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Joint external evaluation tool: International Health Regulations (2005): JEE reporting template

December 31, 2016 World Health Organization

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WHO/HSE/GCR/2016.4

IHR (2005) MONITORING AND EVALUATION FRAMEWORK

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JOINT EXTERNAL EVALUATION TOOL INTERNATIONAL HEALTH REGULATIONS (2005)

JEE Reporting Template

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IHR (2005) MONITORING AND EVALUATION FRAMEWORK

JOINT EXTERNAL EVALUATION TOOL INTERNATIONAL HEALTH REGULATIONS (2005)

JEE Reporting Template

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Contents Executive summary--------------------------------------------------------------------------------------------------- 1

PREVENT----------------------------------------------------------------------------------- 4 National legislation, policy and financing------------------------------------------------------------------------- 4 IHR coordination, communication and advocacy---------------------------------------------------------------- 7 Antimicrobial resistance--------------------------------------------------------------------------------------------- 9 Zoonotic diseases----------------------------------------------------------------------------------------------------- 13 Food safety------------------------------------------------------------------------------------------------------------- 16 Biosafety and biosecurity-------------------------------------------------------------------------------------------- 18 Immunization---------------------------------------------------------------------------------------------------------- 21

DETECT------------------------------------------------------------------------------------- 23 National laboratory system------------------------------------------------------------------------------------------ 23 Real-time surveillance------------------------------------------------------------------------------------------------ 27 Reporting--------------------------------------------------------------------------------------------------------------- 31 Workforce development--------------------------------------------------------------------------------------------- 33

RESPOND---------------------------------------------------------------------------------- 36 Preparedness---------------------------------------------------------------------------------------------------------- 36 Emergency response operations------------------------------------------------------------------------------------ 39 Linking public health and security authorities-------------------------------------------------------------------- 43 Medical countermeasures and personnel deployment---------------------------------------------------------- 45 Risk communication-------------------------------------------------------------------------------------------------- 47

OTHER IHR-RELATED HAZARDS AND POINTS OF ENTRY----------------------- 51 Points of entry--------------------------------------------------------------------------------------------------------- 51 Chemical events------------------------------------------------------------------------------------------------------- 53 Radiation emergencies----------------------------------------------------------------------------------------------- 55 Appendix 1: JEE background---------------------------------------------------------------------------------------- 57

Executive summary Findings from the joint external evaluation The report will be published online on: the ministry of health country website (www.moh.gov.countrycode); Food and Agriculture Organization (FAO), World Health Organization (WHO) and World Organisation for Animal Health (OIE) websites; and OIE/Global Health Security Agenda (GHSA)/partners website (name). <This section to be filled out by the joint external evaluation (JEE) team. Identify and record overarching issues, key findings and priority actions, key strengths and areas which need strengthening, as well as overall best practices and challenges. Include a table of the host country’s scores for each indicator following the example below. Key themes, such as multisectoral engagement and level of political commitment, should be addressed. Keep this section brief but note any important highlights from the JEE tool. Maximum of four pages.>

Mission report

Joint External Evaluation Tool

<Host country> scores Technical areas Indicators National legislation, policy and financing IHR coordination, communication and advocacy Antimicrobial resistance P.1.1 Legislation, laws, regulations, administrative requirements, policies or other government instruments in place are sufficient for implementation of IHR (2005) P.1.2 The State can demonstrate that it has adjusted and aligned its domestic legislation, policies and administrative arrangements to enable compliance with IHR (2005) P.2.1 A functional mechanism is established for the coordination and integration of relevant sectors in the implementation of IHR P.3.1 Antimicrobial resistance detection P.3.2 Surveillance of infections caused by antimicrobial-resistant pathogens P.3.3 Health care-associated infection (HCAI) prevention and control programmes P.3.4 Antimicrobial stewardship activities P.4.1 Surveillance systems in place for priority zoonotic diseases/ pathogens Zoonotic diseases P.4.2 Veterinary or animal health workforce P.4.3 Mechanisms for responding to infectious and potential zoonotic diseases are established and functional Food safety Biosafety and biosecurity Immunization P.5.1 Mechanisms for multisectoral collaboration are established to ensure rapid response to food safety emergencies and outbreaks of foodborne diseases P.6.1 Whole-of-government biosafety and biosecurity system is in place for human, animal and agriculture facilities P.6.2 Biosafety and biosecurity training and practices P.7.1 Vaccine coverage (measles) as part of national programme P.7.2 National vaccine access and delivery D.1.1 Laboratory testing for detection of priority diseases National laboratory system D.1.2 Specimen referral and transport system D.1.3 Effective modern point-of-care and laboratory-based diagnostics D.1.4 Laboratory quality system D.2.1 Indicator- and event-based surveillance systems Real-time surveillance D.2.2 Interoperable, interconnected, electronic real-time reporting system D.2.3 Integration and analysis of surveillance data D.2.4 Syndromic surveillance systems Reporting D.3.1 System for efficient reporting to FAO, OIE and WHO D.3.2 Reporting network and protocols in country D.4.1 Human resources available to implement IHR core capacity requirements D.4.2 FETP1 or other applied epidemiology training programme in place D.4.3 Workforce strategy

Score

Workforce development

Preparedness

R.1.1 National multi-hazard public health emergency preparedness and response plan is developed and implemented R.1.2 Priority public health risks and resources are mapped and utilized R.2.1 Capacity to activate emergency operations

Emergency response operations

R.2.2 EOC operating procedures and plans R.2.3 Emergency operations programme R.2.4 Case management procedures implemented for IHR relevant hazards.

Linking public R.3.1 Public health and security authorities (e.g. law enforcement, health and security border control, customs) are linked during a suspect or confirmed authorities biological event Medical countermeasures and personnel deployment R.4.1 System in place for sending and receiving medical countermeasures during a public health emergency R.4.2 System in place for sending and receiving health personnel during a public health emergency R.5.1 Risk communication systems (plans, mechanisms, etc.) Risk communication R.5.2 Internal and partner communication and coordination R.5.3 Public communication R.5.4 Communication engagement with affected communities R.5.5 Dynamic listening and rumour management Points of entry PoE.1 Routine capacities established at points of entry PoE.2 Effective public health response at points of entry CE.1 Mechanisms established and functioning for detecting and responding to chemical events or emergencies CE.2 Enabling environment in place for management of chemical events RE.1 Mechanisms established and functioning for detecting and responding to radiological and nuclear emergencies RE.2 Enabling environment in place for management of radiation emergencies

Chemical events

Radiation emergencies

Note on scoring of technical areas of the JEE tool The JEE process is a peer-to-peer review and a collaborative effort between host country experts and JEE team members. In completing the self-evaluation, the first step in the JEE process, and as part of preparing for an external evaluation, host countries are asked to focus on providing information on their capabilities based on the indicators and technical questions included in the JEE tool. The host country may score their self-evaluation or propose a score during the onsite visit with the JEE team. The entire external evaluation, including the discussions around the score, strengths/best practices, the areas which need strengthening, challenges and the priority actions, is done in a collaborative manner, with the JEE team members and host country experts seeking agreement. Should there be significant and irreconcilable disagreement between the JEE team members and the host country experts, or among the JEE team, or among the host country experts, the JEE team lead will decide on the final score and this will be noted in the final report, along with the justification for each party’s position. 1

FETP: Field epidemiology training programme

Mission report

Joint External Evaluation

PREVENT NATIONAL LEGISLATION, POLICY AND FINANCING INTRODuCTION The International Health Regulations (IHR) (2005) provide obligations and rights for States Parties. In some States Parties, implementation of the IHR (2005) may require new or modified legislation. Even if a new or revised legislation may not be specifically required, states may still choose to revise some regulations or other instruments in order to facilitate IHR implementation and maintenance in a more effective manner. Implementing legislation could serve to institutionalize and strengthen the role of IHR (2005) and operations within the State Party. It can also facilitate coordination among the different entities involved in their implementation. See detailed guidance on IHR (2005) implementation in national legislation at http://www.who.int/ihr/legal_issues/legislation/en/index.html. In addition, policies that identify national structures and responsibilities as well as the allocation of adequate financial resources are also important.

PREVENT

Target Adequate legal framework for States Parties to support and enable the implementation of all their obligations, and rights to comply with and implement the IHR (2005). New or modified legislation in some States Parties for implementation of the IHR (2005). Where new or revised legislation may not be specifically required under the State Party’s legal system, States may revise some legislation, regulations or other instruments in order to facilitate their implementation and maintenance in a more efficient, effective or beneficial manner. States Parties ensure provision of adequate funding for IHR implementation through the national budget or other mechanism. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> Provide a short introduction to the country’s overall capabilities in this technical area here. Please include a brief description of key strengths, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note areas that need strengthening and any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity.>

INDICATORS AND SCORES P.1.1 Legislation, laws, regulations, administrative requirements, policies or other government instruments in place are sufficient for implementation of IHR (2005) – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Strengths/best practices <Host country should present its strengths and best practices based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the lower score was chosen, the elements of higher capacity should be noted as follows: “<Host country’s> capacity exceeds <indicator number> score of <score #> in the following ways:”>

Mission report

Areas that need strengthening and challenges <Host country should present areas that need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.1.2 The State can demonstrate that it has adjusted and aligned its domestic legislation, policies and administrative arrangements to enable compliance with the IHR (2005) – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas that need strengthening and challenges

PREVENT

Joint External Evaluation

<Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

PREVENT

IHR COORDINATION, COmmuNICATION AND ADVOCACY INTRODuCTION The effective implementation of the IHR requires multisectoral/multidisciplinary approaches through national partnerships for efficient and alert response systems. Coordination of nationwide resources, including the designation of a national IHR focal point, which is a national centre for IHR communications, is a key requisite for IHR implementation.

Target Multisectoral/multidisciplinary approaches through national partnerships that allow efficient, alert and responsive systems for effective implementation of the IHR (2005). Coordinate nationwide resources, including sustainable functioning of a national IHR focal point – a national centre for IHR (2005) communications which is a key requisite for IHR (2005) implementation – that is accessible at all times. States Parties provide WHO with contact details of national IHR focal points, continuously update and annually confirm them.. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: IHR coordination, communication and advocacy”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES P.2.1 A functional mechanism established for the coordination and integration of relevant sectors in the implementation of IHR – Score # <Host country should propose a the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

PREVENT

Joint External Evaluation

Strengths/best practices <Host country should present the strengths and best practices based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the lower score was chosen, the elements of higher capacity should be noted as follows: “<Host country’s> capacity exceeds <indicator number> score of <score #> in the following ways:”>

Areas that need strengthening and challenges <Host country should present the areas that need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

PREVENT

There is a one-hour Friday session where scores are reviewed. However, this should be considered the “last resort”. This session cannot accommodate re-opening of a discussion on all the scores.

ANTImICRObIAL RESISTANCE INTRODuCTION Bacteria and other microbes evolve in response to their environment and inevitably develop mechanisms to resist being killed by antimicrobial agents. For many decades, the problem was manageable as the growth of resistance was slow and the pharmaceutical industry continued to create new antibiotics. Over the past decade, however, this problem has become a crisis. Antimicrobial resistance is evolving at an alarming rate and is outpacing the development of new countermeasures capable of thwarting infections in humans. This situation threatens patient care, economic growth, public health, agriculture, economic security and national security.

Support work coordinated by FAO, OIE and WHO to develop an integrated global package of activities to combat antimicrobial resistance, spanning human, animal, agricultural, food and environmental aspects (i.e. a One Health approach). Each country has: (i) its own national comprehensive plan to combat antimicrobial resistance; (ii) strengthened surveillance and laboratory capacity at the national and international levels following international standards developed as per the framework of the Global Action Plan; and (iii) improved conservation of existing treatments and collaboration to support the sustainable development of new antibiotics, alternative treatments, preventive measures and rapid point-of-care diagnostics, including systems to preserve new antibiotics.. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: Antimicrobial resistance”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by JEE team after they have conducted the evaluation.>

PREVENT

Target

Mission report

Joint External Evaluation

INDICATORS AND SCORES P.3.1 Antimicrobial resistance detection – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

PREVENT

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.3.2 Surveillance of infections caused by antimicrobial-resistant pathogens – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.3.3 Health care-associated infection (HCAI) prevention and control programmes – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.3.4 Antimicrobial stewardship activities – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

PREVENT

Joint External Evaluation

the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the lower score was chosen, the elements of higher capacity should be noted as follows: “<Host country’s> capacity exceeds <indicator number> score of <score #> in the following ways:”>

PREVENT

RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

ZOONOTIC DISEASES INTRODuCTION Zoonotic diseases are communicable diseases that can spread between animals and humans. These diseases are caused by viruses, bacteria, parasites and fungi carried by animals, insects or inanimate vectors that aid in its transmission. Approximately 75% of recently emerging infectious diseases affecting humans is of animal origin; and approximately 60% of all human pathogens are zoonotic.

Target Measured behaviours, policies and/or practices that minimize the transmission of zoonotic diseases from animals into human populations. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: Zoonotic diseases”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.>

Mission report

INDICATORS AND SCORES P.4.1 Surveillance systems in place for priority zoonotic diseases/pathogens – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

PREVENT

Joint External Evaluation

PREVENT

P.4.2 Veterinary or animal health workforce – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.4.3 mechanisms for responding to infectious and potential zoonotic diseases established and functional – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report.

In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

PREVENT

Joint External Evaluation

FOOD SAFETY INTRODuCTION Food- and water-borne diarrhoeal diseases are leading causes of illness and death, particularly in less developed countries. The rapid globalization of food production and trade has increased the potential likelihood of international incidents involving contaminated food. The identification of the source of an outbreak and its containment is critical for control. Risk management capacity with regard to control throughout the food chain continuum must be developed. If epidemiological analysis identifies food as the source of an event, based on a risk assessment, suitable risk management options that ensure the prevention of human cases (or further cases) need to be put in place.

Target

PREVENT

Surveillance and response capacity among States Parties for food- and water-borne disease risks or events by strengthening effective communication and collaboration among the sectors responsible for food safety, and safe water and sanitation.. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: Food safety”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES P.5.1 mechanisms for multisectoral collaboration established to ensure rapid response to food safety emergencies and outbreaks of foodborne diseases – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

PREVENT

Joint External Evaluation

bIOSAFETY AND bIOSECuRITY INTRODuCTION It is vital to work with pathogens in the laboratory to ensure that the global community possesses a robust set of tools – such as drugs, diagnostics, and vaccines – to counter the ever-evolving threat of infectious diseases. Research with infectious agents is critical for the development and availability of public health and medical tools that are needed to detect, diagnose, recognize and respond to outbreaks of infectious diseases of both natural and deliberate origin. At the same time, the expansion of infrastructure and resources dedicated to work with infectious agents have raised concerns regarding the need to ensure proper biosafety and biosecurity to protect researchers and the community. Biosecurity is important in order to secure infectious agents against those who would deliberately misuse them to harm people, animals, plants or the environment.

PREVENT

Target A whole-of-government national biosafety and biosecurity system with especially dangerous pathogens identified, held, secured and monitored in a minimal number of facilities according to best practices; biological risk management training and educational outreach conducted to promote a shared culture of responsibility, reduce dual-use risks, mitigate biological proliferation and deliberate use threats, and ensure safe transfer of biological agents; and country-specific biosafety and biosecurity legislation, laboratory licensing and pathogen control measures in place as appropriate. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: Biosafety and biosecurity”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.>

INDICATORS AND SCORES P.6.1 Whole-of-government biosafety and biosecurity system in place for human, animal and agriculture facilities – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> P.6.2 biosafety and biosecurity training and practices – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

PREVENT

Joint External Evaluation

PREVENT

ImmuNIZATION INTRODuCTION Immunizations are estimated to prevent more than two million deaths a year globally. Immunization is one of the most successful global health interventions and cost-effective ways to save lives and prevent disease.

Target A national vaccine delivery system – with nationwide reach, effective distributions, access for marginalized populations, adequate cold chain and ongoing quality control – that is able to respond to new disease threats.

<This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Prevent: Immunization”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.>

INDICATORS AND SCORES P.7.1 Vaccine coverage (measles) as part of national programme – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

PREVENT

<HOST COuNTRY> LEVEL OF CAPAbILITIES

Mission report

Joint External Evaluation

PREVENT

P.7.2 National vaccine access and delivery – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

DETECT NATIONAL LAbORATORY SYSTEm INTRODuCTION Public health laboratories provide essential services including disease and outbreak detection, emergency response, environmental monitoring and disease surveillance. State and local public health laboratories can serve as a focal point for a national system, through their core functions for human, veterinary and food safety including disease prevention, control and surveillance; integrated data management; reference and specialized testing; laboratory oversight; emergency response; public health research; training and education; and partnerships and communication.

Target Real-time biosurveillance with a national laboratory system and effective modern point-of-care and laboratory-based diagnostics. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Detect: National laboratory system”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES D.1.1 Laboratory testing for detection of priority diseases – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

DETECT

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.1.2 Specimen referral and transport system – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

DETECT

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.1.3 Effective modern point-of-care and laboratory-based diagnostics – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The

JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.1.4 Laboratory quality system – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

DETECT

Joint External Evaluation

RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

DETECT

REAL-TImE SuRVEILLANCE INTRODuCTION The purpose of real-time surveillance is to advance the safety, security and resilience of the nation by leading an integrated biosurveillance effort that facilitates early warning and situational awareness of biological events.

Target Strengthened foundational indicator- and event-based surveillance systems that are able to detect events of significance for public health, animal health and health security; improved communication and collaboration across sectors and between sub-national (local and intermediate), national and international levels of authority regarding surveillance of events of public health significance; improved country and intermediate level regional capacity to analyse and link data from and between strengthened, real-time surveillance systems, including interoperable, interconnected electronic reporting systems. This would include epidemiologic, clinical, laboratory, environmental testing, product safety and quality and bioinformatics data; and advancement in fulfilling the core capacity requirements for surveillance in accordance with the IHR and OIE standards. <HOST COuNTRY> LEVEL OF CAPAbILITIES

For this capacity, utilize the JEE tool section “Detect: Real-time surveillance”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES D.2.1 Indicator- and event-based surveillance systems – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report.

DETECT

Mission report

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and its challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.2.2 Interoperable, interconnected, electronic real-time reporting system – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

DETECT

D.2.3 Integration and analysis of surveillance data – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.2.4 Syndromic surveillance systems – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

DETECT

Joint External Evaluation

final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

DETECT

REPORTING INTRODuCTION Health threats at the human–animal–ecosystem interface have increased over the past decades, as pathogens continue to evolve and adapt to new hosts and environments, imposing a burden on human and animal health systems. Collaborative multidisciplinary reporting on the health of humans, animals and ecosystems reduces the risk of diseases at the interfaces between them.

Target Timely and accurate disease reporting according to WHO requirements and consistent coordination with FAO and OIE. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Detect: Reporting”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES D.3.1 System for efficient reporting to FAO, OIE and WHO – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

DETECT

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.3.2 Reporting network and protocols in country – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

DETECT

WORkFORCE DEVELOPmENT INTRODuCTION Workforce development is important in order to develop a sustainable public health system over time by developing and maintaining a highly qualified public health workforce with appropriate technical training, scientific skills and subject-matter expertise.

Target States Parties with skilled and competent health personnel for sustainable and functional public health surveillance and response at all levels of the health system and the effective implementation of the IHR (2005). <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Detect: Workforce development”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES D.4.1 Human resources available to implement IHR core capacity requirements – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

Strengths/best practices <Host country should present its strengths and best practices based on indicators as well as the questions

DETECT

Joint External Evaluation

in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the lower score was chosen, the elements of higher capacity should be noted as follows: “<Host country’s> capacity exceeds <indicator number> score of <score #> in the following ways:”>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.4.2 FETP or other applied epidemiology training programme in place – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

DETECT

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> D.4.3 Workforce strategy – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report.

DETECT

Mission report

Joint External Evaluation

RESPOND PREPAREDNESS INTRODuCTION The effective implementation of the IHR (2005) requires multisectoral/multidisciplinary approaches through national partnerships for effective alert and response systems. Coordination of nationwide resources, including the sustainable functioning of a national IHR focal point, which is a national centre for IHR (2005) communications, is a key requisite for IHR (2005) implementation. The national IHR focal points should be accessible at all times to communicate with the WHO IHR regional contact points and with all relevant sectors and other stakeholders in the country. States Parties should provide WHO with contact details of national IHR focal points, continuously update and annually confirm them.

Target Development and maintenance of national, intermediate (district) and local/primary level public health emergency response plans for relevant biological, chemical, radiological and nuclear hazards. This covers mapping of potential hazards, identification and maintenance of available resources, including national stockpiles and the capacity to support operations at the intermediate and local/primary levels during a public health emergency. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Respond: Preparedness”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES R.1.1 National multi-hazard public health emergency preparedness and response plan developed and implemented – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The

RESPOND

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.1.2 Priority public health risks and resources mapped and utilized – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

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Joint External Evaluation

RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

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EmERGENCY RESPONSE OPERATIONS INTRODuCTION A public health emergency operations centre is a central location for coordinating operational information and resources for strategic management of public health emergencies and emergency exercises. Emergency operations centres provide communication and information tools and services, and a management system during a response to an emergency or emergency exercise. They also provide other essential functions to support decision-making and implementation, coordination and collaboration.

Target Country with public health emergency operations centre (EOC) functioning according to minimum common standards; maintaining trained, functioning, multisectoral rapid response teams and “real-time” biosurveillance laboratory networks and information systems; as well as trained EOC staff capable of activating a coordinated emergency response within 120 minutes of the identification of a public health emergency. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Respond: Emergency response operations”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity.

<This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES R.2.1 Capacity to activate emergency operations – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

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RECOmmENDATIONS FOR PRIORITY ACTIONS

Mission report

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.2.2 EOC operating procedures and plans – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

RESPOND

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.2.3 Emergency operations programme – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.2.4 Case management procedures implemented for IHR relevant hazards – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

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Joint External Evaluation

RELEVANT DOCumENTATION <Relevant legislation, regulations, guidelines, standard operating procedures and other supporting documentation should be listed in this section.>

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LINkING PubLIC HEALTH AND SECuRITY AuTHORITIES INTRODuCTION Public health emergencies pose special challenges for law enforcement, whether the threat is manmade (e.g. the anthrax terrorist attacks) or naturally occurring (e.g. flu pandemics). In a public health emergency, law enforcement will need to quickly coordinate its response with public health and medical officials.

Target Country conducts a rapid, multisectoral response in case of a biological event of suspected or confirmed deliberate origin, including the capacity to link public health and law enforcement, and to provide and/or request effective and timely international assistance, such as to investigate alleged use events. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Respond: Linking public health and security authorities”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES R.3.1 Public health and security authorities (e.g. law enforcement, border control, customs) linked during a suspect or confirmed biological event – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

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Joint External Evaluation

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mEDICAL COuNTERmEASuRES AND PERSONNEL DEPLOYmENT INTRODuCTION Medical countermeasures are vital to national security and protect nations from potentially catastrophic infectious disease threats. Investments in medical countermeasures create opportunities to improve overall public health. In addition, it is important to have trained personnel who can be deployed in case of a public health emergency for response.

Target National framework for transferring (sending and receiving) medical countermeasures, and public health and medical personnel from international partners during public health emergencies. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Respond: Medical countermeasures and personnel deployment”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES R.4.1 System in place for sending and receiving medical countermeasures during a public health emergency – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

RESPOND

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges faced based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.4.2 System in place for sending and receiving health personnel during a public health emergency – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Strengths/best practices

RESPOND

<Host country should present its strengths and best practices based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the lower score was chosen, the elements of higher capacity should be noted as follows: “<Host country’s> capacity exceeds <indicator number> score of <score #> in the following ways:”>

RISk COmmuNICATION INTRODuCTION Risk communications should be a multilevel and multifaceted process which aims at helping stakeholders define risks, identify hazards, assess vulnerabilities and promote community resilience, thereby promoting the capacity to cope with an unfolding public health emergency. An essential part of risk communication is the dissemination of information to the public about health risks and events, such as disease outbreaks. For any communication about risk caused by a specific event to be effective, the social, religious, cultural, political and economic aspects associated with the event should be taken into account, including the voice of the affected population. Communications of this kind promote the establishment of appropriate prevention and control action through community-based interventions at individual, family and community levels. Disseminating the information through appropriate channels is essential. Communication partners and stakeholders in the country need to be identified, and functional coordination and communication mechanisms should be established. In addition, the timely release of information and transparency in decision-making are essential for building trust between authorities, populations and partners. Emergency communications plans should be tested and updated as needed.

Target State Parties use multilevel and multifaceted risk communication capacity. Real-time exchange of information, advice and opinions between experts and officials or people who face a threat or hazard (health or economic or social wellbeing) to their survival, so that informed decisions can be made to mitigate the effects of the threat or hazard and protective and preventive action can be taken. This includes a mix of communication and engagement strategies, such as media and social media communications, mass awareness campaigns, health promotion, social mobilization, stakeholder engagement and community engagement. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Respond: Risk communication”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.>

Mission report

RESPOND

Joint External Evaluation

INDICATORS AND SCORES R.5.1 Risk communication systems (plans, mechanisms, etc.) – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

RESPOND

R.5.2 Internal and partner communication and coordination – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.5.3 Public communication – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.5.4 Communication engagement with affected communities – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

RESPOND

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> R.5.5 Dynamic listening and rumour management – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

RESPOND

OTHER IHR-RELATED HAZARDS AND POINTS OF ENTRY POINTS OF ENTRY INTRODuCTION All core capacities and potential hazards apply to “points of entry” and thus enable the effective application of health measures to prevent international spread of diseases. States Parties are required to maintain core capacities at designated international airports and ports (and where justified for public health reasons, a State Party may designate ground crossings), which will implement specific public health measures required to manage a variety of public health risks.

Target States Parties designate and maintain core capacities at international airports and ports (and where justified for public health reasons, a State Party may designate ground crossings) that implement specific public health measures required to manage a variety of public health risks. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Other IHR-related hazards and points of entry: Points of entry”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE Team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES PoE.1 Routine capacities established at points of entry – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

OTHER

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> PoE.2 Effective public health response at points of entry – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges

OTHER

CHEmICAL EVENTS INTRODuCTION Timely detection and effective response of potential chemical risks and/or events require collaboration with other sectors responsible for chemical safety, industries, transportation and safe disposal. This would entail that State Parties need to have surveillance and response capacity to manage chemical risk or events and effective communication and collaboration among the sectors responsible for safety.

Target States Parties with surveillance and response capacity for chemical risks or events. This requires effective communication and collaboration among the sectors responsible for chemical safety, industries, transportation and safe disposal.. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Other IHR-related hazards and points of entry: Chemical events”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES CE.1 mechanisms established and functioning for detecting and responding to chemical events or emergencies – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

OTHER

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> CE.2 Enabling environment in place for management of chemical events – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges

OTHER

RADIATION EmERGENCIES INTRODuCTION To counter radiological and nuclear emergencies, timely detection and an effective response towards potential radiological and nuclear hazards/events/emergencies are required in collaboration with sectors responsible for radiation emergency management..

Target States Parties with surveillance and response capacity for radiological and nuclear hazards/events/ emergencies. This requires effective communication and collaboration among the sectors responsible for radiological and nuclear emergency management. <HOST COuNTRY> LEVEL OF CAPAbILITIES <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> For this capacity, utilize the JEE tool section “Other IHR-related hazards and points of entry: Radiation emergencies”. Provide a short introduction to the country’s capabilities here. Please include a brief description of key strengths, areas which need strengthening, important lessons learned about country capacity from the evaluation process, and any best practices that could serve as a model for other Member States. Please also note any challenges or unique circumstances that may impact the country’s ability to address this capacity. RECOmmENDATIONS FOR PRIORITY ACTIONS <This section is to be filled out by the JEE team. As per the JEE process, all of the following should be developed in full collaboration between the JEE team members and host country experts.> <List (in a bulleted format) the top three (maximum of five) key priority actions. These actions should help identify and address major challenges or gaps in the country’s capabilities for this technical area and make recommendations regarding the next steps for improving core capacity. This section will be revised by the JEE team after they have conducted the evaluation.> INDICATORS AND SCORES RE.1 mechanisms established and functioning for detecting and responding to radiological and nuclear emergencies – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Mission report

OTHER

Joint External Evaluation

Areas which need strengthening and challenges <Host country should present areas which need strengthening and any challenges based on indicators as well as the questions in the JEE tool for this technical area. These are enhanced by expert opinions from the JEE team during the facilitated discussion (the results of that professional collaboration are reflected in this final report). In cases where the host country’s capacity has fallen between two scores and the higher score was chosen, the elements of capacity which must be strengthened for the country to fully meet the score requirements should be noted as follows: “To fully meet the capacity requirements of <indicator number> score <#>, the following capacities must be strengthened:”> RE.2 Enabling environment in place for management of radiation emergencies – Score # <Host country should propose the score and its justification based on capabilities relevant to the indicator as described in the JEE tool. If capabilities fall between two scores, the host country should explain their capacities relevant to both the lower and higher scores. No “interim” scores are given, i.e. no 2+ or 3–. The JEE team and host country experts collaborate to decide on the higher or lower score; the corresponding strengths/areas which need strengthening are then noted in the appropriate sections of the final report. In situations where two different sectors have significantly different capacities, such as public health and animal health, separate scores can and should be given, with corresponding remarks in the final report.>

Areas which need strengthening and challenges

OTHER

Appendix 1: JEE background mISSION PLACE AND DATES <This section to be filled out by the JEE team. See example below> City, Country; 15 to 19 June, 2015 mISSION TEAm mEmbERS: <This section is to be filled out by the JEE team; list mission team member names, country of origin, and organization/ministry, specify the team Lead. See example below.> – – – Name of the person, country, affiliation (team lead) Name of the person, country, affiliation (team co-lead) Name of the person, country, affiliation

e.g. Mr John Sharma, Country X, Ministry of Health ObJECTIVE To assess (host country’s) capacities and capabilities relevant to the 19 technical areas of the JEE tool for providing baseline data to support (host country’s) efforts to reform and improve their public health security.

The JEE process The JEE process is a peer-to-peer review. The entire external evaluation, including discussions around the scores, the strengths, the areas that need strengthening, best practices, challenges and the priority actions should be collaborative, with JEE team members and host country experts seeking full agreement on all aspects of the final report findings and recommendations. Should there be significant and irreconcilable disagreement between the external team members and the host country experts, or among the external, or among the host country experts, the JEE team lead will decide the outcome; this will be noted in the final report along with the justification for each party’s position. PREPARATION AND ImPLEmENTATION OF THE mISSION <This section is to be filled out by the “Team Leader”. Describe the preparation and implementation of the mission as a bulleted list; see the example item below> – Prior to the visit, teleconferences were held weekly with assessment team members and the host country on XX date to review the agenda, responsibilities and logistics.

LImITATIONS AND ASSumPTIONS n

The evaluation was limited to one week, which limited the amount and depth of information that could be managed. It is assumed that the results of this evaluation will be publically available.

Mission report

Joint External Evaluation Tool

The evaluation is not just an audit. Information provided by <host country> will not be independently verified but will be discussed and the evaluation rating mutually agreed to by the host country and the evaluation team. This is a peer-to-peer review.

kEY HOST COuNTRY PARTICIPANTS AND INSTITuTIONS Example: Country Y lead representative: Dr John Hussain, Deputy Minister of Health, Ministry of Health, Country Y

Participating institutions: Country Y Ministry of Health Public Health Department Country Y State Sanitary Epidemiology Service Country Y State Medical Department

SuPPORTING DOCumENTATION PROVIDED bY HOST COuNTRY <This section is to be filled out by the “Team Leader” and should include a list of all preparatory materials as well as presentations that would be delivered during the assessment week.>

789 79% 1534651.156 12 14858850.488 569 86% 4685.5456 236 93% 14654654654.65465 589 97% 154654.11 726 84% 321654.54616 56 75% 45646987.65465 102 70% 654654.654 23 80% 7.89 598 86% 12% 81494519.48598 1.2 1534651.156 723 70% 48949.56 5.69 14858850.488 4156654. 625 92% 2% 2.36 4685.5456 45% 5.89 14654654654.65465 0.2% 7.26 154654.11 5% 5.6 321654.54616 1% 1.2 45646987.65465 12% 2.3 654654.654 23% 5.98 81494519.48598 2% 7.23 48949.56 6% 789 6.2579% 1.3% 4156654. 1534651.156 12 14858850.488 569 86% 4685.5456 236 93% 654654654.65465 589 97% 154654.11 726 84% 321654.54616 56 75% 102 70% 45646987.65465 7.89 12% 23 80% 654654.654 1.2 1534651.156 598 86% 81494519.48598 5.69 14858850.488 2% 723 70% 48949.56 2.36 4685.5456 45% 625 92% 4156654. 5.89 14654654654.65465 0.2% 7.26 154654.11 5% 5.6 321654.54616 1% 1.2 45646987.65465 12% 2.3 654654.654 23% 5.98 81494519.48598 2% 7.23 48949.56 6%

Key facts

Organisation World Health Organization (WHO)

Document type Technical Documents

Adoption date December 31, 2016

Source World Health Organization