International Health Regulations (IHR 2005), countries were required to develop core capacities for its implementation in order to prevent the international spread of disease. He said that the meeting was important because it provided an opportunity for Zambia to evaluate its core capacities for implementing the IHR 2005. Dr. Mukonka also said that in order to strengthen its capacity for preventing, detecting and responding effectively to disease threats and outbreaks, Zambia was one of the 25 countries in the African Region which had created national public health institutes in line with the recommendations of the Africa Centres for Disease Control (Africa CDC). With the establishment of the ZNPHI, he said that the functions relating to the IHR 2005 core capacities for disease prevention, disease surveillance, epidemic preparedness and response, laboratory systems and networks, public health research and information systems were moved from the Ministry of Health to the ZNPHI. He said that it was in line with this development that Zambia was designated as the Regional Collaborating Centre (RCC) for the Africa CDC (SADC region) which was mandated to support countries in ensuring that core capacities are implemented and strengthened. He also emphasized the importance of the one health concept in the implementation of the IHR 2005 and said that Zambia had moved ahead in this area.
At the same occasion, the team leader for the JEE team of external evaluators, the Disease Prevention and control Officer at the WHO Country Office in Ghana, Dr. Sally-Anne Ohene, said that the world was a global village and that is was critical to build capacity to protect health. She said that the Ebola outbreak of 2014-2015 in West Africa which claimed more than 28,0000 lives, the Yellow fever outbreak in Angola and DRC in 2016 show that all countries are at risk of outbreaks and other emergencies. She emphasized the importance of openness and transparency in the process of the JEE and that the peer to peer review was critical for the success of the exercise which was intended to not only to measure the progress in implementation but more importantly to highlight gaps and needs for current and future partner support and to inform country level planning and priority setting.
This meeting involves multi-sectoral and full collaborative peer-to-peer discussions based on the 19 technical areas defined in the JEE tool. The team has started by reviewing relevant and available information and assessments which is being conducted mainly through presentations by national experts on the initial evaluation of the 19 technical areas. The presentations have focused on identifying strengths and best practices and areas which need strengthening and the challenges; assigning scores and identifying three to five key priority actions for each technical area which are considered to be critical in increasing the country’s ability to prevent, detect and rapidly respond to health emergencies, whether naturally occurring, deliberate or accidental.
The assessment will also involve several visits to various facilities which include: health facilities (Primary Health Care centre in Kazungula district and Livingstone General Hospital); human and animal health laboratories (National virology laboratory, National veterinary laboratory); international airports (Harry Mwaanga international airports); ground border crossing (Kazungula and Victoria Falls border posts), emergency operation centre (ZNPHI) and surveillance unit (event based surveillance).
The presentations which are being presented by the national experts include: Zambia’s national health system, public health services and health services and health security system, national legislation, policy and financing; IHR 2005 coordination, communication and advocacy. antimicrobial resistance, zoonosis, food safety, biosafety and biosecurity, immunisation, national laboratory system, real time surveillance, reporting, workforce development, preparedness, emergency response operations, linking public health and security authorities, medical countermeasures, risk communication, points of entry, chemical events and radiation emergencies.
The JEE is in line with vision of the WHO African Region which focuses on the realization of a safer region where outbreaks and disasters are no longer major causes of mortality and socio-economic disruption and the overall mission to ensure health security through prevention, prediction, early warning, early detection and rapid and effective response to emergencies and disasters including disease outbreaks, emergencies using an all hazard approach linked to primary health care systems. Fundamental to the multi-sectoral approach embedded in the JEE is the recognition that risks to human health can emerge from other humans, domestic animals/livestock, wildlife, food, chemicals and/or radiation. Therefore, adequate capacity to prevent Detect and respond to events or threats must exist within all relevant sectors.
Phase three of the JEE includes the presentation of the a final draft report to Zambia by the external team of evaluators for feedback after which it will be posted online on The Global Health Security Agenda website and will be publically accessible and will be used to develop a National action plan for health security.