Recent Activities - 2016
April-May 2016: WHO International Health Regulation Joint Evaluation in Pakistan
The International Health Regulations (IHR) came into force in June 2007. As part of their IHR commitment, countries have been asked to conduct an assessment of their capabilities to respond to public health emergencies. The multi-sectorial Joint External Evaluation (JEE) tool was developed with the aim that countries would use the tool to conduct an assessment and would then be invited to undergo a formal assessment of their findings.
The JEE tool requires the country to enlist local experts to assess its capabilities against a specific range of indicators. There are 19 different indicators divided into four groups – Prevent, Detect, Respond and Other IHR-related Hazards. Each indicator has one or more elements which are assessed and scored between 1 and 5, where 1 is “No capacity” and 5 is “Sustainable capacity”. The range of indicators includes national legislation and policy, antimicrobial resistance, zoonotic diseases, food safety, surveillance, work force development, emergency response operations, chemical and radiation emergencies. Once the local experts have conducted their assessment, international experts are invited to perform the same assessment. During the JEE mission, local and international assessors compare their findings and come to a common score which is then published by the WHO to ensure transparency. In this way, a country can determine its capacity, identify gaps and best practices and use the information to inform ministries of health (MoH) and other authorities responsible for public health.
The World Health Organization (WHO) conducted an IHR JEE mission in Pakistan between 27 April and 6 May 2016. Pakistan was only the fourth country, after Tanzania, Ethiopia and Mozambique, and the first country outside Africa to undergo this process. NRL was invited to be part of a team of international experts covering all 19 technical areas who were to conduct the assessment. Experts came from Thailand, Egypt, Qatar, USA, Finland, UK, Australia and Jordan. The team was supported by WHO officials and technical advisors from the Eastern Mediterranean Regional Office (Cairo) and Headquarters (Geneva). Wayne Dimech from NRL participated as the international expert on two indicators – National Laboratory Systems and Biosafety and Biosecurity. The process involved meeting with MoH officials and laboratory directors, visiting medical, veterinary and food testing laboratories and assessing the capacity of each against the JEE Tool. The two week-long mission took the assessors to Islamabad, Lahore and Preshawar, close to the Afghan border.
The local Pakistani MoH and laboratories’ staff were extremely accommodating and welcoming. There was close interaction between the international and local experts, both learning from one another. Pakistan is one of the last two countries to have wild type polio and therefore has one of the last active polio reference laboratories servicing all of Pakistan and Afghanistan. Other infectious diseases not commonly encountered in developed countries such as diphtheria and rabies are not uncommon in Pakistan.
It is expected that future JEE missions will be conducted in other countries over the coming years. Hopefully, NRL will be invited to participate again.