Joint external evaluation of IHR core capacities of the Islamic Republic of Pakistan, 2016

Abstract

Background: The Joint External Evaluation (JEE), a voluntary, collaborative process to assess country's capacity under International Health Regulations (IHR) to prevent, detect, and respond to public health threats. Pakistan was the first country in the region to volunteer for JEE. The objectives were to measure country- status in building the necessary capacities to prevent, detect, and respond to infectious disease threats and to establish a baseline measurement of capacities & capabilities. Methods & Materials: A joint assessment of IHR & Global Health Security Agenda (GHSA) technical core-capacities was conducted during April 27, through May 6, 2016, using GHSA-IHR-JEE tool. The tool covering 19 technical areas, ranging from 1-5 ((1 indicates no implementation; 5 indicates implementation) scoring with color coding. The evaluation was mostly descriptive and qualitative and completed in two stages: self-evaluation by the country and in-country evaluation by multi-sectoral international team. Assessments were based on peer-to-peer model included site visits and discussions with representatives from all relevant sectors. Results: Legislation, Reporting, Risk-Communication, Points of Entry, National Laboratory System, Chemical Events, Food-Safety, Biosafety-Biosecurity and Immunization, all scored as 2/5. Domestic legislation, policies, administrative arrangements were adjusted/aligned (scored 3/5). Functional mechanism for Coordination, Communication and Advocacy is established (scored as 3/5). Linking Public Health and Security Authorities, Zoonotic disease surveillance and response was scored as 3/5. Indicator/event based surveillance was scored as 3/5 while electronic reporting, data analysis and syndromic surveillance scored 2/5. Workforce Development, human resources availability and existence of epidemiology trainings were scored as 3/5 while workforce strategy as 2/5. Preparedness and Antimicrobial Resistance detection, surveillance, stewardship and Infection control was scored as 1/5. Emergency Response Operations scored 3/5 while Case management & operating procedures/plans as 2/5. Medical Countermeasures and Personnel Deployment scored 4/5 and Radiation Emergencies scored 5/5. Conclusion: Five major cross-cutting themes emerged from review of 19 areas. This evaluations provided an opportunity to identify strengths & weaknesses, and to prioritize opportunities for preparedness, detection & response, capacity building and resources allocating. Based on the JEE recommendations, Pakistan has developed five year costed National Action Plan aiming to develop a strong public health system with the standards and competencies required for implementing IHR.