ERM Emergency Risk Management and Humanitarian Response ERM Emergency Risk Management and Humanitarian Response Photo: IRIN/Courtesy of APF WHO’s Work

ERM Emergency Risk Management andHumanitarian Response ERM Emergency Risk Management andHumanitarian Response

Photo: IRIN/Courtesy of APF

WHO’s Work in EmergenciesColombia Health Cluster performance Monitoring Workshop Aug 2015

Presented by Dr Ahmed ZOUITEN

ERM Emergency Risk Management andHumanitarian Response

Every year….

• 700 emergencies reported

• At least 1 in every 5 member state experiences an emergency with public healthconcerns

• >250 million people affected

• 110,000 people die from emergencies

• Health care is increasingly under attack

Why is WHO concerned about emergencies?


Emergencies are everyone’s businessEmergency work is an Organization-wide responsibility.

Death, illness and disabilities inemergencies result from

• Communicable diseases

• Maternal and newborn health complications

• Non-communicable diseases • Trauma and violence

• Lack of emergency risk management and response capacities


• Responding to emergencies from all-hazards

• 100 million people in need of aid

• $18 billion required

• Multiple simultaneous emergencies:

Syria, Iraq, CAR, Ukraine, Gaza, South Sudan, Ebola & MERS

• Ebola and Polio are Public Health Emergencies of International Concern (PHEIC)

What are the current demands on WHO?


So what are we doing about it?

1. Helping countries prepare

2. Getting ourselves ready

3. Responding

Photo


1. Helping countries prepare

• Core capacity strengthening under the International Health Regulations (IHR 2005)

• Assessments of national capacities for emergency risk management

• National Preparedness Programmes and Plans

• Safer Hospitals Programme

• Keeping health at the center of the global emergency risk management agenda


2. Getting WHO ready

Partnerships and Networks

Readiness Checklist

Rapid deployment mechanism

Rapid Response Account

Project Design and Management Capacities

Standard Operating Procedures


3. Responding


WHO’s Emergency Response Framework (ERF)


1. Operating Principle for WHO'sEmergency Reforms

'All Country Offices are empowered and rapidly equipped to lead

during all emergencies‘


2. Development of ERF and the GEMT


ERF and the GEMT• ERF was developed in alignment with the WHO reforms, the UN

humanitarian reforms, and WHO’s obligations to the IASC and under IHR. • ERF is incorporated into EB and WHA resolutions (WHA 65.20) on WHO’s

responsibilities in emergency response, including health cluster leadership.

• The Global Emergency Management Team (GEMT) was established in late 2011 and oversaw the development of the ERF.

• The GEMT is composed of:• Directors of relevant HQ and RO departments (or their delegates) responsible

for emergency risk management, IHR, surveillance and emergency response • Directors overseeing hazard-specific work on natural hazards, epidemic-prone

diseases, zoonoses, food safety, and chemical and radio nuclear hazards • Other relevant HQ, Regional and Country Office representatives may be invited

to join the discussion of the GEMT as required.


• Strengthen WHO leadership, enhance coordination, increase predictability and demonstrate accountability

• Clarify WHO’s roles and responsibilities in emergency response to all emergencies from any hazard with public health consequences

• Provide a common approach for emergency response to all-hazards

The goals of the ERF


3. Core commitments


• WHO’s core commitments in emergency response are those actions which WHO commits always to deliver, and to be accountable for.

• In all countries experiencing emergencies, to support Member States and local health authorities to lead a coordinated and effective health sector with the national and international community, to save lives, minimize adverse health effects and preserve dignity, WHO will: develop an evidence-based health sector response strategy, plan and appeal; ensure that adapted disease surveillance, early warning and response systems are in place; provide up-to-date information on the health situation and health sector performance; promote and monitor the application of standards and best practices; and provide relevant technical expertise to affected Member States and all relevant

stakeholders.

WHO's Core Commitments in Emergency Response


4. Event assessment


1. Monitoring events: WHO will continuously monitor events worldwide to determine their potential impact on public health.

2. Triggers for event risk assessment: These include new information, developments, or perceptions.

3. Event verification and initial event risk assessment: WHO will support Member States to verify events and assess the potential public health impact of that event, based on the scale of the emergency and the urgency of mounting the response.

4. Using the results: Based on the results WHO will continue to monitor the event if the public health impact is unclear, grade the event if the results suggest an emergency situation, or close the event if there is negligible public health impact.

5. Recording events: WHO will record all events along with the results of the risk assessment.

Determining if an event has public health impact


5. WHO grading


Grading purpose

Grading is an internal WHO process that is conducted to:1. inform the Organization of the extent, complexity and duration of Organizational

and or external support required;2. prompt all WHO offices at all levels to be ready to repurpose resources in order

to provide support;3. ensure that the Organization acts with appropriate urgency and mobilizes the

appropriate resources in support of the affected Member State, partners, and the WHO Country Office;

4. trigger WHO’s Emergency Response Procedures and Emergency Policies, and WHO performance standards implementation;

5. remind the HWCO to apply WHO’s Standard Operating Procedures; and6. expedite clearance and dissemination of internal an external communications.


WHO’s grade definitions

Ungraded:An event that is being assessed, tracked or monitored by WHO but that requires no WHO response at the time.

Grade 1: a single or multiple country event with minimal public health consequences that requires a minimal WCO response or minimal international WHO response. Organizational and/or external support required by the WCO is minimal. The provision of support to WCO is coordinated by a focal point in the Regional Office.

Grade 2: a single or multiple country event with moderate public health consequences that requires a moderate WCO response and/or moderate international WHO response. Organizational and/or external support required by the WCO is moderate. The provision of support to WCO is coordinated by an Emergency Support Team run out of the Regional Office.

Grade 3: a single or multiple country event with substantial public health consequences that requires a substantial WCO response and/or substantial international WHO response. Organizational and/or external support required by the WCO is substantial. The provision of support to WCO is coordinated by an Emergency Support Team run out of the Regional Office.


Level of support by grade

Type of support Grade 1 Grade 2 Grade 3

Technical

Remote technicalassistance from international level.

Time-limited missions; remote input tostrategic plans, technical advice.

In-country ongoing technical assistance through surge;issuance of hazard specific and countryspecific guidance

Financial

Minimal to none.

Access to regional WHO financial resources; International resource mobilization on request.

Access to global & Regional WHO financial resources; International resource mobilization.

Human resources Minimal to none.Surge of emergencyexperts, as required.

Surge team deployed on a no-regrets basis.


6. Performance standards


WHO performance standards (PS)

Day 1PS 1: Designate the WHO emergency focal point.PS 2: Repurpose the WHO Country Office and/or relevant other Offices.

Day 2

PS 3: Ensure a continuous presence at the site of the emergency. PS 4: Negotiate access and clearances with government where relevant PS 5: Make widely available the preliminary health sector analysis PS 6: Compile and produce the first sitrep, media brief and other comm. & advocacy products.

Day 3

PS 7: Ensure the arrival in-country of a team of experienced professionals to reinforce or replace the repurposed WCO staff.

PS 8: Establish and deliver emergency administrative, human resources, finance, grant management and logistics services.

PS 9: Establish health sector/cluster leadership and coordination; conduct a health sector/cluster meeting; update the 4W matrix.

PS 10: Represent WHO and the health sector/cluster at meetings of the UNCT, HCT, inter-sector/cluster coordination and other relevant sectors/clusters.

PS 11: Use preliminary health sector analysis to identify major health risks and health sector objectives and priorities.

PS 12: Engage health sector partners to participate in a joint health assessment as part of a multisectoral process.

Day 5PS 13: Develop a flexible, short-term health sector response strategy and action plan.


Day 7

PS 14: Develop a funding appeal.

PS 15: Provide technical assistance.

PS 16: Adapt/strengthen a surveillance and early warning system and produce the first weekly epidemiological bulletin.

PS 17: Promote and monitor the application of protocols, health standards, methodologies, tools and best practices.

PS 18: Compile and produce a second situation report, media brief and other communications and advocacy products.

PS 19: Monitor and share relevant information for decision-making on health indicators, using appropriate parameters of measurement.

PS 20: Monitor the response of the health sector and address gaps.

Day 15PS 21: Make widely available the results of the joint health assessment.

Day 60

PS 22: Lead the health sector/cluster in conducting an in-depth health specific assessment.

PS 23: Develop a health sector transition strategy from response to recovery

WHO performance standards (PS) - 2


7. Critical functions


WHO's four critical functions in emergency response

To deliver on its core commitments and Performance Standards, WHO must fulfil four critical functions:• Leadership: provide leadership and coordination of the health

sector/cluster response in support of national and local health authorities.• Information: coordinate the collection, analysis and dissemination/

communication of essential information on health risks, needs, health sector response, gaps and performance.

• Technical expertise: provide technical assistance including the provision of health policy & strategy advice, technical guidelines, standards & protocols, best practices, implementation/strengthening of disease surveillance & disease early warning systems; ensure provision of health services through partners and cover critical gaps, e.g. mobile clinics.

• Core services: ensure logistics, office establishment, surge & HR management, procurement & supply management, administration, finance & grant management.


8. Response Procedures


WHO’s Emergency Response Procedures (ERPs) define expected outputs:

• for each level of the Organization;• by WHO’s four critical functions; and• with concrete deliverables and timelines.

WHO’s Emergency Response Procedures


9. Emergency policies


WHO has developed three new policies to optimize its response to Grade 2 and 3 emergencies by ensuring the rapid deployment of appropriate staff and resources with the full support of the Organization.

• Surge policy• Health emergency leader (HL) policy• No regrets policy

Essential Policies for Optimizing WHO's Emergency Response


Phase 1: StartupArrival within 72 hours after grading WHO Response Team including HL in specific situations (WHO, +/- Stand-by GHC staff to fill health cluster roles) Duration: minimum 3 weeks, maximum 4 weeks

Phase 2: Reinforcement/ ReplacementFirst arrivals within 2 weeks specialized skills to reinforce or replace surge and/or WCO staff to ensure continuing coverage for WHO's 4 critical functions in emergencies. May require more than one set of surge.(WHO, GOARN, consultants, GHC, Standby Partner Arrangements, etc.)Duration: minimum 6, maximum 8 weeks

WCO Staffing-upRe-assignment of WHO staff or new hires to meet additional requirements created by the emergency in place within 12 weeks of emergency onset

Duration: as required

72 hours 1-2 weeks 12 weeks

Requires early RO/WCO action to

re-assign/hire

All surge staff replaced or phased out by end of week 12 after onset (unless special arrangements are made)

Global Health Cluster Partners own operations

Surge over time

WCO INITIAL RESPONSE (repurposing w/in 12 hours)


Critical assumptions for successful ERF

1. Sufficient risk reduction and preparedness capacities in Member States;

2. institutional readiness of WHO as per standardized checklists at country, regional and headquarters offices;

3. sufficient and sustainable core funding for the above; 4. sufficient and timely response funding; and5. access to the affected populations.


Thank you

Documents

ERM Emergency Risk Management and Humanitarian Response ERM Emergency Risk Management and Humanitarian Response Photo: IRIN/Courtesy of APF WHO’s Work