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Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 1 1 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Managing emergencies in the context of Universal Health Coverage
Ala Alwan
Regional Director
World Health Organization - Eastern Mediterranean Region
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 2 2 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Natural disasters and violent conflicts 700 emergencies occurring globally every year 27 m people 130 000 deaths
Pakistan floods
Iran earthquake
Syria crisis
Europe floods
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 3 3 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Natural disasters reported 1900 – 2011
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 4 4 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
People affected by natural disasters in 2011
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 5 5 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
WHO Eastern Mediterranean Region 13 out of the 23 countries of the region are affected by humanitarian
emergencies ( affecting more than 40 million people)
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 6 6 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
More than 50% of the world’s refugees in 2012 originate in countries of the Eastern Mediterranean Region Out of 7.6 m people who became refugees in 2012, more than 4 million are from this region
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 7 7 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Resource availability
Health workers Injury, killing, kidnapping
Displacement Disrupted training/supervision
Poor morale
Equipment/Supplies Lack of drugs Maintenance
Reduced access to technology Inability to maintain cold chain
Service infrastructure Destruction clinics
Disrupted referral and communication
Service delivery
Shift from primary to secondary care
Urbanization of provision
Decreased campaign health promotion, disease control
and outreach
Reduced access to use, fear, curfews, landmine
Increased private provision
Increased health needs, reduced
response
Service management Diversion from development
More centralized urban based, vertical programs
Disruption complex programs Focus on short term
Service Organizations Reduction in data for decision
Limited mgmt. training Reduced ability to monitor Resources
Increased fragmentation
Economic Support Diversion resources to military
Reduced revenue Reduced control over funds
Increased independence on aid
Damage to health systems
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 8 8 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Universal Health Coverage
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 9 9 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Humanitarian reform UHC is rooted in humanitarian principles
• Intersectoral action
• Neutrality
• Solidarity
• Equity and social justice
• Participation
• Accountability and reliability
• The fundamental right to health for all
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 10 10 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Improved Humanitarian Response
Partnerships
Stre
ngt
he
ned
H
C S
yste
m
Imp
rove
d
fin
anci
ng
Clu
ste
r
Ap
pro
ach
CLAs HCs CERF
Pillars of humanitarian health relief Based on the UN Humanitarian Reform 2005
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 11 11 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Access to public health services and financial risk protection
• Strong surveillance and early warning systems
• Immunization
• Safe water and sanitation
• Access to primary health care supported by effective referral systems to secondary and tertiary facilities.
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 12 12 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Health systems building blocks and emergency management
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 13 13 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Impediments to universal coverage in emergency response
1. Lack of risk assessment and preparedness 2. Insecurity 3. Lack of Access 4. Inadequate Funding 5. Shortage of Supplies 6. Lack of attention to common conditions
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 14 14 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
Conclusions
• UHC and emergency management in health are based on the same principles
• UHC can be achieved during emergencies if the humanitarian principles are adhered to
• Countries need to invest in preparedness and strengthen resilience of their health systems
• Countries need to learn from experience and address the gaps in their response
• International community need to learn from experience and invest in stronger coordination systems
Strategic and operational review of WHO’s response to the Syria crisis
7/7/2013 15 15 | Ministerial Conference on Universal Health Coverage | 27-28 June 2013 | Istanbul, Turkey
WHO’s Strategic vision
• Support countries in developing clear policies and legislation based on an all‐hazard, ‘whole health’ approach;
• Focus on strengthening and safeguarding health facilities and the health workforce;
• Train a cadre of response experts; • Maintain regional emergency stockpiles; • Establish efficient inter-country solidarity
mechanisms; and • Strengthen evidence base through
lessons learnt, best practices and economic assessments.